St. Louis Children's HospitalEach 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. Triggers such as diagnosis types, emergency unit volume, historical data and daily census are monitored closely as we approach the typical months of the season – January through mid-April. High patient volume during this time can result in challenges involving resources, bed availability and patient placement.

For the past several months, a group of WUSM physicians and SLCH staff has been meeting to enhance our plan to insure that during patient surges (i.e. 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 surge plan is ready to implement as needed in the coming weeks as we approach the traditional time for our busy season.

We will be monitoring our surge plan triggers, including:

  • EU volume and admissions
  • Daily census
  • Second and third tier patient placements
  • Medical bed availability
  • Viral reports and isolation needs

We have developed a plan for use of the 10th floor (our surgical floor) for medical patients: 

  • We will use the surge plan between mid-January through mid-April 2016 as needed.
  • During the surge time, we will aim to maintain a census of 10 medical patients on the 10th floor.
  • We will provide medical coverage for these patients with a combination of Hospitalist APN and PL 3’s.  Attending coverage will be provided by our Pediatric Chief Residents, who have undergone credentialing.
  • We have developed a list of diagnoses for medical patients hospitalized on the 10th floor to insure optimal patient care

To permit more PICU-bed availability, monitoring capabilities are being installed into our patient rooms on 7E.  This will provide the flexibility needed to increase our intensive care bed availability when needed.  When these bed spaces are utilized as ICU beds, the PICU APN/Attending team will provide provider coverage for PICU patients.  Traditional pulmonary patients will be admitted to other units throughout the hospital in accordance with our cohorting guidelines.

Thank you for your support of these efforts to manage our patient surges in a coordinated manner, and in the best interest of our patients and families.