"Surge" Plan Readies Hospital for Periods of Seasonal High-Patient Volume
Each year during the winter months, St. Louis Children’s Hospital (SLCH) enters a period of several weeks when patient census is consistently close to capacity. This seasonally high patient volume often results in challenges involving resources, bed availability and patient placement that until now were met on a unit-by-unit basis.
In preparation for the 2011-2012 RSV and influenza season, a group of Washington University School of Medicine pediatric physicians and SLCH staff members have formulated a hospitalwide plan that ensures each patient receives the same safe and effective care as provided during nonpeak periods. This high patient volume or “surge” plan establishes specific strategies for various areas of the hospital.
“For instance, the 10th floor has always served as a patient overflow area when our 8th floor medical unit reaches capacity. At times, this meant as many as 10 ‘overflow’ patients or as few as two would be housed on the 10th floor,” explains Douglas Carlson, MD, director, division of pediatric hospital medicine. “Our strategy now is to keep the overflow census on the 10th floor as close to 10 patients as possible, who will be cared for by a designated care team that includes a hospitalist and pediatric nurse practitioner. In this way, we can keep beds available on the 8th floor for patients who need to be on the medical unit.”
Another example of a change resulting from the surge plan is the ability to admit infants less than 3 months of age to a designated section of the NICU when no beds are available in either the PICU or CICU. In this event, infants with any diagnosis except trauma, burns, nonaccidental trauma and confirmed RSV+ will be eligible for admittance to the NICU.
“An essential element to our surge plan is maintaining communication with referring physicians regarding availability of beds for their patients. We also will concentrate on educating families regarding the reasons we may need to move their children to other rooms in order to ensure the safest environment for them,” says Dr. Carlson.
An important tool to admitting patients as quickly as possible during times of peak patient volume is the hospital’s new computer-based Teletracking bed management system. This new software identifies bed status and other patient-care data in real time to expedite patient placement and service.
“We also are working on ways to expedite our discharge process so that patients who are ready to go home can do so as quickly as possible, thus avoiding any delays for incoming patients,” says Dr. Carlson.
Referring physicians who want updates regarding the hospital’s seasonal high patient volume status may go to the “For Health Care Professionals” section of StLouisChildrens.org. The section will explain the surge planning process, indicate when the hospital is in a surge cycle, and provide a link to the Clinical Laboratories’ weekly virus/microbiology update.
Commenting on the surge planning process, F. Sessions Cole, MD, SLCH chief medical officer says, “We are confident the actions we are taking will permit optimal care for our patients and their families, minimal disruption for staff and physicians, and maintenance of our teaching mission for our pediatric residents during times of peak patient volume.”
