H1N1 and Your Sleep Laboratory

With an economic recovery on the horizon, industries might be tempted to breathe a collective sigh of relief. But with President Obama having declared a national emergency due to the H1N1 flu outbreak this October, the storm clearly isn't over just yet. Between these two global impacts, sleep labs across the country could potentially face a significant lower demand for studies in the months to come. It is expected that the H1N1 virus will affect every industry—sleep medicine included.

Workplace absenteeism is predicted to skyrocket. The International Centre for Infectious Diseases warns of absentee rates hitting 20 percent or more—adding that over a quarter of your workforce could be out for as many as three to four months. Whether it gets this dire or not, it's best for your sleep laboratory to have a plan in place to deal with the effects of the expected H1N1 virus upsurge.

Call it business continuity, crisis management or emergency preparedness—it all boils down to ensuring that your sleep laboratory is prepared to endure a possible flu pandemic. This means making sure that essential business functions are maintained to the highest level possible.

So, how can your sleep laboratory proactively ensure that it remains productive in the wake of a flu outbreak? Below are several items to consider when developing a business continuity plan.

Sandbagging for H1N1—a Business Continuity Plan for Your Sleep Lab

Educate Yourself and Your Employees about both Swine Flu Symptoms and Possible Business Consequences

Current best practice favors encouraging employees who are feeling sick to stay home. To reduce the risk of spreading viruses to other employees, workers should wait at least 24 hours after the cessation of a fever before considering returning to their jobs. For employers, this means allowing flexible leave or alternate work schedules to enable employees to take care of their own health and that of their families.

If your policies concerning absences include measures that discourage employees/technologists from missing work, or include harsh consequences for being absent, revise them. Policies need to be reflective of new priorities including a preference for giving the benefit of the doubt to the individual in favor of keeping the collective safe from infection. Many policies require a written note from a physician when employees are out sick. Keep in mind that organizations are now commonly waiving this condition as infected individuals are often either too sick to see a doctor or forced to wait for appointments at busy doctor's offices.

While there is always the risk that employees may take advantage of new found flexibility, what's more important to remember is that this is perhaps one of the most critical measures for reducing the risk of H1N1 spread. In addition, if a technologist or employee comes to work suffering from obvious symptoms, don't hesitate to send them home immediately— the temporary loss of one worker may mean the preservation of your larger employee base.

Encourage Employees to get H1N1 Flu Vaccinations When They Become Available

While there is a tremendous amount of controversy regarding immunization, encourage your employees to educate themselves. Support their individual decisions on this matter but remind them of their unique role as health care providers.

Determine which of Your Business Operations/Services are Critical and Create a Deployment Plan for the Real- Location of Employees.

Imagine the worst-case scenario. How would you keep your sleep lab operating if the majority of your technologists were sick with swine flu? Determine which activities are most essential and establish who—other than the primary employee dedicated to such tasks—will be suitable to fulfill these responsibilities. Perhaps it's just a matter of swapping shift times. Warn employees that they may be required to work days when they might have previously worked nights and vice versa. As a further precautionary measure, consider training temporary staff or partnering with outside companies to pick up the slack.

Step Up Office Hygiene Practices

Ensure that staff fully understand the importance of proper hand washing. While it may seem like an obvious suggestion, for precisely this reason the activity often gets overlooked. Hand washing signs and instructions in all washrooms and staffrooms will help change the behavioral culture of your workplace. Good hygiene is essential in an era of what could possibly emerge as a pandemic. Education campaigns about hand washing, cough covering and supply sharing are essential for communicating new standards of conduct, but more importantly, they serve as reminders for what should now be considered standard in your workplace. Hand sanitizer, no- touch trashcans and tissues will help make hygiene easy for your staff. Place hand sanitizers in strategic places and encourage individuals to use them through prominent signage. Make sure all office equipment is cleaned and sanitized regularly— especially shared equipment such as computers, phones and office equipment.

