How Intermountain is preparing for a surge of patients with COVID-19

We’re acting in concert with state and local leaders and other health systems to prepare for a surge of patients with COVID-19. 

WE’RE MODELING THE SURGE

  • Intermountain monitors the progression of COVID-19 cases in our system, service area, and across the globe daily.
  • The situation is dynamic, and our model provides an updated view of what may lie ahead. It helps us plan and manage ICU capacity and resources across the system. 
  • Our model shows the impact (up to 50%) that staying home, keeping distance, and washing hands can have on the timing and severity of the surge.
  • We’re preparing in real time for various surge scenarios. We’re planning in real time. This is not a drill. 

WE’RE PLANNING IN PHASES

The first phase started when the virus began spreading in our communities. 

  • Intermountain and other health systems postponed elective procedures and non-urgent treatment. This provided the opportunity to cross-train our teams to support surge-related needs, helped preserve personal protective equipment (PPE), ventilators, and other resources, opens space in facilities for COVID-19 patients, and slows the spread. 
  • We’ve also ramped up our testing capacity to ensure we identify, isolate, and care for those with COVID-19, and support state efforts to map and manage the pandemic.

Overview of Intermountain's surge plans

  • We’re making changes to normal operations, dedicating facilities, equipment, and resources to provide the most effective care. 
  • We’re asking caregivers to be flexible, and everyone is rising to the challenge. Our top priority is safety, so caregivers can remain focused on caring for patients. 

We’re partnering with the state and communities.

We can’t do it alone. We’re working with other health systems, local and state government, and our communities to coordinate services and share resources.

Increasing staffing and capacity in our facilities

What’s happening in hospitals?

  1. We’re adding ICU and medical/surgical beds. 
  2. We’ll distribute patients and allocate resources to optimize facilities, staffing, and equipment across our system.
  3. Hospitals will keep COVID-19 and non-COVID-19 patients apart and safe. 

Here are more details about our surge plans:

  • Large hospitals (Intermountain Medical Center, LDS Hospital, McKay-Dee Hospital, Utah Valley Hospital, Dixie Regional Medical Center, and Primary Children’s Hospital) are prepared to take care of the most critically ill. These hospitals: 
    • Can care for COVID-19 patients as well as patients with other health needs.  
    • Are staffed with highly skilled intensivists, physicians, nurses, and respiratory therapists. Keeping these providers teams together helps optimize staffing resources and preserves PPE and other equipment.
  • Community hospitals can convert spaces and/or units currently used for other clinical services as needed, equipping them appropriately.
    • Community hospital ICUs can treat COVID-19 patients with less-severe symptoms.
    • The most critical patients will likely be transferred to larger facilities.  
  • Most Rural hospitals can handle small numbers of COVID-19 patients from local communities, using telehealth as appropriate; most COVID-19 patients in rural settings will likely be transferred to larger hospitals.

What about specialty hospitals?

  • The Orthopedic Specialty Hospital (TOSH) is designated as a relief-valve facility to treat medical/surgical patients who do not have COVID-19. 
    • Other facilities in the Salt Lake Valley may direct patients to TOSH for non-COVID-19 care. TOSH will be appropriately equipped and staffed for the patients it receives.
  • If necessary, we can move inpatient pediatric care to Primary Children’s Hospital.
    • Pediatric units at Riverton Hospital, McKay-Dee Hospital, and Utah Valley Hospital are prepared to reduce inpatient admissions and redirect pediatric patients to Primary Children’s in Salt Lake as necessary. 
    • Pediatric units in these three hospitals can be temporarily converted to provide adult patient care.
    • Primary Children’s is prepared to accept admissions or transfers of young adult patients up to age 30 if necessary.

How will hospitals be supported?

  • Clinics will continue to provide COVID-19 testing, urgent care visits, and primary care services.
    • Some clinics can be converted to patient rooms to support inpatient care if necessary. 
  • Clinical support services will be expanded: 
    • Telehealth can increase capacity with additional critical care providers.
    • Acute care at home services can be provided.
    • We’re partnering with skilled nursing facilities to extend care to the elderly.
    • We’ll direct care to other community facilities, coordinating as appropriate with local and state government, if necessary. 
  • Our Transfer Center (855-WE-ADMIT) uses a digital tracking board to provide a real-time view of patient beds in the Intermountain system. The Transfer Center: 
    • Is staffed 24/7 with experienced registered nurses as well as tele critical care and tele hospitalist physician “quarterbacks” who triage patients and determine bed placement in close partnership with hospital teams. This service enables us to load balance patients with beds and resources across our system.
    • Coordinates with local facilities to arrange ground ambulance transport, and will provide tele critical care consultation when Life Flight is needed. 

Supporting our care teams

Our top priority is to keep caregivers safe, working, supported, and trained to care for patients. We’re adopting new staffing strategies, introducing additional training, and making sure caregivers have the PPE they need to be safe.

  • Our surge staffing team of 70 leaders from across the system has developed an agile process that uses real-time reporting and daily huddles to match care providers with facilities, PPE, and supplies.
  • Using surge staffing projections, and to relieve caregivers, we’re training, redeploying, and activating physicians, nurses, respiratory therapists and support teams.  
  • If necessary, we'll move clinicians in administrative roles or who have recently retired back into practice, and partner with local nursing schools to hire nurses in their senior year.
  • Our clinical educators are providing additional training to clinical teams in medical facilities and online. The Intermountain Simulation Center has been fully activated for COVID-19 training 

We’ll continue to learn, plan, and evaluate as we prepare for a surge. As we do so, and our surge modeling and plans evolve, we’ll provide ongoing updates and communications. 

Managing our equipment and supplies

  • We track inventories of ventilators, respirators, masks, gowns, shields, and other PPE, and we’re working to increase supplies.
  • Standards for safely reusing and preserving PPE have been implemented across the system.
  • Live dashboards enable our supply management team to direct PPE, ventilators, and other equipment where needed.

We’ll continue to learn, plan, and evaluate as we prepare for a surge. As we do so, and our surge modeling and plans evolve, we’ll provide ongoing updates and communications.