Area hospitals prepare for surge

Emergency Department nurses at UM Shore Medical Center at Easton shared a message of concern with the public.

CAMBRIDGE — Hospitals on the Eastern Shore have been preparing for an influx of patients infected with COVID-19. University of Maryland Shore Health System and Peninsula Regional Health System have conducted drills, set up tents and begun treating patients.
Relatively few Shore residents have been hit by the new strain of coronavirus, to which humans have no immunity. Most cases in Maryland have so been on the western shore.

Shore Health
But with the disease spreading exponentially, work have been underway at local hospitals to get ready for many more patients.
University of Maryland Shore Regional Health (UM SRH) is intensely engaged in planning to care for the community in the event of an influx of patients needing hospital care as result of the possible impact of COVID-19, a statement from the organization said Friday.

As of Friday, in all UM Shore Regional Health locations, the overall number of hospital admissions and emergency department visits are down, largely due to messages from the community and media that have helped to direct concerned people to the appropriate community provider settings and reduce unnecessary hospital volumes.

UM SRH operates facilities in Cambridge, Easton, Chestertown and Queen Anne’s County. Planning for a potential surge of patients at the hospitals began more than a month ago and continues to evolve on a daily basis.
“As part of University of Maryland Medical System, Shore Regional Health is actively preparing for the presence of COVID-19 in our communities,” said Ken Kozel, UM SRH president and CEO. “Every day, our medical and nursing staffs and team members in every aspect of our health care system, are working together to plan for various contingencies in the event of a surge of patients who need hospitalization.”

Key developments
• Enacted system-wide (UMMS) and regional (UM SRH) incident command structures in mid-February staffed by appropriate personnel to coordinate resources and direct actions for the entire organization in relation to COVID.

Duties include:
• Monitoring the rapidly changing state, national and global, COVID situation.
• Real-time monitoring of staff availability, supplies and bed capacity in the hospitals in Cambridge, Easton and Chestertown.
• Preparing to maximize surge capacity in all three hospitals.
• Participating in planning efforts undertaken by local government and health officials in all five counties, and keeping in daily contact with those officials.
• Postponed all elective, non-emergent surgeries and procedures, beginning March 18 to managing a potential increase in patient volume. This action was designed to provide additional capacity for UM SRH hospitals to treat those patients in greatest need.
• Revised visitor policy, effective March 19, prohibiting all visitors into the hospitals unless they have a special exception.
• In partnership with UMMS, created a fully staffed 24/7 Nurse Hotline to answer COVID-19-related concerns. That number is 1-888-713-0711.
• Erected tents adjacent to the three hospital emergency departments and the Emergency Center at Queenstown. While not in use Friday, these tents could serve a variety of purposes should the need arise; in particular, they may be used to expand Emergency Department triage capacity in the evaluation and treatment of patients for fever and upper respiratory symptoms.
• Consolidated laboratory and imaging services at certain locations to maximize efficient use of resources and deployment of staff.
• Ceased all elective/non-urgent imaging at all facilities, effective March 25. Only critical imaging is being performed. Critical imaging services include: trauma, oncology, infection, ischemia, acute bleeding, and acute neurologic changes. Other requests are reviewed on a case-by-case basis by radiologists. Affected patients are being contacted directly regarding cancelled appointments and rescheduling options.
• Shore Regional Health has identified its surge expansion plans at all inpatient and emergency facilities. As of March 25, the system has the ability to double inpatient capacity and quadruple ICU capacity across the system if needed.
• On Friday, March 27, conducted a drill at UM Shore Regional Health’s four emergency departments to test and evaluate the functionality of the triage tents in the event of a surge in patients requiring hospitalization.
“Shore Regional Health conducted a drill to test and evaluate the operational effectiveness of the triage tents located at our four emergency departments,” William H. Huffner, MD, senior vice president, Medical Affairs and chief medical officer said on Friday. “As a routine aspect of our operation as a health-care system, emergency drills enable us to identify the strengths and weaknesses of emergency plans, and this one was very useful in that regard. Our medical and nursing care providers and a wide range of support personnel worked together to put our strategy for the tents in use and ensure that in the event of a patient surge, our plans can be operationalized seamlessly.

“We also are in close and continuous contact with our state and county health departments, emergency management officials and a host of community organizations that are all working in concert to help minimize the spread of the virus and to assist vulnerable populations in need of food, shelter and transportation during this time,” Mr. Kozel said.

Peninsula Regional
Peninsula Regional Health System (PRHS), including Peninsula Regional Medical Center and Nanticoke Memorial Hospital, began canceling elective, non-emergency surgeries on March 23, as a part of the overall strategy to conserve and direct resources to the highest areas of need.
“Not every surgery will stop,” a statement from the system said. “It means that all surgeries will be evaluated and those that can be canceled will be. Patients will be notified ahead of time.”

PRHS suspended all inpatient visitation beginning on March 20 at both Peninsula Regional Medical Center in Salisbury, and Nanticoke Memorial Hospital in Seaford, Delaware.
Also on March 20, PRMC announced that a portable hospital had been erected to help handle a surge. The facility, set up in a parking lot, has heat, air conditioning, basic medical supplies and 20 cots.
The tent measures 22 feet wide and 70 feet long and is wind rated up to 70 miles per hour. It is the only inflatable regional medical station on the Eastern Shore, the statement said.

An update from PRHS dated March 25 contained the following points:
• Many outpatient services are closing temporarily to help everyone observe social distancing.
• Many non-emergency surgeries and procedures are being canceled.
• Patients coming to the Emergency Department will be triaged outside the building and those with COVID-19 symptoms will be further evaluated in a separate triage tent.
• All patients will be verbally screened for COVID-19 risk.
• All of the Health System’s public events, classes and support groups are canceled.

Helpful Coronavirus links

Maryland Department of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage

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