40 health systems unite to share COVID-19 lessons, successes and best practices in managing patient surge challenges

Virtual roundtable provides health system leaders with opportunities to collaborate, learn and share.

Pittsburgh, April 27, 2020—More than 90 individuals representing 40 healthcare systems from across the country, who are on the front lines of the COVID-19 pandemic, are collaborating virtually to share the lessons they are learning, the successes they are having and the best practices they are implementing to protect patients and caregivers. The conversations are hosted weekly by TeleTracking, whose clinical experts have also been on the frontlines of healthcare, provide guidance in creating capacity and managing patient throughput.

Over the past few weeks, representatives from Beth Israel Deaconess Medical Center in Boston, MA; Carilion Clinic in Roanoke, VA; Huntington Hospital part of Northwell Health in New York, NY; Kettering Health Network in Dayton, OH; Methodist Healthcare in San Antonio, TX; and University Medical Center of El Paso in El Paso, TX have shared their experiences.

These systems include some of the nation’s foremost experts in disaster and incident response, having managed through mass shootings, tornados and hurricanes—and are now bringing their expertise to bear on the COVID-19 pandemic. They are also leveraging their Command Centers powered by TeleTracking to centrally track vital resources such as ventilators on a system-wide basis, add and manage new beds at alternative care sites, and provide visibility to suspected and confirmed COVID-19 cases in real-time for all stakeholders. Below is a sampling of COVID-19 recommendations and best practices shared to date.

Incident Command Center / Health System Command Center COVID-19 Best Practices

Kettering Health Network’s Incident Command Center, located adjacent to its Network Operations Command Center, was established in early March and includes members from nearly every operation across the network—including marketing and communications; nurses and physicians; data analysts; logistics, operations, lab services and infection control staff; police departments, etc. As Kettering ramped up for COVID-19, the ability to get information in real-time was essential, and the TeleTracking COVID-19 dashboard makes it possible to look at metrics hour by hour. The team at Kettering knew the processes and data that was necessary to effectively manage a large-scale health crisis like the COVID-19 pandemic after dealing with a major tornado and a mass shooting within a few months last summer. Prior to that, each hospital had their own approach and process. All levels and functional areas of the network understand and are strong proponents of the benefit of centralizing operations in a command center.

The Incident Command Center at Beth Israel Deaconess Medical Center is sharing information about capacity at each hospital, including community hospitals, as well as available ventilators. Senior staff members meet morning and afternoon to share critical information.

The Carilion Clinic Transfer and Communications Center (CTaC) makes it possible to quickly and easily share and communicate information across the system. For example, the CTaC can identify negative pressure rooms, in real time, at an enterprise level and prioritize patients that can be moved in order to open space for incoming patients. The CTaC is also responsible for indicating persons under investigation (PUI) for COVID-19 when a bed is needed; they can quickly assess the location of available beds across the system in TeleTracking and start the patient transfer / admission.

Preparing for the Surge

Methodist Healthcare in San Antonio started its preparations in early February after receiving notification from the Southwest Texas Regional Advisory Council (STRAC) that American citizens returning from Wuhan, China would be sent to the Joint Base San Antonio - Lackland military base. Citizens who showed signs and symptoms for COVID-19 would then be transported to Methodist Hospital | Texsan for care. Approximately 100 American citizens were housed on the base. Three citizens were transported to Methodist Hospital | Texsan with one testing positive for COVID-19. This patient remained at the hospital for approximately one week. Joint Base San Antonio was also where 300 passengers from the Diamond Princess cruise ship were evacuated upon arriving back in the United States. One patient tested positive for COVID -19 and was cared for at Methodist Hospital | Texsan.  Methodist continued to prepare for what the pandemic would look like, with things being slow, at first. However, that changed around the time of spring break, with an increase of cases that appeared to be travel-related with people returning from New York, New Orleans and Colorado. All Methodist Healthcare facilities implemented surge plans and developed COVID-19 cohorting units. To expand capacity within Methodist Healthcare, an ambulatory surgery center was transformed into a COVID-19 facility within 48 hours. Inside Command Central for coronavirus response at Methodist Healthcare.

