COVID-19 is challenging healthcare systems around the world. According to the CDC, the United States was considered in the “acceleration phase” of the pandemic in late March, meaning the peak of the illnesses were occurring.
Since the World Health Organization officially labeled COVID-19 a pandemic, healthcare organizations have been assessing and adopting various strategies to address the growing healthcare needs of their communities. One area that has been particularly concerning for hospitals is the availability of beds and other resources, as organizations see a surge in the number of COVID-19 cases.
In early March when cases of COVID-19 in Chicago were starting to grow, Rush University System for Health dedicated resources to help the system adopt a more aggressive approach to address the situation. The organization came up with a number of strategies, which are summarized in its response plan linked above. These strategies – some of which are described below – may help other organizations increase their operational efficiency during this time of crisis.
Increase the Number of Available Operational Beds by Converting Beds in Other Units
As the country sees more cases of COVID-19, there is growing concern that hospitals will run out of beds to treat patients who require inpatient care. To address the growing concern regarding bed availability, Rush made the decision to use its rehab facility as a medical unit, as well as convert half of the beds in its orthopedic unit into negative pressure rooms to help isolate COVID-19 patients.
The unique design of the organization’s building – which was specifically built to isolate in scenarios like a pandemic – has special functions so that each wing of the hospital can be isolated and the ED can be redesigned with hidden walls to increase patient capacity. The ED also has a mechanism for managing air circulation, which is of the utmost importance to contain the spread of infections.
Increase Screenings With Satellite Clinics and Swab Swat Teams
To address the increase in patients that must be screened and tested, Rush set up a COVID-19 clinic to more quickly evaluate high-risk patients. Patients can be referred to the clinic from a virtual visit or another location. Minutes before their arrival, patients are supposed to call the clinic and remain in their vehicle until a nurse can meet them and bring them a mask if they do not already have one. The patient is brought into the clinic for the swab test and then sent home to self-quarantine until the test results are available.
In addition, a Mobile Swab Swat Team consisting of trained nurses was created to assist in screening at clinics that are not set up for point-of-care flu and COVID-19 testing. These clinics can page the mobile team when a suspected case of COVID-19 presents. The team collects the sample and sends it to the lab for testing.
Rush also set up tent triage in its ambulance bay area, which allowed staff to screen about 100 patients per day in the first week. By initiating these methods to test patients, the organization has helped avoid overcrowding in the ED while also addressing the growing demand for testing.
Provide Virtual Care to Limit Unnecessary Hospital Testing and Treatment
To further avoid overcrowding in the hospital, the organization uses e-visits and on-demand video visits to address various concerns of patients. Before virtual care was made more widely available, providers at Rush were given training on virtual care so that they were better equipped to deliver high-quality care via the technology.
Patients initiate the process by filling out a self-evaluation. If patients are at moderate or high risk based on this questionnaire, a free video visit is initiated. Based on the consultation, patients with symptoms of fever, cough, or shortness of breath and a history of travel or close contact with a COVID-19 positive patient are then referred for testing.
Optimize Supply Chain to Appropriately Use Personal Protective Equipment
Rush’s supply chain management team is continuously coordinating with the distributors and manufacturers of various supplies. The organization has come up with simple changes to manage the use of personal protective equipment, such as reducing the number for persons conducting rounds on patients with COVID-19. The organization’s supply chain management team also created “PPE go-packs” that contain N95 masks, face shields, isolation gowns, and sanitation wipes for the clinical teams that must test and treat patients under investigation.
While organizations are still trying to figure out the best processes for responding to the current crisis, the measures in Rush University System for Health’s response plan can help drive more efficient use of resources, expand testing capabilities, and keep patients and staff safe.
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