Effective HLIU Twinning: Strengthening Isolation Unit Capabilities Worldwide
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High-Level Isolation Units (HLIUs) are essential in protecting communities from high-consequence infectious diseases (HCIDs). To strengthen preparedness globally, NETEC’s International Partnerships & Programs (IPP) developed Effective Approaches to High-Level Isolation Unit (HLIU) Twinning, a new guide based on pilot programs conducted in 2023–2024 between RESPTCs and international HLIUs. Twinning pairs HLIUs together in partnerships that allow them to share knowledge, resources, and strategies. The guidance, which can be adaptable to other healthcare settings, highlights what Twinning is, why it matters, how to select partners, and effective approaches for making it work. Read the full guide HERE.
What is Twinning?
Twinning is a mutually beneficial relationship between two or more HLIUs that voluntarily share expertise, lessons learned, and practical tools. Unlike a one-sided mentorship, Twinning is based on reciprocity—each unit contributes knowledge while also gaining new perspectives. Because every HLIU operates in a unique context, Twinning relationships are flexible and adaptable, shaped by the priorities and realities of the partners involved.
Why Twin?
The pilot programs demonstrated that Twinning helps units build lasting professional relationships and expand their awareness of best practices across health systems. Participants gained valuable insight into different operational models, staffing structures, and cultural approaches to patient care. All agreed that the exchange was an effective way to strengthen connections with global peers and enhance preparedness for future outbreaks. Twinning not only improves individual capacity but also fosters trust and collaboration that can be critical during emergencies.
Who to Twin With
Selecting the right partner is a key step. Effective Twinning depends less on finding a unit that looks exactly like yours and more on identifying one that is committed to engagement and learning. Respecting differences in infrastructure, resources, and health system design is essential. Some units may benefit from a partner with similar characteristics, while others may find greater value in collaborating with a unit that operates in a very different context. What matters most is openness, reciprocity, and a shared willingness to grow together.
Effective Approaches
Successful Twinning begins with a clear structure. Partnerships typically start with a kickoff meeting to set expectations, identify points of contact, and establish shared goals. Early conversations should focus on learning about each unit’s strengths, challenges, and capacities. From there, partners can define concrete objectives for the first year and agree on how often to meet, whether virtually or in person. Regular check-ins help maintain momentum, while structured activities such as joint trainings, demonstrations, or exercise observations deepen the collaboration.
Lessons from the pilots underscore the importance of clarity and consistency. Well-defined goals keep partnerships on track, while flexibility ensures that the relationship can adapt as needs evolve. NETEC’s Twinning Toolkit offers templates and resources to support this process, making it easier for units to plan agendas, track progress, and evaluate outcomes.
Why This Matters
High-consequence infectious diseases can spread rapidly across borders, and no facility can prepare in isolation. Twinning provides a practical framework for strengthening both individual HLIUs and the global network they form together. By building trust, sharing expertise, and exchanging lessons learned, HLIUs can collectively enhance readiness and resilience.
To learn more, connect with NETEC’s International Partnerships & Programs team.
Dr. Jocelyn Herstein, NETEC Director of International Partnerships & Programs (jocelyn.herstein@unmc.edu)
Katie Stern, MPH, NETEC Evaluator and Project Manager of International Partnerships & Programs (katherine.stern@unmc.edu)
Download and explore the guide HERE.