American Hospitals Are Vastly Unprepared for Ebola Patients, Reveals Black Book™ Survey of Emergency Physicians, Nurses and Infection Control Practitioners

Press Release | Black Book Rankings | August 27, 2014

A Black Book survey of nearly 1,000 hospital executives and clinical leaders probed emergency preparedness and infectious disaster resource capabilities including technology and services. The resulting responses uncovered ten common yet precarious situations that collectively restrict nearly all U.S. hospitals regardless of size or location to efficaciously diagnose, isolate and treat even a single Ebola patient while protecting its workforce and other patients.

New York, NY (PRWEB) August 27, 2014--The extensive polling of 970 American hospital administrators, physicians and nurses by healthcare research group Black Book Rankings uncovers several alarming facts that community hospitals are not adequately staffed, supplied or built to care for even a single Ebola patient.

“Black Book initiated this annual survey to gain stakeholder insight into the technology support tools around hospital infection control, epidemiology and emergency preparedness systems,” said Doug Brown, Managing Partner. “What we learned additionally was that our hospitals are not as well prepared as we would like to think.”

Key findings include:

1.     Regardless of size or location, It is extremely rare to find any American hospital with the physical facilities required such as negative pressure isolation rooms to isolate more than one or two Ebola patients. Only a handful of hospitals across the entire nation have negative pressure isolation rooms outside the vicinity of general patient populations to keep uninfected patients and staff well secluded from suspected infectious patients.

Less than half of US hospitals have a single negative pressure isolation room on campus anywhere. On a positive point, academic medical centers have the most advanced facilities and about half nationally claim to be prepared to admit and treat up to ten Ebola patients with such facilities.

2.    Infection and disease transmission between hospital patients is extremely common. Once admitted to a hospital for another condition, over 1.7 million preventable infections occur in US hospitals annually after a patient passes through the emergency department, and 95,000 died during their 2013 hospitalizations. 1 in 24 hospital patients every day has at least one hospital acquired infection. The threat of a highly infectious, deadly diseases like Ebola among health care workers and inpatients is among the top unresolved concerns of emergency physicians and nurses, infection control practioners, and epidemiologists today.

“US hospitals may not be the ideal place to screen, diagnose, isolate and treat highly infectious patients,” said Brown. “Most are currently failing to control the spread of hospital acquired infections such as MRSA and C. difficile. Based on the track record controlling those infectious transmissions, hospitals are likely not capable of managing the radical precautions needed for Ebola.”

3.    Emergency preparedness drills for biological disease outbreaks and Ebola specific admissions have been practiced by fewer than 8% of hospitals within the past 12 months.

4.    Overcrowded emergency departments pose an increased risk to patients, families, visitors and staff in an Ebola presentation. Emergency department nurses, in particular insist that overcrowding increases the risk transmission for hospital spread diseases.

9 out of 10 emergency physicians in hospitals of less than 400 beds are convinced their assigned hospital is not prepared to diagnose, isolate, and treat a single Ebola patient. Additionally, 88% of ED physicians and nurses are adamant their hospital cannot handle any community or staff quarantine activities at their hospital campus which may follow. In contrast, about half of Administrators are skeptical that overcrowding affects disease transmission and believe all CDC precautions are guidelines are in practice to safeguard staff and patients.

5.    Hospitals regularly face supply issues with equipment, prescription and medical provisions out of stock because of tight budgets and decreasing reimbursement. 89% of hospital nurses and physicians state that regularly in the last 3 months, a needed supply or drug item was not in stock or unavailable at their hospital for infectious disease patients. Ebola patients require unique isolation supply and disposal procedures, specialty medications that are not readily available or stocked for contingencies.

6.    Hospitals rarely have a full time, certified infection control practioner or epidemiologist on staff. On average, a hospital staffs one full time equivalent in infection control for every 202 occupied beds. Most infection control nursing RN coordinators in hospitals under 250 beds are assigned other duties beyond infection control. Certified professionals are an even rarer breed and most hospitals do not pay a premium for advanced certifications of infection control coordinators. The average infection control coordinator has 5.6 years of infection control procedure and budgeting experience, and 93% have experience only within the facility they are currently employed.

7.    Hospitals typically self-assess their own disaster or infection control preparedness. In 2013, 97% did not make any major changes to annual plans and only 8% sought outside advisory or consulting services to provide objective, external feedback.

8.    Less than 20% of US hospitals under 250 beds have/will allocate 2014 - 2015 funds for information technology enhancements or initial purchases for Clinical Decision Support Systems or Population Health tools. More than half of larger hospitals and health systems have/are budgeting increased funds for Population Health and clinical analytic tools such as CDSS in 2015 to address pending payment reforms and accountable care initiatives. These tools can contribute to improved community health initiatives including infectious disease programming.

9.    Nearly 100% of hospital physician leaders and executives agree that their facilities are not equipped to quarantine community members and or hospital staff with or without government support or resources.

10.    The majority of hospital managers are concerned with reactionary staff call-offs after an Ebola patient admission including trained isolation staff team members. The same administrators are uncertain of their facility’s ability to protect staff members adequately with current processes and resources. 96% of hospital operations managers state that housekeeping, maintenance, and dietary staff have not received training in Ebola or other highly dangerous and infectious patient supply disposal and/or equipment sterilization. 93% expect those staff members to call-off or refuse assignments in hospital areas treating Ebola patients.

The survey results can be accessed at

About Black Book™

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The largest user opinion poll of its kind in healthcare IT and managed services, Black Book™ collects over 400,000 viewpoints on information technology and outsourced services vendor performance annually. For methodology, auditing, resources, comprehensive research and ranking data see

Open Health News' Take: 

Time to pay attention to this warning from Médecins Sans Frontières (MSF) "Global Bio-Disaster Response Urgently Needed In Ebola Fight." Roger A. Maduro, Publisher and Editor-in-Chief, Open Health News.