Development and Implementation of an Alternate Care Site During the COVID-19 Pandemic.

Kurien Mathews,Joseph Basile,Mikhail Podlog,Brahim Ardolic,Eric Cioè‐Peña,Bartholomew Cambria,Barry Hahn,Josh Greenstein

doi:10.7759/cureus.10799

Abstract

IntroductionWith the rampant spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the subsequent pandemic of coronavirus disease 2019 (COVID-19), the need for medical resources has never been greater. In recent history, the deployment of surge medical facilities and their importance in improving the provision of crisis care became relevant. The primary objective of this study was to describe the development and implementation of an alternate care site (ACS) during the COVID-19 pandemic.MethodsThis was a retrospective, single-center study that was conducted between April 7, 2020, and May 26, 2020, of adult patients from a primary facility admitted to an ACS, labeled Staten Island University Hospital East (SIUH-E). These select patients met specific inclusion criteria for SIUH-E before transfer.ResultsDuring the operational course of SIUH-E, 813 patients were screened and 203 patients were accepted for transfer. Of the patients admitted to SIUH-E, 120 (59%) were male. The mean age was 63 years (SD = 13.91). The mean length of stay was 3.93 days (SD = 3.94). Among discharged patients, 179 (88%) were discharged to home or another long-term facility, whereas 24 (12%) patients required a transfer back to the main campus.ConclusionsIn this study, we describe the development and implementation of an alternate care surge facility during the COVID-19 pandemic. SIUH-E played a vital role in effectively caring for select COVID-19 patients, which allowed the primary facilities to treat a greater volume of higher acuity patients. The combined efforts of the state and hospital were able to create and sustain a safe, practical alternative care facility.

Highlights

With the rampant spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the subsequent pandemic of coronavirus disease 2019 (COVID-19), the need for medical resources has never been greater
This was a retrospective, single-center study that was conducted between April 7, 2020, and May 26, 2020, of adult patients from a primary facility admitted to an alternate care site (ACS), labeled Staten Island University Hospital East (SIUH-E)
During the operational course of SIUH-E, 813 patients were screened and 203 patients were accepted for transfer

Summary

Introduction

With the rampant spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the subsequent pandemic of coronavirus disease 2019 (COVID-19), the need for medical resources has never been greater. The deployment of surge medical facilities and their importance in improving the provision of crisis care became relevant. As of June 2020, the total cases in the New York City (NYC) Region are more than 210,000, whereas deaths confirmed and related to COVID-19 tower at 6,488. During the peak of the pandemic, cases within the NYC region spiked up to 1,700 patients hospitalized in a single day, with 900 patient deaths per day. This volume of patients placed a tremendous burden on the city's healthcare infrastructure. Staten Island University Hospital (SIUH), which is part of the Northwell Health System, was at the epicenter and experienced a significant patient burden. During March and April of 2020, where the case density was the highest, SIUH's intensive care unit operated at 300% capacity [1]

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