Abstract
Coronavirus disease (COVID-19) has been identified as an acute respiratory illness leading to severe acute respiratory distress syndrome. As the disease spread, demands on health care systems increased, specifically the need to expand hospital capacity. Alternative care hospitals (ACHs) have been used to mitigate these issues; however, establishing an ACH has many challenges. The goal of this session was to perform systems testing, using a simulation-based evaluation to identify areas in need of improvement. Four simulation cases were designed to depict common and high acuity situations encountered in the ACH, using a high technology simulator and standardized patient. A multidisciplinary observer group was given debriefing forms listing the objectives, critical actions, and specific areas to focus their attention. These forms were compiled for data collection. Logistical, operational, and patient safety issues were identified during the simulation and compiled into a simulation event report. Proposed solutions and protocol changes were made in response to the identified issues. Simulation was successfully used for systems testing, supporting efforts to maximize patient care and provider safety in a rapidly developed ACH. The simulation event report identified operational deficiencies and safety concerns directly resulting in equipment modifications and protocol changes.
Highlights
As of early February 2021, about 106 million cases of coronavirus disease (COVID-19) have occurred worldwide, with approximately 27 million cases reported in the United States.[1,2]
Health care systems in the state of Rhode Island were asked to partner with the state and other agencies in creating 3 alternative care hospitals (ACHs), with the largest having a 600-bed capacity
While the development and implementation of the ACH will help alleviate the burden, these have created a new set of obstacles
Summary
As of early February 2021, about 106 million cases of coronavirus disease (COVID-19) have occurred worldwide, with approximately 27 million cases reported in the United States.[1,2] While this disease was first encountered in Wuhan, China, it has rapidly spread throughout the world, causing a global pandemic. Hospital systems have recognized the need to increase inpatient and critical care bed capacity. In order to meet this demand, many states have developed alternative care hospitals (ACHs), more commonly referred to as field hospitals. Health care systems in the state of Rhode Island were asked to partner with the state and other agencies in creating 3 ACH, with the largest having a 600-bed capacity. This ACH is located in the exhibit hall of a convention center. The design of the ACH includes 6 wards consisting of 3 to 6, 24-bed pods each, a 12-bed transition pod for decompensating patients requiring a higher level of care at the hospital system’s academic facility, and a resuscitation room for patients requiring intubation or more aggressive resuscitation measures
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