By Ana Kelegama, MD, MBA, Medical Director
When South Florida’s first wave of COVID-19 cases arrived nearly a year ago, we had very little idea about how the virus behaved or progressed. Frontline clinicians were challenged to treat sick patients inflicted with an infectious disease we knew very little about. However, understanding the virus was only part of our challenge. Well before COVID-19 began to surge in the United States, clinicians and administrators began preparing for surges in patient load. These preparations allowed us to evolve and respond in real time as COVID-19 cases surged and receded in South Florida, saving lives and preserving precious resources along the way.
In January 2020, my colleagues and I partnered with our health system’s administration to prepare for a forthcoming wave of COVID-19 cases. As our lead for COVID-19 operations, I managed a team that had to tackle several challenging questions: how do we move patients from the emergency room to a bed without exposing other patients? How do we minimize clinician exposure? How do we manage personal protective equipment, such as masks, face shields and gloves?
One year ago, as the pandemic came into full focus in the midst of a peak daily case load, these were relatively easy questions to answer. By summer, when cases spiked to 120 a day, our preparations and flexibility became essential. We went from one or two COVID-19 units at the hospital to five. An existing pre-operative area was turned into a COVID ICU, while another unit was converted to hospice care. We reconfigured rounds so physicians were more efficient, seeing as many patients as possible. We isolated COVID-19 patients and committed to one patient per room to protect the rest of the hospital. We also quickly realized vectors that spread the disease rapidly, such as nursing homes. When we received a patient from a particular facility, a task force within our hospital would work directly with the nursing home to mitigate spread.
TeamHealth committed significant resources to the system’s pandemic response. Our Emerging Infectious Disease Task Force offered best practices for treating patients and managing hospital capacity, incorporating the experiences of clinicians across the country to assist with COVID-19 response. When our clinicians were stretched thin, TeamHealth deployed additional clinicians to provide relief.
Today, we find ourselves still managing a high COVID-19 case load, and we still don’t know how or when this pandemic will truly end. We do know, however, that we are better prepared to deal with COVID-19 today thanks to both our learned experiences and the steps we took at the outset to prepare ourselves. While we might not know what waits around the corner, we can be certain that this pandemic will not be the last major health event that strains our system and presents unique challenges for clinicians and administrators.
In many ways, South Florida was ground zero for the hospital strain that affected much of the country. Thanks to forward-thinking leadership, we tackled these challenges and protected both patients and clinicians – during this pandemic and beyond.
Dr. Ana Kelegama is a TeamHealth hospital medicine clinician and the Vice Chief of Medicine at her client facility in South Florida. Download the PDF version of this article.