Questions answered from Nov. 17 town hall re: COVID Surge Plan

Q: What were the ratios you were discussing? 2/3 Acute and 1/3 ICU? Can you discuss again the ratios of 2/3 acute and 1/3 ICU? How does this impact us?

A:  This number represents the mix of ICU and acute COVID-19 patients we are seeing during this recent surge. In the spring, it was about ½ ICU and ½ acute, our current numbers are 1/3 ICU and 2/3 acute.

The ratio of ICU and acute level patients matters because different patient populations require different resources. Bringing acute care physicians to care for ICU level patients would not be as beneficial as bringing critical care physicians to care for that patient population. Thus, the plan for staffing the units with appropriately qualified physician, nurses, RTs, and ancillary staff, is very dependent upon the number of patients in each level of care. We are prepared for any ratio given the design of the Pavilion A rooms. However, ICU patients require more human resources.

Q: Any plans to limit outpatient surgeries to select days of the week to open up inpatient beds?

A: Not at this time. The majority of outpatient surgeries do not require inpatient beds.

Q: Where are the patients who would typically be residing in 5 West?

A: By closing this unit, these patients will be absorbed in other locations.

Q: Where does research fall into this leveled plan?

A: The research unit (5 North) is not currently part of the surge plan. Research in general is governed by the dean and not UK HealthCare.

Q: Is Level 2 equivalent to Code Yellow?

A: No, that is only the color for the next surge level. Code Yellow is a separate response and will be initiated as determined by Hospital Incident Command.

Q: Is there a point in the surge plan where a Code Yellow would be activated?

A: Code Yellow is mentioned in the plan but will be activated by Hospital Incident Command as needed. There is no designated number of patients at this time.

Q: In the plan, is there a point when we would reestablish the field hospital?

A: Not at this time. We will use the Regional Operations Center (ROC) to help us triage patients in and out of the hospital before numbers would escalate to a level where the field hospital would be implemented.

Q: At what patient number do services other than critical care and hospital medicine start to manage COVID-19 patients.

A: There is no specific number as the plan is currently evolving based on our needs. Emails went out last week asking surgical and specialty staff to assist in caring for patients who are COVID-19 negative and would normally be admitted to medicine/pulmonary services as their resources are being focused on COVID-19 positive patients.

Q: What is Plan C? People keep mentioning it, but it doesn’t appear anyone below a senior level knows what it is. And are there opportunities to engage staff?

A: Plan C was a modified staffing plan that allowed fluctuations based off patient acuity. It involved pulling providers from 5 West, 6 East, and Good Samaritan ICU.

We are happy to share, however, with the rising numbers, we may be moving into Plan D shortly.

Q: Are there still Plans to bring the Good Samaritan ICU nurses over to the 10.200 MICU?

A: Yes, that is part of our plan, however there are units in Pavilion H that would close before this would be activated.

Q: What is your plan for redeployment of subspecialty fellows and faculty if the need arises?

A: Currently, we have no specific plan for redeployment of subspecialty fellows and faculty. However, if the need arises, subspecialty faculty and house staff may be asked to assist as needed.

Q: Does UK HealthCare have enough medical staff for a potential COVID-19 surge (as in, enough nurses for over 300 COVID patients)?

A: As numbers rise, human resources become more difficult. The more patients we have, the more medical personnel are stretched. That is why strategies like the Regional Operations Center (ROC) become so important to triage patients to appropriate hospitals and conserve UK resources for the sickest patients.