How Texas Health Resources Managed Its Ebola Crisis

(Sketch by Phil Foster)
(Sketch by Phil Foster for D CEO)

Thomas Eric Duncan was already isolated in the emergency department at Texas Health Presbyterian Dallas last September when Barclay Berdan, the CEO of the hospital’s nonprofit parent company, Texas Health Resources, heard for the first time that Duncan had probably contracted Ebola.

Berdan didn’t hear it from doctors or other hospital personnel. The information came from CNN.

Duncan, 42, had been sent home from Presby, as it’s commonly known, with antibiotics, his headache and abdominal pain and fever misdiagnosed as sinusitis. He returned by ambulance two days later and was isolated in a wing of the ER.

A day later, on Sept. 29, the THR chief executive found himself in a hotel room 1,330 miles from Dallas in Washington, D.C., attending a Healthcare Leadership Council meeting. Berdan (pronounced burr-DAN) was aware before leaving for D.C. that Duncan had returned to Presby. But he learned about the likely Ebola diagnosis from an interview on the cable news network with some of Duncan’s out-of-town relatives.

In short order, Berdan’s phone vibrated. Dr. David Lakey, the Texas health commissioner, was hurriedly trying to arrange a news conference with then-Gov. Rick Perry. The idea was to officially announce that a patient with Ebola was being treated in a room to himself at the 898-bed acute care hospital on Walnut Hill Lane, less than a mile east of North Central Expressway.

At first, though, Lakey suggested holding the news conference away from Presbyterian. This concerned Berdan, who knew how delicate the situation was and how any misstep could fuel panic. After all, Ebola can only be transmitted through direct contact with an infected, symptomatic person’s bodily fluids. It isn’t airborne. To Berdan, it was important to show that Presby—one of Dallas County’s largest and busiest hospitals—was safe and open for business.

“I was conscious and aware of the fear factor,” Berdan recalls. “But I also knew there was no issue in regard to safety for anybody at the hospital, and certainly not for the governor to be there having a press conference.” The CEO stated his case—and eventually prevailed.

It was the first of many high-impact decisions demanded of Berdan over the next month. The treatment of Duncan—and the safety of the men and women who volunteered to care for him—rested squarely on his shoulders. So, Berdan would order and oversee an internal investigation to account for the misdiagnosis and to identify areas for improvement. Later, he would share this information with hospitals across America. THR also would have to make things right with Duncan’s family, which was understandably upset with the misdiagnosis. When two nurses who treated Duncan also contracted the virus, the hospital system would be forced to pivot, modifying federal guidelines that were meant to protect healthcare workers treating patients infected with Ebola.

Admissions at Presby would dip, and the hospital’s bondholders would need assurance that the hospital and the system could stay afloat. Meanwhile, local, state, and federal stakeholders required constant updates to calm the public. Then there were Berdan’s own employees. In the midst of a flood of criticism and concerns and misinformation, how do you keep their spirits up?

First, though, there was the matter of that press conference. “There is no place in the world I would suggest to you that has better professionals and a better ability to address this than in Texas,” Gov. Perry said from Presby on Oct. 1. “We wish it were somewhere else, but the fact is, it’s here.”

This story appears in the March issue of D CEO magazine. You can read the whole thing at this link.