Dr Jaimie Henry1,2, Dr Mary Wyer1,3, Ms. Jaisa Kuriakose1,4, Dr Nicky Gilroy1,3,5, Associate Professor Matthew O'Sullivan1,3,5, Dr Patricia E Ferguson1,3,5
1NSW Biocontainment Centre, Westmead Hospital, Sydney, Australia, 2Faculty of Medicine and Health, University of Sydney, Sydney, Australia, 3Sydney Infectious Diseases Institute, University of Sydney, Westmead, Australia, 4The Children's Hospital at Westmead, Sydney, Australia, 5Department of Infectious Diseases, Westmead Hospital, Sydney, Australia
Biography:
Dr Jaimie Henry is the Fellow at the NSW Biocontainment Centre (NBC), at Westmead Hospital, Sydney. Jaimie is a senior intensive care medicine trainee with interests in High Consequence Infectious Diseases (HCID), mass critical care, and crisis management. His work at the NBC focuses on enhancing critical care delivery for HCID patients, investigating novel models of care and enhancing operational resilience. Jaimie is also a committed clinician educator: he is a Clinical Lecturer at the University of Sydney, medical advisor to the NSW Health Education and Training Institute and trainee representative to the College of Intensive Care Medicine.
Abstract:
Background: The NSW Biocontainment Centre is the High-Level Isolation Unit (HLIU) for High Consequence Infectious Diseases in New South Wales. HLIUs demand bespoke operational, infrastructure and staffing requirements. As a state-level contingency, continuous readiness to admit a patient within 4 hours is required. However, activation of HLIUs worldwide is approximately once every 5 years. Identifying threats to readiness is challenging; the absence of formal Australasian or international standards leaves a gap in quality management systems for HLIUs.
Actions: Following identification of critical domains, a quality management system was developed. A modified failure mode and effect analysis was conducted per domain: single points of failure threatening readiness were identified, stratified by risk and subject matter experts engaged to develop mitigation. Building on examples in the literature, an all-systems quality assurance tool was created, providing data on operational readiness to inform governance processes.
Results: Analysis identified four critical domains: infrastructure, staffing, personal protective equipment (PPE) and operational procedures. The quality assurance tool identified multiple concerns in each domain. Novel quality control activities included PPE burn modelling, preventative maintenance schedules, designing enhancements to rostering software, and simulation. Misalignment of risk assessments and PPE requirements were corrected, achieving local environmental sustainability goals by reducing waste.
Conclusions: Maintaining operational readiness in HLIUs is complex, resource intensive and requires both quality control and assurance activities. Implementing comprehensive quality management processes identifies areas of concern, reduces cognitive load, enhances stakeholder engagement and improves environmental sustainability. These processes are adaptable for outbreak readiness assurance in other clinical environments.