Infection prevention and pharmacy leaders discuss COVID-19 surge preparedness

As the U.S. continues to face rising cases of COVID-19, industry leaders reflected on their experience with initial surges of the virus, the significant challenges it presented their organizations and what can be done to keep everyone safe. 

During a July 8 panel discussion hosted by Becker's Healthcare and sponsored by clinical surveillance platform VigiLanz, infection prevention and pharmacy leaders from hospitals across the U.S. shared the biggest challenges they faced during COVID-19 surges and how clinical surveillance enhanced patient care. Moderated by Stephanie Kovalick, chief strategy officer for Sage Growth Partners, the discussion also focused on surge preparedness and recommendations for other pharmacists and infection preventionists.

The speakers were: 

  • Joanna Mills, RN, MSN, director of infection prevention at Walnut Creek, Calif.-based John Muir Health
  • Jessica Liberty, BSN, RN, infection prevention and control manager at Joplin, Mo.-based Freeman Health System
  • Joshua Courter, PharmD, antimicrobial stewardship clinical pharmacist at Cincinnati Children's Hospital Medical Center
  • Michael Sanchez, PharmD, pharmacy residency coordinator at New York City-based Health First

The speakers discussed how to prepare for, prevent and respond to the spread of COVID-19 and other respiratory viral illnesses with tactics including the use of VigiLanz's award-winning clinical surveillance platform. 

Briefly describe your hospital and role during previous pandemic peaks:

Ms. Mills: My role has been quite active since February, when the first cases here in California came from the cruise ship in Japan. Since then, we've been dealing with an unknown insanity that requires constant adaptation. It's been challenging to keep staff educated relative to whatever current state we're in and what they need to stay safe. In the middle of April, our hospital admissions briefly declined for about two weeks, but since then, cases are surging and we're ramping up infection control measures.

Ms. Liberty: I work at an acute care hospital in Missouri. When the pandemic hit the U.S., we initiated our incident command with the leadership team and developed several processes, like a COVID call center, a drive-thru process and PPE conservation policies. Initially, we didn't really have the case numbers necessary for these measures. However, toward the end of May, we started to see a surge that has continued throughout June and into July. Using all the processes we developed earlier, we've been able to continue care safely amid the surge.

Dr. Courter: As a pediatric institution, we fortunately did not see a large influx of COVID-19 patients until the last couple weeks. Now that we are seeing many more positive cases in children, we are making lots of operational changes.

Dr. Sanchez: As a county wide health system in Florida, we developed a taskforce to organize an action plan and were able to conserve PPE. Over the last week and a half, hospitalizations have significantly increased statewide, along with COVID-19 cases. Mortality rate has stayed steady, but is beginning to trend upward. In my role, I've had more contact with the IT/lab side than ever before to optimize the pharmacy response and integrate our team into daily surveillance of COVID patients.

On patient-related difficulties and using clinical surveillance to enhance safety

Ms. Mills: Surveillance has been the biggest challenge, specifically contact tracing. The VigiLanz system has helped by providing real-time data. We've become dependent on immediate notifications and making changes on a regular basis. Being able to modify alerts in the constantly changing environment has been key in keeping patients and staff safe.

Ms. Liberty: The biggest challenge has been receiving timely notification of positive results. Initially, the lab would notify me of positive cases, and then I would notify patients. It was difficult to effectively communicate instructions and notify patients in a timely manner. 

Dr. Courter: Surveillance and supply chain management are among our biggest challenges.  Real-time surveillance to detect when patients can be removed from protective precautions has really helped remedy those problems.

Dr. Sanchez: There's the issue of patients receiving positive test results after being discharged. Contacting patients and physicians after discharge was a very manual process. Being able to reach out immediately and divert the patient and begin tracking for possible exposure has been extremely beneficial. 

Preparing for COVID-19 surges

Ms. Mills: I anticipate this to be ongoing, specifically with the upcoming flu season. Frankly, I think it will become a lot worse. The key will be giving staff and patients the most information we can. We have the systems in place to adapt to the next changes. 

Ms. Liberty: We've developed a semi-permanent process for the COVID call center and drive-thru. We also created a subset department group with 11 staff members that will be with us for the rest of the year. We're expecting the surges to just bleed into each other. 

Dr. Courter: We have everything we need from a surveillance point. Now we're working on enforcing universal masking for all patients, visitors and employees. 

Dr. Sanchez: We were quickly able to get an anticoagulation report for all positive COVID patients from VigiLanz, and now have more patient data regarding dosing, type of prophylaxis and monitors. We were able to get a sense of what type of improvements we needed to make and have updated order sets in response.

For VigiLanz COVID-19 clinical surveillance resources, click here. To watch the full webinar, click here.   

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