TRAINING ON HOSPITAL MANAGEMENT FOR EBOLA VIRUS DISEASE DEPARTMENT OF HEALTH RESEARCH INSTITUTE FOR TROPICAL MEDICINE TRAINING ON HOSPITAL MANAGEMENT FOR EBOLA VIRUS DISEASE CELIA C. CARLOS, MD, FPPS, FPIDSP, FPSMID Director III

General Training Objective To be able to provide safer care for patients with EBOLA Virus Disease and to stop disease transmission in the healthcare and community setting.

Series of specific objectives for each activity

Scientific Program Day 1 Time Activity/Lecture Faculty/Speaker Registration Completion of Pre-training Assessment Form by participants during registration Secretariat 8:00 – 8:45 AM Opening prayer National Anthem Welcome Address Messages Introduction to the Course Introduction of Participants Group Picture Emcee: Mr. Jun Orbina (RITM) Dr. Socorro Lupisan (RITM) Usec. Janette Garin (DOH) Acting Secretary of Health Dr. Julie Hall (WHO) Dr. Celia C. Carlos Mr. Jun Ryan Orbina (RITM) 8:45 – 9:15 EBOLA BASICS AND BACKGROUND Dr. Manolito Chua (RITM) Emeritus Prof. Rick Speare (WHO) 9:15 - 9:30 AM EBOLA RESTON IN THE PHILIPPINES Dr. Catalino Demetria (RITM) 9:30 - 10:00 AM Clinical Care Of EVD: Screening and Triage Dr. Mari Rose De los Reyes (RITM) 10:00 - 10:30 AM BREAK 10:30 – 10:50 AM Laboratory Diagnosis of EVD 10:50 - 11:20 AM Clinical Management and Discharge Criteria Dr. Arthur Dessi Roman (RITM) 11:20 - 11:45 AM Laboratory Support And Biosafety In Specimen Handling In The Management Of EVD Dr. Catherine Masangkay (RITM) 11:45 - 12:45 PM LUNCH

Time Activity/Lecture Faculty/Speaker 12:45 – 1:45 PM SIMULTANEOUS SESSION Lecture 1 Auditorium Risk Assessment and Biosafety For Laboratory Personnel Biosafety in the Laboratory – Mr. Neil Yabut (RITM) Referral System, Transport and Storing of Specimens - Dr. Lea Apostol (RITM) Laboratory Waste Management, Decontamination and Laboratory Emergencies - Mr. Edson Simon (RITM) Patient Screening and Triage Exercise Lead Facilitator: Dr. Arthur Dessi Roman Emeritus Prof. Rick Speare  Facilitators: Ms. Chelsea Lynch (WHO) Ms. Wendy Rhymer (WHO) Ms. Meredith Black (WHO) Dr. Manolito Chua (RITM) Dr. Charissa Tabora (RITM) Dr. Maria Tricia Subido (RITM) Dr. Rose De los Reyes (RITM) Dr. Joanne De Jesus (RITM) Dr. Arthur Dessi Roman (RITM) Dr. Mark Pasayan (RITM) 1:45 - 3:00 PM My experience with SARS (testimonial) Mr. Laredo Azores (RITM)  Infection Prevention and Control Dr. Charissa Tabora (RITM) 3:00 - 3:30 PM PPE Lecture Demonstration of proper donning and doffing of PPE Ms. Babes Cabanting (RITM) Ms. Loida Oliquino/Erlinda Guevara

Time Activity/Lecture Faculty/Speaker SIMULTANEOUS SESSION 3:30 – 6:30 PM Auditorium Lecture Rm. 2 & 3 NTRL PPE Practical Exercise Respiratory Fit Test 3:30 - 5:00 PM Group A 5:00 - 6:30 PM Group B Facilitator: Ms. Babes Cabanting Florence Pegollo/Lorela Mendoza Laboratory Exercise Donning and doffing of PPE Training in coverall and standard PPE Facilitators: 1. Charissa Tabora (RITM) 2. Wendy Rhymer (WHO) 3. Prof. Rick Speare (WHO) 4. Dr. Joanne de Jesus (RITM) 5. Dr. Charmian Hufano 6. Dr. Jemelyn Garcia 7. Ms. Meredith Black 8. Evelinda Guevarra 9. Myrna Acero 10. Eden Balanza 11. Loida Oliquino 12. Dr. Mark Pasayan 13. Jo Pastorel 14. Abella Rabadan Group Discussions on Ethical Issues 3:30 - 5:00 PM Group B 5:00 - 6:30 PM Group A Facilitators: Dr. Rossanna Ditangco (RITM) Dr. Marilla Lucero (RITM) Dr. Ma. Cecilia Ama (RITM) 4. Dr. Noel Macalalad (RITM) Blood extraction practicum (with PPE) Specimen handling practicum (with PPE) Packaging/transport practicum (with PPE) Ms. Chelsea Lynch Mr. Edson Simon 3. Mr. Neil Yabut 4. Mr. Dominic Tomas 6:30 PM One Minute Reflection Form (to be filled up by participants) 6:30-7:00 PM Meeting of faculty and facilitators Moderator: Dr. Charmian Hufano Officer of the Day: Dr. Blanca Jarilla

