Hotel Rooms, Navy Ships, and Pop-Up Tents: What’s Your Surge Plan?

Hospitals all over the world are putting their surge plans into action. As the number of confirmed cases of COVID-19 increases, responding to the pandemic can be wildly unpredictable for some facilities, especially in urban areas where the virus can spread exponentially over a short period of time. Some hospitals and care centers can go from just a few confirmed cases to reaching capacity overnight.

Every hospital should have a surge plan in place, but the coronavirus may put your strategy to the test. Find out how hospitals around the country are dealing with a surge in patients.

How the U.S. Hospital System Is Holding Up

The spread of the coronavirus has been very uneven up until this point. Over half of all U.S. cases are in the state of New York, with heavy concentrations in New York City and the town of New Rochelle, just north of the city. Gov. Andrew Cuomo recently stated in a press conference that he believes around 80% of the state’s 19.4 million residents will get the virus. The governor has also issued an emergency order asking hospitals to increase their capacity by 50% as coronavirus cases across the state surged 38% overnight to 20,875. Ideally, the governor wants hospitals to increase their capacity by 100%, but he realizes that might be a stretch. Many facilities in the NYC area have already reached capacity, and making space for more patients may not be an option.

California is grappling with a shortage of beds for COVID-19 patients as well. Gov. Gavin Newsom now believes the state will need an additional 50,000 hospital beds in the days and weeks to come, more than doubling his original projections overnight. He has also asked the state’s 416 hospitals to double their surge plans to accommodate the growing number of virus cases. To increase capacity, the state recently commandeered a 1,000-bed Navy medical ship that’s being rerouted to the Los Angeles port. Officials are also reopening two shuttered hospitals in the state.

Many hospitals and states are looking to expand capacity before the worst of the virus hits. Even though many of them have shelter-in-place orders in effect, health officials warn that more infections are on the way. Facility administrators are asking themselves and their staff tough questions as they look for ways to increase capacity.

Refining Your Surge Plan in the Age of the Coronavirus

Even if your facility has a surge plan in place, local health officials or even the governor of your state may ask you to expand capacity in the event of an emergency. Keep these tips in mind as you go over your surge plan:

• Temporary Screening Stations for Incoming Patients

You’re bound to see an increase in the number of patients that may have the coronavirus in the weeks to come. Some individuals may need to be hospitalized, while others may only have mild symptoms. To free up some space inside your facility, consider setting up temporary screening areas for incoming patients. You can set up a tent in the parking lot for triaging symptoms, testing patients, and determining who needs to be hospitalized. You can also convert storage areas, basements, and waiting rooms into screening areas.

• Separating Infected Patients from the Immunocompromised

Once you have a way to stem the flow of incoming patients, you’ll need to find ways to separate confirmed cases of COVID-19 from the immunocompromised, including elderly individuals, hematology/oncology patients, and those with pre-existing conditions. Patients will still be coming into your facility for other reasons, so make sure they have access to a safe area that limits their exposure to those that may have the virus. Consider devoting separate rooms or wings to COVID-19 patients to reduce exposure. Allocate healthcare workers to certain patients and rooms to reduce the chances of cross-contamination.

• Limiting Entrances/Exits

To reduce the chances of exposure, you may want to adjust the flow of traffic in and out of your building. Create a separate entrance/exit for potential coronavirus patients, so they don’t come in contact with patients that are there for other medical reasons. Use proper signage to direct incoming traffic, so individuals know which door to use or where to park their cars.

• Essential Personnel Only

It’s all-hands-on-deck for healthcare providers, but all nonessential personnel should leave the building, including volunteers, students, interns, and even maintenance crew. This will also help reduce crowding inside your facility. Your nurses and care providers should be more focused on caring for patients and less on educating the next generation of nurses.

You may also need to reduce visiting hours or do away with them altogether over the course of the pandemic. Send out messages to your patients’ loved ones asking them to stay away until further notice.

• Cancelling Non-Urgent Medical Appointments

Reschedule non-urgent medical appointments at your facility. Encourage your patients to stay away unless they need urgent medical care. You may need to have someone reviewing individual case files and patient medical records to determine which procedures/appointments are essential and which are not. Urge your patients to try telehealth as an alternative.

• Emergency Shift Swaps/Scheduling Overtime

Your staff may need to adjust their work schedules during this time. Make sure your nurses can remotely switch/pick-up shifts as this pandemic continues. Talk to your nurses about possibly working overtime. Identify workers that can come in late or work extra hours. Some workers may need to be home with their children, so be aware of who’s available and who’s not. Create a plan for recruiting additional healthcare providers, including retired workers and specialty providers.

Even if the coronavirus has yet to show up on your doorstep, your facility may need to ramp up capacity at a moment’s notice, so refine your surge plan sooner rather than later. The U.S. healthcare system has never seen a crisis like this, so your surge plan may need adjusting.