Physicians: Here’s how hospital prepared

Chang

Zinggeler-Berg

Mantilla

York

Strait

Hoopman

Scoggins

| March 26, 2020 1:12 AM

As members of the only Pulmonary and Critical Care physician group in northern Idaho, with the responsibility of caring for the patients in the Critical Care Units at Kootenai Health, we believe it is important to inform the public about our preparations for COVID-19 at Kootenai Health.

Preparations began three-and-a-half weeks ago at Kootenai Health for patients with COVID-19 infections. At that time we were unsure about the potential burden this pandemic could place upon the hospital, its staff and the community. It became clear that we needed to prepare for a large number of infected patients with the potential for a large number of critically ill patients. Critically ill patients affected by COVID-19 require significant resources including health care workers, ICU hospital beds, ventilators, and personal protective equipment (PPE). As so many other hospital systems across the country and the world have indicated, we can expect to be limited in all of those critical supplies and resources.

Why this is critical

Due to rapid community expansion and an aging population with increased health needs, Kootenai Health’s 26-bed critical care unit is near maximum capacity most days, even without any COVID-19 infected patients. We deal with common infections such as Influenza and bacterial pneumonias on a regular basis. We also help provide care for critically-ill patients with traumatic injuries, stroke, complex surgical issues, and patients with cardiac issues including heart attacks and coronary bypass surgery.

The providers and patients of Kootenai Health are blessed with a high-functioning critical care unit filled with an enthusiastic, well-trained and highly intelligent nursing staff and respiratory therapists. Our critical care processes are built around handling this fairly consistent, but high volume of critically ill patients, which we experience year after year.

The challenge we face, and the crisis currently experienced across the country and the world, is that with the rapid spread of the COVID-19 illness and a likely surge of critically ill patients in a short period of time, we can expect to experience a shortage of resources like nothing we have ever seen.

Preparation paying off

When the reports of COVID-19 infections in the Seattle area were first reported, Kootenai Health switched into high gear with its preparations. Kootenai Health was the first in the region to institute a screening system for its emergency department, establish a drive-through testing station, cancel elective procedures to preserve resources, and develop a plan to care for as many patients as possible in the hospital.

Close work has been done with Panhandle Health District to develop a community plan and assess resources daily. There has been a coordination meeting of all the health care entities in the region occurring on a daily basis for the last few weeks. While the majority of these preparations have taken place out of view of the community, we can assure everyone that these efforts have been thoughtful, professional, and carried out with the intention to meet this challenge and emerge stronger as an institution and a community.

The COVID-19 pandemic has required “outside the box” approaches to medical issues that four weeks ago we would not have even fathomed. We have plans to expand our critical care unit, utilize every possible ventilator in the region, provide PPE for our staff, and continue to replenish the supplies we need.

As a result of excellent hospital leadership, we were able to begin the planning early and feel we are ahead of many hospitals in the country. We have not run out of vital N95 masks, gowns, or testing materials due to policies that were put into place early.

We have established COVID-19 units in the hospital to cohort suspected patients and are training a large number of our nursing staff to care for these patients. Fortunately, we are experiencing lower-than-expected positive reported cases, which affords us valuable additional time to plan, prepare, and refine processes.

We are in constant contact with hospitals, physician colleagues, and nurses around the country who are already dealing with infected patients to help us learn from their experiences. We cannot promise that all will go smoothly and that we will be perfect. We can promise that we will work vigilantly to prepare for and tirelessly care for those affected by COVID-19.

Community response is key

At this time, we ask the community to help us and support the health care system of northern Idaho. Adhering to the social distancing guidelines and utilizing good infection prevention measures published by the Centers for Disease Control and the federal government may mean the difference between our ICU having enough ventilators or not.

We are proud members of this community and just like all of you, we live, work, and play in the beauty of northern Idaho. We are honored to work at Kootenai Health alongside the greatest nurses, respiratory therapists, hospital staff, and employees we have ever encountered. We are privileged to be trusted with the care of our community at such a critical time.

We will continue to show up every day despite the challenges we will face. The nurses, respiratory therapists and hospital employees beside whom we work will continue to show up every day to care for everyone who has been affected. We implore everyone in the community to do their part to help reduce the spread of COVID-19. Please listen to the experts, follow the guidelines, and become an unseen member of our team.

Robert Scoggins MD, PhD