ED Management – June 1, 2020
June 1, 2020
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Leveraging Hospital Incident Command to Battle COVID-19
Frontline providers battling COVID-19 in New York, where the outbreak may go down as the worst in the United States, share the latest updates and techniques that are paying dividends.
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Plan for a Range of Demand Scenarios
When preparing for any disaster, plan for a range of scenarios, including worst case. Determine where beds and staff will come from under the direst of circumstances. Use predictive modeling to anticipate daily care needs and identify alternative locations where patients could be relocated if the community demand reaches a boiling point.
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Rule No. 1: Take Care of Staff
There is no denying the fear and anxiety that frontline staff are experiencing as they race to care for COVID-19 patients. Employees are living in personal protective equipment, and they are witnessing people of all ages go through terrible courses of illness. In one New York-based facility, leaders formed “code lavender” teams for instances in which staff members may have seen or been involved with some type of crisis.
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Prepare to Ramp Up Quickly, Treat All Patients as if They Have COVID-19
Prepare for a rapid escalation of cases as soon as evidence of community spread of COVID-19 emerges. At this point, assume everyone is carrying the virus, and act accordingly.
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Smaller EDs Should Treat Lower-Acuity Patients Outside the Hospital
A California-based hospital set up an area in its parking lot to screen for COVID-19. Many people who arrive are low acuity (i.e., looking for a test, showing no signs of the virus, and can be treated in their cars). Still, the facility is prepared to admit high-acuity patients who may need more complex care inside the facility.
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Opinions Evolve Regarding When to Ventilate a COVID-19 Patient
While there is no consensus on the issue, there are physicians from the frontlines in New York who now favor performing more noninvasive ventilation. Some are trying to avoid using a ventilator at all.
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Leverage In-House Resources, Work with Outside Labs to Streamline COVID-19 Testing Processes
Expanded testing capacity is crucial to fully understanding how broad the COVID-19 problem is in the United States. But how can providers reach that goal if there are not enough tests?
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Nurse Practitioners Pitch in to Meet Urgent COVID-19 Care Needs for Minorities
There have been widespread reports about how the pandemic is adversely affecting minority populations. The extent of this disparity is particularly clear in New Orleans, one of the hotspots for COVID-19.
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What the Quality Improvement Community Brings to the Table During a Pandemic
Healthcare providers around the world are relying on innovation to help their organizations survive the COVID-19 pandemic, a crisis that has brought with it unprecedented challenges and complexity. Some structure is needed to curate the best ideas and ensure they are shared widely.
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A Framework Designed to Generate Transparency, Teamwork, Trust, and Calm
Considering the demand for leaders’ attention has been stretched thin during the COVID-19 pandemic, there is a simple framework administrators can leverage to help them stay attuned to the big picture.