Review: Hospital preparedness for COVID-19: A practical guide from a critical care perspective

Review: Hospital preparedness for COVID-19: A practical guide from a critical care perspective

This article describes how a hospital in New York (Weil Cornell) prepared for a surge of critically ill patients and provides a helpful roadmap for centers that are getting getting for a surge of COVID-19 patients.

The hospital’s surge planning included the following:

  • initial highest priorities included obtaining an adequate supply of personal protective equipment (PPE) for the staff and
    evaluating/expanding intensive care unit (ICU) and ventilator capacity
  • developing protocols about clinical decisions around intubation, the use of high-flow
    oxygen, infectious disease consultation and cardiac arrest
  • minimizing staff exposure by bundling care as much as possible
  • using technology to minimize staff exposure to COVID-19 and to facilitate family engagement and end of life discussions
  • infection control
  • clinical operational challenges
  • planning for intensive care unit surge capacity by increasing bed capacity and outsourcing procedures
  • support for clinical and nonclinical staff affected by the impact of COVID-19
  • using interdisciplinary collaboration and iterative surge planning
    as intensive care unit admissions rose
  • ensuring clinicians were up to date on  literature about COVID-19 patient management and communicated with each other  to standardize care through virtual conferences/seminars.
  • providing a rapid simulation curriculum focused on pronation and COVID cardiac arrests for both day and night shift
    nurses in non-medical ICUs (led by pulmonary and critical care physicians)
  • encouraging emergency medicine and hospital medicine physicians to pursue early, honest conversations
    with patients and families regarding goals of care and clarifying advance directives. This was supported by access to palliative care and ethicists to help facilitate these conversations.

 

|2020-04-21T11:09:00-04:00April 21st, 2020|COVID-19 Literature|Comments Off on Review: Hospital preparedness for COVID-19: A practical guide from a critical care perspective

About the Author: Seema Mohapatra

Seema Mohapatra
Seema Mohapatra is an Associate Professor of Law and Dean's Fellow at the Indiana University Robert H. McKinney School of Law, She teaches Introduction to Health Care Law and Policy, Genetics and the Law, Torts, and Bioethics and the Law. Seema Mohapatra is an expert in the areas of health care law, public health law, bioethics, torts, and international health and family law. Her research interests include the intersection of biosciences and the law, assisted reproduction and surrogacy, international family and health law, health care disparities in the United States, and informed consent. Her work has been published in several journals, including the Wake Forest Law Review, Colorado Law Review, Brooklyn Law Review, and the Harvard Journal of Law & Policy. Professor Mohapatra currently teaches Torts, Introduction to Health Care Law, Bioethics, and Genetics and the Law. She has authored articles and book chapters on topics such as insurance coverage of infertility and assisted reproduction, genetics and health privacy, international surrogacy laws, and equity in healthcare coverage. Professor Mohapatra regularly presents her research nationally and internationally at legal and medical conferences and symposia. Prior to teaching, Professor Mohapatra practiced health law in Chicago at Sidley & Austin and Foley & Lardner. She earned a J.D. degree from Northwestern University School of Law and has a master’s degree in Public Health with a concentration in Chronic Disease Epidemiology from Yale University. She earned a bachelor of arts in Natural Sciences (with a minor in Women's Studies) from Johns Hopkins University.

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