In the wake of the COVID-19 pandemic outbreak, health care organizations across the country have found themselves overburdened and under-supplied.
That being said, as the Washington State Hospital Administration points out, hospitals throughout the United States were not totally unprepared to face this crisis. Here is a sampling of preparedness measures in place:
- Medical facilities around the country conduct emergency preparedness training year-round.
- Medical professionals treat patients with infectious diseases every day and so have protocols in place to protect hospital personnel and patients alike from contagious pathogens.
- Medical facilities network with each other, their state's Department of Health, and the CDC.
- State governors are aware of hospital capabilities and will take measures to ensure that people with infectious diseases are directed to medical facilities that can provide adequate treatment. For example, as ProPublica reported in February, New Jersey Governor Phil Murphy directed possible Coronavirus cases from a cruise ship to University Hospital in Newark since the hospital has isolation rooms to safely care for those with contagious diseases.
Regardless of these measures, hospitals have found themselves facing operational challenges associated with COVID-19.
What Challenges are Hospitals Facing?
As Vox reports, hospitals in hard-hit states are running out of ventilators and vital medications. Medical professionals are coming down with the coronavirus as they treat sick patients, so many hospitals are also facing shortages of personnel. What's more, many hospitals are hamstrung by political squabbling as states bid against other states in a race to get ahold of scarce supplies. To make matters worse, Modern Health Care has found that some supplies kept in high-traffic areas have been stolen, leading many hospitals to move PPE and other items to secure storage facilities in the hospital. These supplies are often kept under lock and key, accessible only to supervisors and others in charge of dispensing medical equipment to authorized workers.
It should be noted that, in almost all cases, the shortfalls that hospitals are facing in caring for the sick are not the fault of hospital administrators. There is no way to know when and how a pandemic will hit months or years in advance. While there were warning signs that COVID-19, which began in China in December 2019, would eventually hit the United States, there was no way to adequately prepare for the scenario that hard-hit states across the U.S. are facing. Even so, there are some important lessons that can be learned from the current situation.
Future hospital administrators can, however, learn some valuable lessons from this situation. Providence Health care in Washington offers a good example of what to do in a crisis situation. The health care provider restricted hospital visitors in mid-March and opened a separate clinic for COVID-19 patients on March 19. On March 24, the SW Washington Branch announced that it was postponing elective procedures, canceling most Providence outpatient rehabilitation services, and suspending most outpatient tests. The health care provider has continued to provide updated guidance to ensure that its medical professionals are able to safely and adequately care for COVID-19 patients without endangering others.
In many cases, state governments are working with hospitals to set up temporary treatment areas, a move that, according to the New York Times, was facilitated by the Federal Government relaxing guidelines on what can be counted as a hospital. The ability to set up additional hospital space is a godsend as it enables medical care providers to provide additional treatment facilities to large numbers of sick people. Even so, this option comes with additional challenges. Medical personnel will need a safe, clean place to rest and eat. The hospital will need to have plans in place to prevent unauthorized visitors from entering the premises. Furthermore, a hospital administrator will need to ensure the makeshift hospital can be packed up and the area cleaned and restored.
What Can Be Done Differently in the Future?
The John Hopkins Center for Public Health offers invaluable guidance for hospital administrators who want to prevent future problems. As the center accurately notes, hospitals should assume that re-supply may be difficult during a pandemic and so stockpile enough masks to last for three weeks. The same could likely be applied to other forms of PPE, bearing in mind that the PPE with the highest level of protection is what should be purchased.
JH also recommends “cohorting,” a practice that involves limiting the number of doctors and nurses exposed to the pandemic by staffing COVID-19 units at minimal levels. Overtime and long shifts ensure that only a limited number of medical professionals are exposed to the coronavirus; ideally, these medical professionals should be individuals who have already caught and recovered from COVID-19. John Hopkins also recommends "just in time" education and "buddy teaming" for hospitals facing a shortage of qualified personnel. These systems make it possible for medical professionals who don't have the training and/or experience needed to treat COVID-19 patients on their own to learn how to do it partnering with trained, qualified doctors and nurses. Hospitals would do well to create programs and systems to allow medical professionals who need additional training to receive this training on the go, thus preventing personnel shortfalls that would hamper a facility's ability to provide care and treatment to sick patients.
Devising New Ways of Testing
Another important aspect in the fight against the novel coronavirus is the development of and participation in studies that can help combat it. In partnership with the Los Angeles County Department of Public Health, USC Price School’s Neeraj Sood is spearheading a study that is testing for antibodies to the virus causing COVID-19. The study tests a randomly selected group of people every few weeks for several months with the end goal of better understanding how the virus has spread, the mortality rate associated with infection and the immunity levels that could exist in the population.
Studies like this one are critical to understanding the virus and ultimately getting control over it. Additionally, it could help hospitals better allocate resources:
“Think about health care workers on the frontlines. Some might have antibodies, and if they know that they have those antibodies, they’ll feel less anxious. I’m all for testing health care workers if it can reduce their anxiety and the anxiety of their families.
If there is a shortage of personal protective equipment and there’s only one mask, who do you want to wear that mask? The person with antibodies or a person without antibodies? Ideally, you want everyone to wear a mask. But if there is a shortage, this also might help prioritize limited resources to certain individuals.”
Early results of the testing revealed that “a surprising number” of residents had actually already been infected with COVID-19 – meaning that the fatality rate associated with infection might be lower than initially thought.
USC President Carol L. Folt and Professor Neeraj Sood recently joined mayor Eric Garcetti at a COVID-19 briefing to discuss how the results and impact of this study could also extend outside the health care realm. It could help get the population one step closer to “normal.” Slowly, people with antibodies could lead the population in returning to work.
A Lesson to Learn
For aspiring health care leaders, there has never been a better time to experience real-world lessons. Combining your Executive Master in Health Administration curriculum with attention to how medical centers and hospital administrators are handling the COVID-19 pandemic can help you learn from important successes and shortfalls. Observing how to handle such a medical emergency in real life can help future hospital administrators know what to expect should a local or national medical emergency occur at some point in the future.