How hospitals are preparing for future public health crises

The COVID-19 pandemic has tested hospitals' disaster preparedness plans and prompted them to assess crucial areas to prepare for future health crises. Some have strengthened partnerships with local organizations, invested in diagnostic testing platforms and updated workflows and oxygen infrastructure. 

To dive deeper into how organizations are planning for another pandemic or public health crisis, Becker's Hospital Review asked hospital and health system leaders to share steps they've taken. Below are their answers:  

Editor's note: Responses were lightly edited for length and clarity.

Nick Duncan. Director of Emergency Management at Tufts Medical Center (Boston): As a result of the coronavirus pandemic, we have a better institutional knowledge of the hospital incident command structure, to be better prepared to organize ourselves and assign leaders roles when faced with a crisis. We have developed stronger connections with our local partners and city of Boston agencies to help respond to, and prepare for, events. We also have better capability to engage our neighbors more frequently when things arise and address concerns before they become a problem. As a health system, we are more coordinated than ever and can transfer supplies and resources across sites daily, if needed. We now have a warehouse to help stockpile and serve as a central distribution site for key resources. We also have constructed multiple testing and vaccination sites, which can be called a point of dispensing, which are critical to public health responses. We have more leadership depth and have streamlined our communication. Finally, we have operated a command center for months at a time with staff who have the skills to step in so others have a chance to rest. For all these reasons, this crisis has helped us to be much better prepared for the next one.

John Fox. President and CEO of Beaumont Health (Southfield, Mich.): We believe society's greatest public health risk remains an ongoing or a new viral or bacterial infectious disease outbreak. Further, COVID-19 remains at significant risk for becoming endemic to humans, like influenza, requiring ongoing annual vaccine management rather than ultimate eradication. To mitigate these risks, Beaumont has built a strategic large-scale inventory of necessary personal protective equipment for our healthcare teams and has 2 million vaccination syringes in reserve. Further, we have invested in multiple diagnostic testing platforms utilizing both polymerase chain reaction and serological testing capabilities. All the above need to be reviewed regularly for relevance and periodic adjustment. 

Laura Iavicoli, MD. Director of Emergency Management at NYC Health + Hospitals (New York City): Being a network of 11 hospitals was considered one of our strongest assets to respond to the COVID-19 pandemic, especially during times of surges. But while we had the flexibility of space, staff and resources throughout our facilities, coordination wouldn't have been possible without intricate and diverse modes of communicating between facilities and to our workforce of more than 40,000 brave hospital workers. During the first COVID-19 surge in the spring of 2020, NYC Health + Hospitals built up reporting tools to help share data between facilities on staffing, patient volumes and surge capacity, as well as to share timely updates to staff. 

At the first signs of the spring 2020 surge, we established systemwide briefing calls with our emergency management teams, chief medical and nursing teams, CEOs, communications directors and more to bring all executives up to speed on where the system was capacitywise and what surge plans were being activated. Additionally, central office leadership has daily planning meetings as well as daily logistics meetings to plan internally. We also established new workflows to update our employees-only Intranet page to house updated policies and guidance, as well as resources to ensure our workforce felt supported, were kept updated and had access to important amenities, like hotels for those isolating from their families, almost in real time. We established a weekly, live COVID-19 webinar, which created a two-way conversation between executives and staff. And we leveraged our mass notification systems to push out urgent messages to all staff when immediate updates were deemed urgent. Our expanded communications tools allowed New York City's public hospital system to work more as one unified, cohesive network of hospitals than we already were before the pandemic, helping to save more lives.

Tami Minnier, MSN, RN. Chief Quality Officer of UPMC (Pittsburgh): This pandemic and the heavy demand it created for the use of high-flow oxygen to treat COVID-19 patients have highlighted the critical importance of our oxygen infrastructure, which we took for granted before. Before the recent peaks in COVID-19 hospitalizations, our maintenance team proactively inventoried our oxygen systems across our 40-plus hospitals and deliberately strengthened that infrastructure — even drawing on lessons learned from our facilities in Italy. For instance, every facilities director now receives a daily report that gives the information necessary to proactively monitor and adjust the incoming pressures to avoid failures or interruption of oxygen flow to patients. And we've added multiple and redundant regulators on the incoming bulk oxygen feeds. These changes and others have ensured that we've had no service interruptions and that we're well-prepared to care for patients long after this pandemic is over. 


More articles on leadership and management:
New Jersey Hospital Association taps former state official as first COO
Florida governor could fill hospital district board seat left vacant by resignation
Limiting workers' inhalation of COVID-19 virus must be top Biden priority, experts tell CDC 

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