Abstract
Alternate care sites (ACS) are locations that can be converted to provide either in-patient and/or out-patient health care services when existing facilities are compromised by a hazard impact or the volume of patients exceeds available capacity and/or capabilities. In March through May of 2020, Michigan Medicine (MM), the affiliated health system of the University of Michigan, planned a 500 bed ACS at an off-site location. Termed the Michigan Medicine Field Hospital (MMFH), this ACS was intended to be a step-down care facility for low-acuity COVID-19 positive MM patients who could be transitioned from the hospital setting and safely cared for prior to discharge home, while also allowing increased bed capacity in the remaining MM hospitals for additional critical patient care. The planning was organized into six units: personnel and labor, security, clinical operations, logistics and supply, planning and training, and communications. The purpose of this report is to describe the development and planning of an ACS within the MM academic medical center (AMC) to discuss anticipated barriers to success and to suggest guidance for health systems in future planning.
Highlights
At the onset of the COVID-19 pandemic, modeling estimates placed the number of cases as far-beyond the projected availability of patient beds in many areas across the United States
Termed the Michigan Medicine Field Hospital (MMFH), this Alternate care sites (ACS) was intended to be a step-down care facility for low-acuity COVID-19 positive MM patients who could be transitioned from the hospital setting and safely cared for prior to discharge home, while allowing increased bed capacity in the remaining MM hospitals for additional critical patient care
The ACS was intended for low-acuity COVID-19 patients who could be transitioned from the hospital setting, allocating bed capacity in the main hospital for more critical patient care
Summary
At the onset of the COVID-19 pandemic, modeling estimates placed the number of cases as far-beyond the projected availability of patient beds in many areas across the United States. Alternate care sites (ACS) are facilities that can be converted to provide health care services when existing facilities are compromised by a hazard impact or the volume of patients exceeds available capacity and/or capabilities.[1] By the end of April 2020, up to 28 freestanding ACS ranging from 50 beds to 3,000 beds were either under construction or accepting patients.[1]. A licensed non-profit, MM is one of the largest medical centers in the state, with 1,043 licensed beds and reporting close to 2.5 million clinic visits in 2018.2 Located in the greater Detroit (Michigan USA) area, one of the initial US hotspots, MM accepted a higher number of transfers requiring critical care, while maintaining access for other programs such as trauma and burn care. The purpose of this report is to describe the development and planning of an ACS within the MM system, and to suggest guidance for health systems in future planning by detailing an account of the efforts for establishing future ACS
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