BWH Prepared for No Diversion with Surge Pod
With a new surge pod and additional efforts to improve operational efficiencies around inpatient admissions, unit-to-unit handoffs and patient discharges, BWH is preparing for a new Massachusetts Department of Public Health policy prohibiting emergency departments across the state from diverting ambulances beginning Jan. 1.
Under the leadership of Anthony Whittemore, MD, chief medical officer, and Mairead Hickey, PhD, RN, chief nursing officer and senior vice president for Patient Care Services, the hospital opened a 10-bed surge pod on Tower 12D to accommodate boarder patients when the hospital census peaks and excessive numbers of inpatients are boarding in the Emergency Department. The surge pod, which has seen frequent duty since its October opening, provides a more appropriate locus of care for boarders until they are able to move to their assigned inpatient unit.
“The entire hospital is gearing up to improve our practices in many areas, accommodate patient demand, and minimize the times when we have to resort to boarding inpatients in the ED,” Whittemore said.
The BWH ED received 57,504 patient visits in the last fiscal year. Approximately 27 percent of those patients presented via ambulance. The option of requesting diversion status ends Dec. 31. Diversion status applied only to those patients who were not critically ill, victims of major trauma or established patients of BWH.
The ED has several initiatives to help respond to patient demand. Three hundred forty-eight patients were admitted directly from the BWH ED to an inpatient bed at Faulkner Hospital, and the ED staff and care facilitators continue to attempt to rapidly identify patients who can avoid a BWH inpatient admission and be directly admitted to Faulkner as well as rehab and skilled nursing facilities. In addition, the ED is reviewing ED-inpatient transfer processes to expedite the time between when a patient is ready to be moved to an inpatient unit from the ED and when they actually get there.
Nursing Administration, Emergency Medicine and Patient Access Services (Admitting) collaborate on the decision of when to open the surge pod. Once the decision is made to open the surge pod, it can be ready for patients in four hours, thanks to a collaborative response from Nursing, Dietary, Pharmacy, Materials Management, Biomedical Engineering, Transport, Phlebotomy and others. Depending on need, the pod can stay open for anywhere from eight hours to several days.
“Our overall goal is to have beds available to provide the best possible care for our patients,” said Hickey. “Having the ability to open the surge pod when needed goes a long way in meeting this goal.”