Lisa Bagley, RN, TOSH nurse administrator, says TOSH teams are ready to help sister hospitals and the community.
TOSH was ready to begin taking non-COVID patients on Wednesday to help load balance Intermountain’s hospitals, in part, because the team had already prepared to do the same thing in May.
TOSH - The Orthopedic Specialty Hospital, which usually only does orthopedic procedures like knee, hip, shoulder, and spine surgeries, mobilized caregivers and worked out the complex details that had to be resolved before it could bring in medical patients last May. TOSH teams prepared, made checklists, and even did a trial run with a dozen patients but were never asked to fully implement their plans, says Lisa Bagley, RN, TOSH nurse administrator.
Lisa says as case counts increased in the fall, they began to prepare again so they could help if caregivers were needed.
“We walked through our playbook and we’re so grateful we put that together,” Lisa says. “We created a checklist of everything we needed to do to make sure we were prepared. It took a day or two to dust all of that off and reconnect with our teams and our ancillary support areas to make sure we were ready. As we pulled our team together and walked through that checklist of things, it was pretty empowering and it felt great to hear everybody’s willingness to help.”
The team still had to revamp plans because at least one critical factor had changed.
“When we did the pilot back in the spring, we'd shut down elective surgeries and had all the beds and the staff available,” Lisa says. “This time we’re going full bore on surgeries and we have volumes back up to our normal levels.”
She says they can only reserve ten of their surgical beds for the medical patients because they need the rest for recovering surgery patients. Bringing in medical patients while still dealing with orthopedic surgeries creates some staffing challenges.
“All of our surgical services caregivers are busy in OR or busy in recovery,” she says. “Our inpatient ortho nurses are busy in the ortho unit but they’re picking up extra shifts.”
TOSH is drafting nurses from Homecare and Hospice who can be temporarily spared from their regular duties to help out. They’ll come in and do an orientation shift or two and be put to work, Lisa says.
“We’re reaching out to everyone, everywhere, and anyone who’s willing to come out and help us,” she says. “We know all nursing areas are busy and having challenges with staffing right now, but we’re digging deep and asking everyone to step up and help. It really is a full, all-hands-on-deck effort to provide the staff that’s needed to take care of these medical patients.”
All-hands-on-deck includes Lisa.
“I’m going back to the bedside,” Lisa says. “I’m doing a refresher course to shine up my nursing skills and I’ll be doing a functioning nursing role so I can be there as an extra set of hands, so I can do whatever they ask of me.”
TOSH will also be bringing in some medical resource nurses who can help the orthopedic nurses if they need assistance with anything, she says.
Lisa says she’s “concerned but optimistic we’ll be able to provide the staff needed to care for the new patients safely.”
Bob Mazzola, MD, TOSH medical director for inpatient medical services, says the hospital has a "solid, efficient plan" in place for caring for medical surge patients.
TOSH physicians, along with advance practice clinicians, will care for the med-surge patients in collaboration with telehospitalists who will help work with patients in the evening and weekends, says Bob Mazzola, MD, TOSH medical director for inpatient medical services and chairman of medicine.
“We have a solid, efficient plan that works for our patients and allows our lines to all collaborate toward the goal of outstanding patient care,” says Dr. Mazzola, who is also the director of respiratory care for TOSH.
Dr. Mazzola, who is a pulmonary critical care and sleep medicine physician, will be working directly with the medical surge patients too. Thursday afternoon TOSH admitted its first medical surge patient, Dr. Mazzola says.
Last May it was a trial run. This time it’s for real, Lisa says.
“I’m sure there will be learning along the way,” she says. “We’ve a great team that’ll watch and each day do huddles and say, ‘What do we need to do to tweak, or move, or change or add?’ They’ll make sure we do it right.”
Dr. Mazzola says TOSH ready to receive patients.
“At TOSH we appreciate being a part of the Intermountain system and we are trying to do our part to support that system in its times of need,” Dr. Mazzola says.
Lisa agrees.
“We want to help our sister hospitals, and we also want to help the community,” she says. “We’ve been very busy doing surgeries here but our ability to help with the COVID-19 pandemic has been limited.”