4 lessons on pandemic preparedness from NYC emergency physicians

More than a dozen emergency medicine physicians from New York City hospitals reflected on their response to last spring's COVID-19 surge and identified many opportunities to improve crisis planning in a Feb. 25 report from the Johns Hopkins Center for Health Security in Baltimore. 

In October 2020, Johns Hopkins convened 15 intensive care unit directors from New York City hospitals to discuss how they implemented crisis standards of care last spring. The critical care physicians shared numerous lessons and suggestions to improve crisis standards of care, a summary of which you can find here.

On Jan. 8, Johns Hopkins hosted a follow-up meeting with 13 emergency physicians, among other stakeholders, to share more observations. Below are four.

1. The pandemic took hospitals and health systems by surprise, and most clinicians and administrators were unfamiliar with crisis standards of care. Physicians said it was hard to effectively convey the gravity of the situation to administrators or other people who were not experiencing the COVID-19 surge firsthand. 

2. None of the hospitals represented at the meeting had a crisis plan that was ready to be implemented when the pandemic hit. Emergency physicians said they were also excluded from boardroom discussions about crisis standards of care, which they said had adverse effects for their emergency departments.

3. Patient load-balancing did not occur among hospitals last spring. This effort needs to be better coordinated both within healthcare organizations and among those across New York during a crisis, the group said. 

4. ED staff was often redeployed to other areas of the hospital, even though EDs were sometimes overwhelmed with COVID-19 patients. The redeployments occurred because overall ED volume was much lower than normal due to a dip in usage among non-COVID-19 patients. 

To view the full report, click here.

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