tetano
Editor, Senior Moderator
Health Aff (Millwood)
. 2020 Jun 11;101377hlthaff202000901.
doi: 10.1377/hlthaff.2020.00901. Online ahead of print.
Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic
Amit Uppal[SUP] 1 [/SUP], David M Silvestri[SUP] 2 [/SUP], Matthew Siegler[SUP] 3 [/SUP], Shaw Natsui[SUP] 4 [/SUP], Leon Boudourakis[SUP] 5 [/SUP], R James Salway[SUP] 6 [/SUP], Manish Parikh[SUP] 7 [/SUP], Konstantinos Agoritsas[SUP] 8 [/SUP], Hyung J Cho[SUP] 9 [/SUP], Rajneesh Gulati[SUP] 10 [/SUP], Milton Nunez[SUP] 11 [/SUP], Anjali Hulbanni[SUP] 12 [/SUP], Christine Flaherty[SUP] 13 [/SUP], Laura Iavicoli[SUP] 14 [/SUP], Natalia Cineas[SUP] 15 [/SUP], Marc Kanter[SUP] 16 [/SUP], Stuart Kessler[SUP] 17 [/SUP], Karin V Rhodes[SUP] 18 [/SUP], Michael Bouton[SUP] 19 [/SUP], Eric K Wei[SUP] 20 [/SUP]
Affiliations
Abstract
New York City (NYC) has emerged as the global epicenter for the COVID-19 pandemic. The NYC Public Health System (NYC Health +Hospitals, NYC H + H) was key to the city's response because its vulnerable patient population was disproportionately affected by the disease. As cases rose in the city, NYC H+H carried out plans to greatly expand critical care capacity. Primary ICU spaces were identified and upgraded as needed, while new ICU spaces were created in emergency departments (EDs), procedural areas, and other inpatient units. Patients were transferred between hospitals in order to reduce strain. Critical care staffing was supplemented by temporary recruits, volunteers, and military deployments. Supplies to deliver critical care were monitored closely and obtained as needed to prevent interruptions. An ED action team was formed to ensure that the experience of frontline providers was informing network level decisions. The steps taken by NYC H+H greatly expanded its capacity to provide critical care during an unprecedented surge of COVID-19 cases in NYC. These steps, along with lessons learned, could inform preparations for other health systems during a primary or secondary surge of cases. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the manuscript. The final edited version will appear in an upcoming issue of Health Affairs.].
Keywords: Access to care; COVID-19; Coronavirus; Emergency departments; Health care providers; Health policy; Health system; Hospitals; Intensive care; Intensive care units; Nurses; Pandemics; Patient care; Public health; Safety net hospitals.
. 2020 Jun 11;101377hlthaff202000901.
doi: 10.1377/hlthaff.2020.00901. Online ahead of print.
Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic
Amit Uppal[SUP] 1 [/SUP], David M Silvestri[SUP] 2 [/SUP], Matthew Siegler[SUP] 3 [/SUP], Shaw Natsui[SUP] 4 [/SUP], Leon Boudourakis[SUP] 5 [/SUP], R James Salway[SUP] 6 [/SUP], Manish Parikh[SUP] 7 [/SUP], Konstantinos Agoritsas[SUP] 8 [/SUP], Hyung J Cho[SUP] 9 [/SUP], Rajneesh Gulati[SUP] 10 [/SUP], Milton Nunez[SUP] 11 [/SUP], Anjali Hulbanni[SUP] 12 [/SUP], Christine Flaherty[SUP] 13 [/SUP], Laura Iavicoli[SUP] 14 [/SUP], Natalia Cineas[SUP] 15 [/SUP], Marc Kanter[SUP] 16 [/SUP], Stuart Kessler[SUP] 17 [/SUP], Karin V Rhodes[SUP] 18 [/SUP], Michael Bouton[SUP] 19 [/SUP], Eric K Wei[SUP] 20 [/SUP]
Affiliations
- PMID: 32525713
- DOI: 10.1377/hlthaff.2020.00901
Abstract
New York City (NYC) has emerged as the global epicenter for the COVID-19 pandemic. The NYC Public Health System (NYC Health +Hospitals, NYC H + H) was key to the city's response because its vulnerable patient population was disproportionately affected by the disease. As cases rose in the city, NYC H+H carried out plans to greatly expand critical care capacity. Primary ICU spaces were identified and upgraded as needed, while new ICU spaces were created in emergency departments (EDs), procedural areas, and other inpatient units. Patients were transferred between hospitals in order to reduce strain. Critical care staffing was supplemented by temporary recruits, volunteers, and military deployments. Supplies to deliver critical care were monitored closely and obtained as needed to prevent interruptions. An ED action team was formed to ensure that the experience of frontline providers was informing network level decisions. The steps taken by NYC H+H greatly expanded its capacity to provide critical care during an unprecedented surge of COVID-19 cases in NYC. These steps, along with lessons learned, could inform preparations for other health systems during a primary or secondary surge of cases. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the manuscript. The final edited version will appear in an upcoming issue of Health Affairs.].
Keywords: Access to care; COVID-19; Coronavirus; Emergency departments; Health care providers; Health policy; Health system; Hospitals; Intensive care; Intensive care units; Nurses; Pandemics; Patient care; Public health; Safety net hospitals.