Administrators from UMC El Paso started meeting in mid-February, and by March, it was all hands-on deck. UMC El Paso has done many disaster preparation drills, and having responded to a shooting incident last August, the team knew they were ready for just about anything. Organizing teams and organizing information was very important early on. Custom views in TeleTracking were created for leadership to track in real-time the volume of patients and those testing positive or negative for COVID-19, and read-only views are being shared with pharmacy, respiratory and food service for increased visibility and staff safety. Engineering also expanded the number of negative pressure rooms by placing exhaust fans in windows. El Paso, TX is seeing on average 40-50 positive cases every day, for a total of more than 400 cases to date, and the spike is projected for early May.

Northwell Health – Huntington Hospital’s Incident Command Center opened in early March and has been staffed 24 hours a day for the last 45 days. The critical role that TeleTracking plays in managing patient logistics across the system was evident when Governor Cuomo instructed hospitals in New York to increase capacity by 50 percent. Northwell Health has added 1,000 additional surge beds. For tracking purposes, Northwell is using TeleTracking to indicate the location of the newly added beds. Huntington Hospital, for example, converted PACUs, Cath Labs and vacant spaces into 50 additional ICU beds since elective surgeries have been canceled or delayed.

Identifying COVID-19 Patients

Of the systems that have shared stories to date, all are using COVID-19 patient attribute icons in TeleTracking to indicate patients that are under investigation versus confirmed for COVID-19. These icons are displayed on electronic whiteboards on hospital units so that caregivers can quickly see patient status. The hospitals are also tracking positive cases of COVID-19 through an isolation report in TeleTracking to ensure caregivers take precaution and have appropriate PPE, and to indicate if caregivers have been exposed to an infected patient. Many of the hospitals are also cohorting COVID-19 patients.

Reports & Dashboards

TeleTracking released an enterprise COVID-19 capacity and census dashboard to its SynapseIQ Enterprise customers on April 1, 2020 to equip health systems with the critical information needed to prepare for and respond to the COVID-19 patient surge. The dashboard provides real-time information related to patient census, bed availability, confirmed and possible COVID-19 patients, patients in need of ventilation, capacity of specialized treatment areas such as negative pressure and ICU rooms and patients by age. The dashboard is also available to hospitals currently using TeleTracking Capacity Management Suite™ version 3.4 or greater.

Methodist Healthcare developed and deployed a COVID-19/PUI COVID -19 count dashboard that is displayed in the Incident Command Center and Patient Placement Center with real-time updates as patients’ progress through the testing process. Methodist Healthcare also created a census epidemiology dashboard in TeleTracking SynapseIQ® Enterprise, which is updated in real-time and is also displayed in the Incident Command Center.

Carilion Clinic is using the TeleTracking COVID-19 dashboard to show the number of confirmed COVID-19 patients, those that have been ruled out, the location of each patient, in addition to other critical metrics.

“The COVID-19 dashboard allows us to see how best to utilize valuable resources and most effectively place patients in order to provide the best possible care. I don’t know how health systems are operating without this level of visibility,” said John Weimer, Kettering Health Networks’ vice president of network emergency, trauma and operations command center. 

Final Thoughts

Kettering Health Network and neighboring, competing health systems are working together to share information and stay connected. Methodist Healthcare and UMC El Paso are already thinking through different scenarios and lessons learned to improve processes related to disaster preparedness and infectious diseases. Carilion Clinic has expanded their CTaC to include a number of large monitors so that at a glance all are aware of the current status.

The common thread is that a centralized approach to care helps maximize valuable resources, provides vital visibility into bed capacity, improves care and safety for patients and protects the health of caregivers.