Leadership planning for COVID-19

Jason Moretz, MHA, BSN, RN, CEN, CTRN, Associate Director, BRG | Prism Healthcare, Emergency Department Optimization Team Lead -

COVID-19’s spread across the United States has prompted emergency departments (ED) to address overcrowding and surges in visits related to viral and flu-like symptoms.

This comes at a time when the regular influenza season is still impacting ED volumes and throughput. Organizations can plan for or implement simple, yet thoughtful, processes to prepare for an increase in census.

  • Implement marketing campaigns to educate patients on the proper care locations for their illness(es).

    • Most cold/viral/flu patients do not require an ED visit. Create messaging strategies to direct patients to other care locations, such as urgent care or telehealth visits, to reduce unnecessary ED visits. This also helps limit hospital staff’s exposure to these viruses.
  • Review staffing models to determine the ability to expand staffing, if necessary.

    • Facility staffing models are not typically built for the “what ifs.” Determine the ability to expand staffing by calling in extra staff, creating additional shifts, or activating a disaster response plan. Developing an on-call schedule for departments, such as the ED, for short periods of time could also be prudent.
  • Ensure that you have a surge plan ready if your facility does become overcrowded, and that hospital leaders are educated in its operation. Remember that ED overcrowding and surges are not an “ED challenge,” but a health system challenge.

    • A surge plan provides actions that occur when the facility hits predetermined trigger points of crowding. Trigger points typically include inpatient census, planned surgical cases, ED volume, and/or NEDOCS (National Emergency Department Overcrowding Score). During creation of the plan, hospital leadership will determine actions to be taken, which may include opening ancillary care units, decreasing or eliminating meetings to free up leadership, and opening a hospital command center.

While COVID-19 is the springboard for surge planning right now, these plans are appropriate interventions for the seasonal flu also. The more pre-planning and education are provided to leadership and staff, the better equipped your facility can be to ensure a less-chaotic event, should it occur.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions, position, or policy of Berkeley Research Group, LLC or its other employees and affiliates.

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