Decide What to Do if Your Regular Suppliers Are Cut Off

Access to suppliers could be limited should H1N1 reach the pandemic levels that have been predicted. Consider how your sleep lab will be able to continue operating if this happens. Stock up. Certain types of supplies around the office can help make employees more comfortable and deter the spread of H1N1. Basics like tissues and hand sanitizers should be readily available. Ensure you have enough sleep supplies and equipment including electrodes, EEG paste, linens, cannulas, etc. Make sure that your sleep lab is prepared to run for extended periods of time without having to wait for additional supplies to arrive.

Plan B—When in Doubt, Get Outside Help

Before hitting the panic button, remember that when you reach the limit of your internal resources, there's always the option to go external. Public health officials predict that worker absentee rates will increase over the next several months. This includes not just sick employees, but people who need to care for others who are sick and those who are avoiding the workplace out of fear of contracting H1N1. For some sleep labs the impact can be disastrous, so it's crucial to have a back-up plan.

Hiring a scoring service to assist with the analysis of patient studies will ensure that backlogs are kept to a minimum and that internal employees are reserved for patient hook-ups. Developing a relationship with a sleep scoring service that you trust is good practice even once the status quo has been restored. They can assist when employees fall ill or when a backlog of sleep studies occurs. Such partnerships allow you to provide patients and stakeholders with a reliable assurance that business will remain as usual even during times of crisis. More importantly, a scoring service makes it easier to allow employees the time off they need to care for themselves or their families. There's no need for H1N1 to be a crisis provided you've developed the necessary relationships with outside service providers. Now is the time to start researching the ideal fit. Here are several factors to consider when selecting a scoring service to assist your laboratory.

Registered Polysomnographic Technologists

For top-quality sleep-scoring services, look for a company that hires only registered polysomnographic technologists (RPSGT). Ask for the BRPT certification credentials for every technologist scoring for your account. Ensure the company is not using unregistered techs for any process of the scoring of sleep studies.

Manual Scoring

For the best accuracy, sleep studies should be scored manually by ONLY a registered technologist.

Quality Assurance Department

The scoring company should have a designated quality- assurance department to ensure quality control and address issues. The department should have an internal quality program to routinely review all scoring technologists. Quality process should include internal reviews of all scorers along with inter-rater reliability and audit reviews. The company should also have a policy for the re-scoring of studies and if they guarantee the quality of their scoring.

Liability Insurance & Errors & Omissions

The sleep-scoring company should carry the same level of insurance as your sleep laboratory. This should include general liability and errors and omissions insurance. Ensure to ask for verification of the certificate of insurances before moving forward and sending studies.

Management Experience and Expertise

The company should have an experienced management team and identified account representatives to manage your account and answer your questions. Be sure that the technologist scoring your studies is NOT managing your account. Ask for client references and look for industry recognized hospitals as proof of the level of expertise the scoring company has.

Things to Remember

Preparing a business continuation plan for your sleep lab will help direct employees and management should key employees become ill causing a temporary interruption to your operations. Because large numbers of staff could contract the flu, employers should ensure that their sleep labs can continue operating by training other employees and partnering with a reputable sleep scoring service.

No one really knows whether there will be an H1N1 flu pandemic or not—and if so, how dire it might be. But it's always better to be prepared and organized for the worst rather than getting caught off guard. You don't want to be found in a predicament if two or three technologists catch the flu and are out for any length of time—particularly if you run a small sleep laboratory with only a handful of employees to begin with.

If H1N1 becomes a crisis in your sleep lab, it's important that you have a contingency plan in place. This means critical business functions should be shared amongst several different employees/technologists. Cross-train your employees to cover for others that could be impacted negatively by illness. It also doesn't hurt to construct a comprehensive policies and procedures manual to help employees manage when someone is out sick. This manual can be instrumental in keeping your sleep lab afloat in the face of adversity.

The H1N1 flu pandemic could be even worse than the flu pandemic of 1918. Or it could be just an accumulation of hype and media propaganda. Whatever the end result, being prepared for the worst may just keep your employees and technologists healthy and your sleep laboratory productive and profitable.

Chad Doucette is the V.P. Sales & Marketing for Sleep Strategies Inc, a leading provider of sleep scoring and training services for sleep disorder facilities worldwide. He can be reached at cdoucette@sleepstrategies.com.

For more information on Sleep Strategies, please visit the company web page at www.sleepstrategies.com.

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