Ebola outbreak preparedness planning: a qualitative study of clinicians' experiences

Objectives The 2014–15 Ebola outbreak in West Africa highlighted the challenges many hospitals face when preparing for the potential emergence of highly contagious diseases. This study examined the experiences of frontline health care professionals in an Australian hospital during the outbreak, with a focus on participant views on information, training and preparedness, to inform future outbreak preparedness planning. Study design Semi-structured interviews were conducted with 21 healthcare professionals involved in Ebola preparedness planning, at a hospital in Australia. Methods The data were systematically coded to discover key themes in participants' accounts of Ebola preparedness. Results Three key themes identified were: 1) the impact of high volumes of—often inconsistent—information, which shaped participants' trust in authority; 2) barriers to engagement in training, including the perceived relative risk Ebola presented; and finally, 3) practical and environmental impediments to preparedness. Conclusions These clinicians' accounts of Ebola preparedness reveal a range of important factors which may influence the relative success of outbreak preparedness and provide guidance for future responses. In particular, they illustrate the critical importance of clear communication and guidelines for staff engagement with, and implementation of training. An important outcome of this study was how individual assessments of risk and trust are produced via, and overlap with, the dynamics of communication, training and environmental logistics. Consideration of the dynamic ways in which these issues intersect is crucial for fostering an environment that is suitable for managing an infectious threat such as Ebola.
Highlights • Outbreak communication needs to be rigorously controlled for consistency and transparency at all levels. • Risk perception is influenced by lack of trust in the communication provided. • Assessment of training effectiveness and feasibility for outbreak threats should include frontline clinicians. • Dynamics of communication and mistrust can strongly influence the ability of an organisation to implement best practice.