Weekly virus/microbiology update
Surge Plan
A team of Washington University and St. Louis Children's Hospital physicians and staff members has been working to formulate a plan to ensure that during patient surges, periods when our resources are stretched due to high census for an extended time, we can maintain our usual high quality of care and avoid multiple room changes for patients and families.
The following surge plan is ready to implement as needed as we approach the traditional time of our busy season, mid-January through mid-April.
- Watch closely for indicators to trigger the surge plan, including diagnosis types, emergency department volume, historical data and daily census.
- Implement plan for use of the 10th floor (surgical floor) for medical patients, including:
- During the surge time, aim to maintain a census of ten medical patients on the 10th floor
- Preferentially admit to fill these beds during daytime coverage hours
- Provide medical coverage for these patients with a combination of hospitalist APN and 8E interns
- We have developed a list of diagnoses for medical patients hospitalized on the 10th floor to ensure optimal patient care
- During patient surges, the newborn intensive care unit (NICU) may flex to admit eligible infants to the NICU referred from the emergency unit (EU). Infants will be admitted to the NICU from the EU only if no beds are available in pediatric intensive care unit (PICU) or cardiac intensive care unit (ICU), and all such NICU admissions will be hospitalized in the NICU "A" room for these patients. Eligible patients include:
- Infants less than 3 months of age
- Any infant diagnosis except trauma, burns, non-accidental trauma, confirmed RSV+ or any respiratory symptoms
- The PICU and CICU will use a census-based system proactively to identify appropriate patients for unit transfer should it become necessary to free ICU beds during surges. We will use a worksheet/checklist continuously maintained by a charge nurse for early notification of parents, consulting services, and primary pediatricians and for identification of a target unit/bed for each patient deemed suitable for transfer. The PICU and CICU have also developed a plan to enhance coordination among the PICU, CICU, anesthesia and surgery should it be necessary to evaluate delaying start times for elective surgery for children who will require recovery in either the CICU or PICU. For example, when multiple trauma cases utilize necessary clinical capacity.
- The new TeleTracking bed management system will allow us to have a real-time, facility-wide view of our bed situation, with faster room cleaning and patient placement. We can also use the system to assess and prepare for scheduled admits several days in advance.
