You are an administrator at Worcester General Hospital, in Worcester, Massachusetts, faced with an outbreak of tuberculosis (TB) in your community. It is your job to work with the local health department (LHD) to investigate, monitor, control, and contain the disease.

The index case, Rosa Cruz, is a recent undocumented immigrant to Worcester from El Salvador. When she and her family arrived in Worcester, they lived in a homeless shelter temporarily until they found permanent housing. She now works part time at a local daycare center and is a devout member of her church. She lives with her husband, three children, and four other members of her extended family.

A nurse who attends Mrs. Cruz's church noticed that Mrs. Cruz was coughing a lot and had lost weight and advised her to seek testing and treatment. Not having health insurance, Mrs. Cruz went to the emergency room at Worcester General Hospital. The laboratory at Worcester General Hospital confirmed that Mrs. Cruz has active TB. In the days following Mrs. Cruz's diagnosis, 13 other members of the community, including several members of her family, were also diagnosed with TB.

You are a healthcare administrator at Worcester General Hospital (WGH). Create presentation, with presenter notes. The presentation will be shown to the board of directors of WGH. It should describe your proposed plan, step-by-step, for containing this potential tuberculosis (TB) outbreak in partnership with federal, state, and local entities, including the local health department and the Centers for Disease Control and Prevention (CDC).

Your slide presentation should:

• describe the healthcare system in El Salvador, where the patient originated before arrival in Massachusetts.
  • Include information about health insurance coverage and payers of each country
  • Data on the rate of insured; the healthcare delivery mechanism (public and private services, public and private funding sources, and requirements for individuals to pay for insurance) physician density
  • Methods for healthcare provision in remote and underserved areas
  • Vaccination requirements; and similar indicators used to measure health-system operations
  • Explain how this system compares to the U.S. healthcare system
• Explain the connection between global health issues and local healthcare management, and which Millennium Development Goals and Healthy People 2030 Goals apply to this scenario.
• Explain how infectious diseases are identified and tracked, including an explanation of how the hospital and local health department (LHD) worked together to create the line list, and which locations in the community merit further investigation.
• Explain an 8 action steps to manage this potential health threat. Describe the collaborative approach between the Massachusetts state and local health department and the hospital to investigate and contain the outbreak.
• Describe at least three responsibilities of the Massachusetts state and local health department in this specific outbreak scenario.
• Explain the role of the Centers for Disease Control and Prevention (CDC) in responding to an outbreak like the one in the scenario.
• Explain the role of the World Health Organization (WHO) in responding to an outbreak like the one in the scenario. Include a description of at least three specific programs or initiatives that illustrate the role of the WHO in public health.