OVERVIEW

Over the course of these past several weeks, our area system and hospitals (Harborview Medical Center, UW Medical Center-Montlake, UW Medical Center-Northwest, Valley Medical Center, UW Neighborhood Clinics and Airlift Northwest) have been crafting a set of rapidly evolving protocols to combat the spread of COVID-19, and develop best practices to care for our COVID-19 patients.

Since the outbreak began, our colleagues, locally and nationally, have been reaching out to us for assistance as they start to see cases. We hope that by sharing our work, we can assist your teams and facilities to prepare and move more quickly.

Though the protocols are frequently being revised as we learn more, there are several ways to ready your Emergency Departments and Intensive Care Units for these patients. These include: creative approaches to staff training, improving the physical space for isolation capacity, equipment to procure/inventory, and systems for providing patient care to minimize staff exposure.

We hope you can benefit from these recommendations while you have the time to prepare yourselves and your departments. The most important and time-critical component of COVID-19 response protocol is communication.

COMMAND SYSTEM

Consider activating your incident command system. Your incident command system should include communication early and often between Emergency Departments, hospitalist services, Intensive Care Units, local and state Departments of Health (DOH), Emergency Medicine Services (EMS), leads and outreach leads to vulnerable populations (eg. local SNF, jail, homeless). In our experience, Skilled Nursing Facilities (SNF) have been particularly vulnerable.

Developing communication links with local SNFs for the purpose of creating a transportation and hospital disposition plan prevents proximately located hospitals from being overwhelmed by a single SNF experiencing an outbreak.

COVID-19 SYMPTOMS

Our institutions use the CDC’s list of COVID-19 symptoms to screen for potential patients with COVID-19:

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

GUIDE

The following Guide is a flow of ideas in the STAFF/SPACE/STUFF/SYSTEMS format of ideas to consider for department preparation.