RECAP of 1 minute reflection Day 2 Time Lecture Faculty 8:00 – 8:45 AM RECAP of 1 minute reflection CABBAGE GAME Dr. Charmian Hufano (RITM) Ms. Rowena Capistrano (RITM) 8:45 – 9:30 AM Isolation and Patient Flow Mr. Julian Donald (WHO) Dr. Charissa Tabora (RITM) 9:30 – 10:30 Isolation and Patient Flow Exercise Facilitators: Ms. Meredith Black (WHO) Ms. Chelsea Lynch (WHO) Ms. Wendy Rhymer (WHO) Prof. Rick Speare (WHO) Co-facilitators: Dr. Manolito Chua (RITM) Dr. Mari Rose de los Reyes (RITM) 3. Dr. Arthur Dessi Roman Dr. Jemelyn Garcia (RITM) Dr. Mark Kristoffer Pasayan (RITM) 6. Dr. Maria Tricia Subido (RITM) 7. Dr. Joanne De Jesus (RITM) 10:30 - 11:00 AM BREAK 11:00 - 11:15 AM Management of Sharps Dr. Maria Tricia Subido (RITM) 11:15 -11:30 PM Post Exposure Management Dr. Joanne De Jesus/Ms. Chelsea Lynch 11:30 – 12:30 PM Transport, Environmental Cleaning Waste Management Ms. Erlinda Cabanting (RITM) Dr. Charissa Tabora (RITM)

Time Activity/Lecture Faculty/Speaker 12:30-1:30 PM LUNCH SIMULTANEOUS SESSION 1:30 – 4:30 PM Auditorium Lecture Rm. 2 & 3 NTRL PPE Practical Exercise Respiratory Fit Test 3:30 - 5:00 PM Group A 5:00 - 6:30 PM Group B Facilitator: Ms. Babes Cabanting Florence Pegollo Lorela Mendoza Laboratory Exercise Dr. Effie Espino Lecture Room 1 Donning and doffing of PPE Training in coverall and standard PPE Facilitators: 1. Dr. Charissa Tabora (RITM) 2. Ms. Wendy Rhymer (WHO) 3 Prof. Rick Speare (WHO) 4. Dr. Joanne De Jesus (RITM) 5. Dr. Charmian Hufano 6. Dr. Jemelyn Garcia (RITM) 7. Ms. Chelsea Lynch (WHO) 8. Evelinda Guevarra 9. Myrna Acero 10. Edem Balanza 11. Loida Oliquino Group Discussions on Ethical Issues 3:30 - 5:00 PM Group B 5:00 - 6:30 PM Group A Facilitators: Dr. Rossanna Ditangco RITM) Dr. Marilla Lucero (RITM) Dr. Cecilia Ama (RITM) 4. Dr. Noel Macalalad (RITM) Demo on Step by Step procedure 1. Blood extraction practicum (with PPE) 2. Specimen handling practicum (with PPE) 3. Packaging/transport practicum (with PPE) Facilitators: 1. Ms. Janet Ubaldo 2. Mr. Edson Simon 3. Mr. Neil Yabut 4. Dominic Tomas 4:30 PM One Minute Reflection Form (to be filled up by participants) 4:30-5:30 PM Meeting of faculty and facilitators Moderator: Dr. Aileen Gianan / Officer of the Day: Ms. Agnetha Olorosa

RECAP of 1 minute reflection Day 3 Time Lecture Faculty 8:00 – 8:30 AM RECAP of 1 minute reflection Dr. Aileen Gianan (RITM) 8:30 – 8:50 AM Open Forum Facilitators 8:50 – 9:10 AM Community Health and Support Returning home and how to handle the 21 day waiting period and how to recognize Ebola/post-traumatic distress syndrome. Videos Presentation Dr. Leo Capeding (UP Manila) Ms. Wendy Rhymer (WHO) 9:10 – 9:40 AM Staff health and support (Psychosocial First Aid) Causes of workplace stress associated with treating Ebola, individual commitment required to work in an Ebola outbreak setting, when to access healthcare and other support for responders  Dr. Leo Capeding (UP Manila)   9:40 - 10:00 AM Safe and dignified burials Ms. Rowena Capistrano (RITM) 10:00 - 10:20 AM BREAK 10:20 -11:20 AM FLOOR PLAN CRITIQUING Julian Donald 11:20 – 12:10 PM Introduction to the Philippine Surveillance System Contact Tracing Completion of PIDSR Form Dr. Aurora Corpuz (WHO) Ms. Rowena Capistrano (RITM) 12:10 - 1:10 PM LUNCH

