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Preparing the Health System for the Pandemic

In This Article

  • Battling the COVID-19 pandemic requires health care coalitions to bring together health systems and local and regional partners to develop frameworks of consistent care
  • Health care providers must be creative in finding underutilized facilities and resources and developing innovations to protect against shortages in supplies

In The New England Journal of Medicine, Paul Biddinger, MD, chief of the Division of Emergency Preparedness and director of the Center for Disaster Medicine at Massachusetts General Hospital, co-authors a perspective piece on steps health care providers and public health officials should be taking during the COVID-19 pandemic.

Dr. Biddinger and co-author John L. Hick, MD, emergency medical physician at Hennepin Healthcare, outline the two major strategies to flatten the curve: encouraging population-based interventions and creating frameworks that support a consistent level of care.

Below are the actions that health care organizations should prioritize to provide immediate relief and to protect health care systems from future pandemics:

  • Establish an incident command center: This pandemic is a long-term dynamic event that requires well-developed principles of incident action planning and the concepts of crisis standards of care. Hospitals should put in place plans for volume-based adjustments to care in all service lines, balancing demand and focusing resources on acute care
  • Expand access to diagnostic testing: Hospitals, along with public health efforts, need to rapidly increase access to diagnostic testing through commercial, hospital and public health laboratories. Rapid testing is needed to manage the influx of patients seeking care. Guidance is needed from public health officials to determine which patients need testing and which can safely stay home
  • Expand inpatient critical care: Health care providers should follow the American College of Chest Physicians' staged plan to meet the need for increased critical care beds. Processes must be implemented in order to tackle the expected shortage of apex therapies and medical equipment as well. Planning for long-term care, alternative care sites and home-based care may aid in bearing the burden of discharges, freeing up more space for inpatient critical care
  • Protect health care workers: In order to protect health care workers, conservation measures must be taken to provide enough masks and protective equipment despite global shortages. In order to fully meet the demands of a strained health care system, providers should enlist the help of convalescent community volunteers, family members and ancillary personnel to reduce the stain on health care workers
  • Augment resources: Excess capacity should be utilized in areas where COVID-19 is not as prevalent to provide outpatient and inpatient support. Creative use of space and resources can be utilized in areas that are experiencing decreases in demand such as in pediatrics, specialty clinics and elective procedures

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