As the number of COVID-19 cases continues to rise in Colorado, Gov. Jared Polis has issued an executive order that will allow Colorado Department of Public Health and Environment to “order hospitals and freestanding emergency departments to transfer or cease the admission of patients to respond to the current COVID-19 disaster emergency in Colorado.”
Polis stated, “While we have seen indications that our efforts to “flatten the curve” are working, transmission of the virus continues to threaten Coloradans’ way of life and livelihoods and current data shows a recent increase in COVID-19 infections.
“Unfortunately, given the increase in infections,” Polis stated, “the number of persons seeking medical treatment at hospitals may far exceed the capacity of any given hospital.
“Hospitals that have reached capacity may need to cease admitting patients and may also need to transfer such patients to a separate facility without first obtaining the person’s written or informed consent for such transfer.
“The transfer of patients from hospitals that have reached capacity to other specified care facilities will combat the current pubic health emergency due to COVID-19 and promote public health,” the executive order stated.
In Chaffee County, Heart of the Rockies Regional Medical Center usually has a total of 25 beds available. That includes 19 in the medical-surgical unit, two in the intensive care unit and four in the family birthing center.
HRRMC marketing and public relations director Allison Gergley said that number could be expanded using 14 beds available in the post anesthesia care unit for non-COVID-19 patients and two operating rooms could be converted into negative pressure rooms to supplement the two negative pressure rooms in the ICU.
That would bring the total number of beds to 41.
In the event of a surge in Chaffee County, Gergley said incident command leaders at the hospital have been developing a comprehensive preparedness strategy drawn from HRRMC’s facilities-wide pandemic experiences during the spring and summer, and guidance from the Centers for Disease Control and Prevention and state public health.
Triggers for preparedness activation have been identified based on several factors, such as patient volumes, COVID-19 volumes, staffing and supplies.
Detailed plans have also been in development for full, partial and limited scopes of work for all service lines Gergley said.
Based on those activation triggers, the hospital would move to limit or stop several elective services, such as clinic visits, elective surgeries and some procedures, as well as elective rehab appointments.
Many of those would be determined on a case-by-case basis.
Gergley said, “If we do need to limit in-person appointments to our clinics, we can very quickly and efficiently increase our volume of Telehealth appointments, which we established in the spring.”
She said with increased hospitalized patients across the state, HRRMC has worked closely with the Western Healthcare Alliance and the Colorado Hospital Association in cooperation with state public health to develop transfer plans and timely transport as a priority.
In the spring many employees were doing alternate duties as needed within their qualifications when many services were suspended during the stay at home level of precaution.
If activation triggers prompt closure or limitations of some services that labor pool may be reactivated.
“We have built a list of cross-trained employees whose expertise can be utilized across more than one department,” Gergley stated.
For example a clinical neurology nurse who has a background in emergency medicine may be utilized in the emergency department if the neurology clinic limits seeing patients in-person.
Keeping staff and patients safe a is the priority at the hospital. That includes making sure the hospital has a good supply of personal protective equipment (PPE).
The medical center’s materials management department works directly with Cardinal Health which accepted the hospital into their new PPE program, which guarantees a supply of high quality PPE, available over a 12-month period.
The materials management department plans and anticipates all future PPE needs in advance with a supply spreadsheet updated daily to identify and prioritize needs Gergley said.
Each day before starting their work shift, each employee is actively screened, which includes having their temperature taken and being asked several symptom questions before being cleared for work.
Since the beginning of the pandemic there have been 16 cases of COVID-19 among HRRMC staff, from outside the hospital.
Gergley said the medical center encourages employees to communicate with their managers and employee health anytime they have any type of symptom, COVID-19 or non-COVID-19 related.
Employee health and human resources track employees’ COVID-19-related status and needs. Remote work options are offered where it is a viable option.
“We also continuously reiterate several messages to employees, as we all continue to feel pandemic fatigue nationwide. Many of these include staying home if you are sick, wearing your mask, practicing social distancing and hand hygiene. We’ve hosted five virtual town halls for all employees since the pandemic started as a platform for resources and questions,” Gergley said.
“We would like the community to know that we are prepared and can adapt quickly and nimbly to our situation based on our experiences from this spring and summer. We feel that everyone in this community contributes to keeping us all safe,” she said.