Dr. Amado Tandoc III (RITM) 1:10 – 1:30 PM Subnational Labs, regional hospitals and referral centers: Roles in EVD RITM Laboratory Forms Dr. Amado Tandoc III (RITM) 1:30 - 2:00 PM Overview of DOH EID Program Dr. Lyndon Lee Suy 2:00 - 3:00 PM PRESENTATION OF ACTION PLANS Participants 3:00 - 3:45 PM POST TEST Moderator 3:45 - 4:00 PM BREAK 4:00 - 5:00 PM PPE Practice Dr. Charissa Tabora (RITM) Ms. Erlinda Cabanting (RITM) 5:00 - 5:15 PM MESSAGE FROM WHO Dr. Julie Hall (WHO) 5:15 - 5:30 PM CLOSING REMARKS Dr. Celia C. Carlos (RITM) MODERATOR : DR. CRISTINA AMBAS OFFICER OF THE DAY : MR. BENJAMIN DE VERA

Questions: will be answered at end of lecture if with time or submitted in writing to be addressed first thing the following morning References have been provided but several of them are “Interim” 11

Outputs of workshop Improve competencies in providing safer care for patients with EBOLA Virus Disease and to stop disease transmission in the healthcare and community setting (i.e. case management, infection control) Draft own hospital EVD preparedness plan to include training plans

Ebola Lab Preparedness Matrix OBJECTIVES STRATEGY ACTIONS RESPONSIBLE STAKEHOLDER SUPPORT NEEDED Review risks and signs and symptoms of Ebola, and train all front-line clinical staff on how to identify signs and symptoms of Ebola. Capacity building 1. Conduct training in the different levels of care 1.1 HCW in hospitals - especially those designated to care for EVD patients 1.2 Community DOH, RITM, PMA, PSMID, PIDSP, PHICS 1. Funds 2, Training syllabus/ module/ materials 3. Supplies Subheading Here

Ebola Lab Preparedness Matrix OBJECTIVES STRATEGY ACTIONS RESPONSIBLE STAKEHOLDER SUPPORT NEEDED Conduct spot checks and inspections of triage staff to determine if they are incorporating screening procedures and are able to initiate notification, isolation, and PPE procedures for your hospital. Monitoring and evaluation 1. Create hospital EBOLA preparedness team with monitoring and evaluation as 1 of key functions 2. Hospital EBOLA preparedness team to create preparedness plan to include monitoring and evaluation 3. Designate staff to undertake monitoring and evaluation 4. Implement monitoring and evaluation 5. Provide feedback on results of M & E to concerned staff/areas of the hospital 6. Repeat M & E of areas with identified problems 1. Hospital director 2. Hospital EBOLA preparedness team 1. Hospital administrative order 2. Funds for training on M & E, meetings, training & re-training, if needed Subheading Here

Ebola Lab Preparedness Matrix OBJECTIVES STRATEGY ACTIONS RESPONSIBLE STAKEHOLDER SUPPORT NEEDED Review the guidelines for environmental infection control in Health-Care Facilities. "Evaluation" of current guidelines vis-a-vis current recommendations for EBOLA environmental infection control 1. Search for updated guidelines 2. Modify existing hospital guidelines to align with current guidelines 3. Disseminate and implement revised guidelines 1. Hospital ICC 1. provision of updated guidelines/references 2. funds for revision of guidelines/information dissemination Subheading Here

Participants to be slowly filling up the matrix as the training goes on.

Training target: 4 batches of trainees with the ultimate goal of improving competencies of both government and private sector health workers at national and local levels to be able to confidently diagnose, treat, and safely care for EVD cases without further disease transmission

HOUSE RULES Please come on time. Pay attention to the lecturers. Audience participation is highly encouraged. Kindly put your phones on SILENT MODE. Answer calls OUTSIDE THE AUDITORIUM. Eating is NOT allowed inside the auditorium Questions may be submitted in writing (sheets of paper inside your kit). Submit these questions to the moderator of the day. Certificates of attendance will only be issued to participants who will complete the 3 days’ training and the posttest. Hard copies of lecture slides will only be provided on day 1 in support of the advocacies on environmentalism but USBs of all lectures and handouts have been prepared.

Acknowledgments Department of Health World Health Organization/WHO consultants Faculty/support staff of RITM