Morristown (N.J.) Medical Center was one of many hospitals on the East Coast tasked with quickly responding to a surge of COVID-19 patients this spring.
Morristown-based Atlantic Health System, the hospital's parent system, has treated more than 11,000 COVID patients since March, including more than 900 inpatients at its peak.
Today, this picture looks very different. Morristown Medical Center's inpatient COVID population is less than 1 percent — the lowest figure seen since the pandemic started, according to Trish O'Keefe, PhD, RN, vice president of Atlantic Health and president of the hospital.
"We really had a phased approach to facility, staffing and resource management this spring," Dr. O'Keefe said, noting that the system started evaluating its pandemic plan, implementing simulation training for staff and adjusting staffing plans in January. "The mantra we used at every single meeting, which we held every couple of hours, was that this situation is going to be a marathon, not a sprint."
Here, Dr. O'Keefe discusses how Atlantic Health is preparing for a potential second wave this fall and shares advice for hospitals in current COVID-19 hot spots.
Editor's note: Responses were lightly edited for length and clarity.
Question: How are you preparing for a potential second wave this fall? Are you tweaking this approach based on lessons learned in the spring?
Dr. Trisk O'Keefe: In the first surge, we learned as we evolved. Now, we have systemwide policies for a majority of response efforts, including infection prevention and clinical policies. We created a workforce plan to ensure we will have enough appropriately trained staff to meet demand. We've also looked at redeploying our staff, which is what we did in the first phase. For example, some members of our nursing staff worked in critical care or acute care for a few years before going to an ambulatory or outpatient site. We've redeployed these staff members back to the acute care facility. We also did on-the-job training for them to make sure they had the basic skills needed to care for COVID-19 patients, knew all of our policies and processes, and had a critical care nurse available to support them.
The Atlantic Health quality team, led by CMO Jan Schwarz-Miller, MD, has also overseen the creation of more than 20 playbooks to standardize care across our system as much as possible. For example, we have an Atlantic Health nursing playbook, a critical care playbook, a pediatrics playbook, etc. They serve as a reference to utilize if the second wave occurs, so we are ready and prepared.
For supply chain, Atlantic Health's goal is to have a 90- to 120-day supply of necessary resources on hand. This is based on our ratio of supplies at our peak back in mid-April. It's really a daily focus for many departments, especially strategic sourcing to make sure our patients, physicians and employees are safe.
Q: What advice do you have for hospitals seeing surges in states like Florida or Texas right now?
TO: This is going to be a journey for them; it's not over in a day. Communication is critical. This spring, some members of our medical staff were not coming into the hospital because we canceled elective surgeries. We realized we needed a communication plan for our internal and external communities. Having that communication go out as frequently as possible was important. You need to communicate as much as you possibly can.
We all have our surge plans, but realize those plans need to be adjusted based on the patients' and population's needs. It's also important to support your staff. Visibility of leadership was so key for us. So was outreach from the community in supporting our hospital. It is very much a team approach. Everyone in the organization had a role in caring for COVID-19 patients. It was never "that's not my job." It was always a can-do approach, which is so important to get through this tough time.
You also need to think about, not just employees' basic physical needs, but also emotional needs, because this pandemic is very different from other crises. Our staff was scared of what they were potentially bringing home to their families. We knew we needed to support our physicians and teams from a behavioral health and crisis management perspective. Having virtual and spiritual support for them was key.
Q: Any other thoughts?
TO: We have so many different roles as healthcare providers, and one is being a community leader. Our communities look to us for knowledge and education. So reach out to your communities and ask them to wear masks and maintain social distancing because we know it really decreases the incidence of COVID-19.
Healthcare can be competitive. What we've seen— and what I'm sure hospitals in hotspots are seeing right now — is that there's been such an outpouring of sharing knowledge, advice and processes. We hope that will continue in healthcare. University of Washington [in Seattle] shared all of its policies and processes with us, which we really learned from. I think healthcare is a team sport, and we need to continue working together as this pandemic continues. This will help improve care in so many ways.
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