How a New York City hospital converted its ORs into ICUs

At the height of the coronavirus surge in New York City, NewYork-Presbyterian Weill Cornell Medical Center found itself in a situation where demand for intensive care unit beds far exceeded its capacity, leading the hospital to convert operating rooms and other units into ICUs, physicians from the hospital wrote in an article for the New England Journal of Medicine.

In late March, the hospital decided to convert ORs and post-anesthesia care units, which were free because elective procedures had been postponed, to ICUs where possible. By doing so, the hospital was able to add 60 beds for critically ill COVID-19 patients who needed ventilators, increasing the hospital's ICU capacity by 52 percent.

The hospital selected ORs and PACUs that were best suited for being turned into ICUs based on their size, location and available infrastructure. They reversed the airflow of certain ventilation systems and implemented high-efficiency particulate air filters over exhaust vents in the selected ORs and PACUs. They also repurposed some OR equipment to assist with critical care, such as suction canisters and storage carts, and used the hospital's existing ICU inventory lists to fill shelves and medication-dispensing systems with the necessary supplies and medications.

In addition, the hospital retrained all available perioperative staff and deployed them to the new ICU areas. For example, certified registered nurse anesthetists familiar with anesthesia machines served as respiratory therapists, and anesthesia intensivists supervised the new ICUs.

"This transformation of ORs and PACUs to ICUs has allowed us to support the needs of our surrounding community while also permitting an influx of patients from other hospitals in New York City that were operating over capacity," the physicians wrote.

More articles on patient flow:
New York hospital closes emergency department
Northwell opens ventilator recovery units at 2 hospitals
LA Surge Hospital to close in June

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