Capacity Management & Redesigning Care Delivery
With the closure of elective procedures and surgeries and rapidly rising COVID-19 case volumes, BH needed to devise plans to accommodate a surge of critically ill and infectious patients while still delivering on care for the emergency needs of western Massachusetts.
BMC President Nancy Shendell-Falik convened a daily System Bed and Operations Huddle with over 150 operations leaders from across the system that allowed for dramatic expansion of capacity. The MassMutual and Daly buildings were identified as COVID-19 treatment zones because of favorable airflow characteristics and private rooms. The Chestnut Ambulatory Surgery Center converted into space for surgical and cardiac intensive care. In all, the model allowed for the expansion to 175 critical care beds (an over 200% increase) with additional bed capacity of up to 180 (a 40% surge).
Novel team-based models of care with cross-trained staff were implemented, and complex adaptation by support services (e.g., respiratory, pharmacy, environmental, laboratory, imaging, etc.) were also part of this complex choreography. This allowed BMC to care for 173 COVID-19 patients at the peak of the surge, while also providing care for over 400 non-COVID patients. Similar work redesign and surge planning went on in the community hospitals as well.