Compartmentalization of wards to cohort symptomatic patients at the beginning and end of norovirus outbreaks

Abstract

Outbreaks of norovirus can have a significant operational and financial impact on healthcare establishments. To assess whether containment of symptomatic patients in single rooms and bays at the beginning and end of norovirus outbreaks reduced the length of bed closure. In 2007, we introduced a new strategy to limit the operational impact of hospital outbreaks of norovirus. Early in an outbreak, symptomatic patients were cohorted in single rooms or bays in an attempt to contain the outbreak without closing the entire ward. Once a ward had been closed, and as beds became available through discharges, patients were decanted into single rooms or empty bays with doors to facilitate earlier cleaning and opening of affected areas on the same ward. The impact of these changes was assessed by comparing outbreak data for two periods before and after implementation of the new strategy. Prior to June 2007, 90% of outbreaks were managed by closure of an entire ward, compared with only 54% from June 2007 onwards. The duration of closure was significantly shorter for bays compared with entire wards, both before (3.5 vs 6, P=0.0327) and after (3 vs 5, P<0.0001) June 2007. When considering all outbreaks, there was a significant reduction in duration of closure after the change in strategy (6 vs 5, P=0.007). Using ward compartmentalization to cohort affected patients at the beginning and end of norovirus outbreaks improved the efficiency of outbreak management and reduced operational disruption.