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Bracing for the Storm: One Health Care System's Planning for the COVID-19 Surge.

ABSTRACT: University of Washington Medicine (UW Medicine), an academic health system in Washington State, was at the epicenter of the first outbreak of the COVID-19 pandemic in the United States. The extent of emergency activation needed to adequately respond to this global pandemic was not immediately known, as the evolving situation differed significantly from any past disaster response preparations in that there was potential for exponential growth of infection, unproven mitigation strategies, serious risk to health care workers, and inadequate supply chains for critical equipment. The rapid transition of the UW Medicine system to account for projected COVID-19 and usual patient care, while balancing patient and staff safety and conservation of resources, represents an example of an adaptive disaster response. Although our organization's ability to meet the needs of the public was uncertain, we planned and implemented changes to space, supply management, and staffing plans to meet the influx of patients across our clinical entities. The surge management plan called for specific actions to be implemented based on the level of activity. This article describes the approach taken by UW Medicine as we braced for the storm.

SUBMITTER: Kim CS

PROVIDER: S-EPMC7546945 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Bracing for the Storm: One Health Care System's Planning for the COVID-19 Surge.

Kim Christopher S CS Meo Nicholas N Little Danica D Morris Stephen C SC Brandenburg Lisa A LA Moratti Michelle M Dold Cynthia L CL Staiger Thomas O TO Sayre Cindy C Goss J Richard JR Dayao Jerome M JM Dellit Timothy H TH

Joint Commission journal on quality and patient safety 20201010

<h4>Problem</h4>University of Washington Medicine (UW Medicine), an academic health system in Washington State, was at the epicenter of the first outbreak of the COVID-19 pandemic in the United States. The extent of emergency activation needed to adequately respond to this global pandemic was not immediately known, as the evolving situation differed significantly from any past disaster response preparations in that there was potential for exponential growth of infection, unproven mitigation stra ...[more]

PMID: 33069619

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Project description:IntroductionThe COVID-19 pandemic revealed an urgent need for analytic tools to help health system leaders plan for surges in hospital capacity. Our objective was to develop a practical and locally informed Tool to help explore the effects of public health interventions on SARS-CoV-2 transmission and create scenarios to project potential surges in hospital admissions and resource demand.MethodsOur Excel-based Tool uses a modified S(usceptible)-E(xposed)-I(nfected)-R(emoved) model with vaccination to simulate the potential spread of COVID-19 cases in the community and subsequent demand for hospitalizations, intensive care unit beds, ventilators, health care workers, and personal protective equipment. With over 40+ customizable parameters, planners can adapt the Tool to their jurisdiction and changes in the pandemic.ResultsWe showcase the Tool using data for Ontario, Canada. Using healthcare utilization data to fit hospitalizations and ICU cases, we illustrate how public health interventions influenced the COVID-19 reproduction number and case counts. We also demonstrate the Tool's ability to project a potential epidemic trajectory and subsequent demand for hospital resources. Using local data, we built three planning scenarios for Ontario for a 3-month period. Our worst-case scenario accurately projected the surge in critical care demand that overwhelmed hospital capacity in Ontario during Spring 2021.ConclusionsOur Tool can help different levels of health authorities plan their response to the pandemic. The main differentiators between this Tool and other existing tools include its ease of use, ability to build scenarios, and that it provides immediate outcomes that are ready to share with executive decision makers. The Tool is used by provincial health ministries, public health departments, and hospitals to make operational decisions and communicate possible scenarios to the public. The Tool provides educational value for the healthcare community and can be adapted for existing and emerging diseases.

Project description:Background Based on the early international COVID-19 experience, it was anticipated that intensive care services and workforces in Australia would be placed under similar pressure. While surge capacity of medical and nursing workforces was estimated, little was known about baseline allied health staffing making it difficult to estimate surge capacity and coordinate planning. Objectives The purpose of this study was to 1) capture baseline allied health staffing levels in Australian adult ICUs prior to the COVID-19 pandemic emergence in Australia; and 2) describe the allied health pandemic planning and surge response in Australian ICUs during the early waves of the pandemic. Methods This was a cross-sectional, investigator-devised, prospective survey study. The survey was administered via the national chief allied health network to a convenience sample of senior ICU allied health clinicians at hospitals throughout Australia. Results A total of 40 responses were received from tertiary and metropolitan hospitals; physiotherapists 12 (30%) and occupational therapists eight (20%) were the most frequent respondents. Prior to the COVID-19 pandemic, 28 (70 %) of allied health respondents had a mean (IQR) of 1.74 (2.00) full-time equivalent (FTE) staff designated to the ICU, where these ICUs had a mean of 21.53 (15.00) ventilator beds. Few respondents serviced their ICU on a referral-only basis and did not have dedicated ICU FTE 12 (20%). Surge planning was mostly determined by discussion within the ICU, allied health department, and/or respective disciplines. This approach meant that allied health staffing and associated decision-making was ad hoc at a local level. Conclusions The baseline rate of allied health coverage in Australian ICUs remains unknown and the variability across allied health and within the specific disciplines is undetermined. Further research infrastructure to capture ICU allied health workforce data is urgently needed to guide future pandemic preparedness.

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Bracing for the Storm: One Health Care System's Planning for the COVID-19 Surge.

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Bracing for the Storm: One Health Care System's Planning for the COVID-19 Surge.

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