🧵 Ever want to make sure every patient who needs a bed, has a bed? Read on for this short Tweetorial on practical tips for make sure “No patient is left behind”. Thanks to my co-conspirators Lisa V, @medyr1, @DrDMIEMSS1, and @galvagnosam for their wisdom and friendship.
As COVID-19 cases and hospitalizations rise again, many cities/regions/states are running critically low on inpatient beds-especially specialized beds for highly complex care.
npr.org/2021/08/19/102…
npr.org/2021/08/19/102…
In your hospital (or area if you know), how is the overall bed situation?
Tip 1: Just start. Don’t get bogged down in perfection
In Maryland, we started with some phones, a simple SmartSheet tracker, and a Tableau dashboard. Minimal startup cost! A spreadsheet with all ICU contacts is INVALUABLE. @GalvagnoSam @DrDMIEMMSS1
In Maryland, we started with some phones, a simple SmartSheet tracker, and a Tableau dashboard. Minimal startup cost! A spreadsheet with all ICU contacts is INVALUABLE. @GalvagnoSam @DrDMIEMMSS1
Tip 2: Relentless improvement and humility are your guideposts
The virus is crazy fast at changing its impacts-we should be too. EVERY day ask: "what are we missing, how can we improve our mission, who needs to know or be brought in, even…who can do this better?” @medyr1
The virus is crazy fast at changing its impacts-we should be too. EVERY day ask: "what are we missing, how can we improve our mission, who needs to know or be brought in, even…who can do this better?” @medyr1
Tip 3: Get approval from system/hospital association/DOH
Need all on board-they are crucial advocates. In WA, old rivalries and political foes GLADLY aligned behind “we are all in this together”. CEO’s signed document affirming process. Trust & buy in come w transparency @medyr1
Need all on board-they are crucial advocates. In WA, old rivalries and political foes GLADLY aligned behind “we are all in this together”. CEO’s signed document affirming process. Trust & buy in come w transparency @medyr1
Tip 4: Remember: this is about the patients
Lots of talk about disparities-this is something you can DO about it. We empowered statewide intensivists (on call 24/7) to remain relentless-don’t stop until appropriate care found for each patient. Not all need an ICU bed @GalvagnoSam
Lots of talk about disparities-this is something you can DO about it. We empowered statewide intensivists (on call 24/7) to remain relentless-don’t stop until appropriate care found for each patient. Not all need an ICU bed @GalvagnoSam
Tip 5: Be transparent with a minimal data set
A simple Tableau dashboard or Excel sheet will pay dividends. We started by tracking # of consults, # requiring ECMO,# who could stay in place (with consultation). Creates situational awareness for state/hospital leaders @GalvagnoSam
A simple Tableau dashboard or Excel sheet will pay dividends. We started by tracking # of consults, # requiring ECMO,# who could stay in place (with consultation). Creates situational awareness for state/hospital leaders @GalvagnoSam
Do you have a regional or statewide placement center?
Tip 6: Write your process down and advertise widely
Everyone from CEOs to ED HUCs need to know the process to get help, which should be simple enough to describe in a sentence or flow chart. Post it everywhere – online, nursing stations, bathrooms….
Everyone from CEOs to ED HUCs need to know the process to get help, which should be simple enough to describe in a sentence or flow chart. Post it everywhere – online, nursing stations, bathrooms….
Tip 7: Stay low-tech to start
Regions have stayed in lockstep with BID calls or a group text sharing bed availability daily. Awareness & immediate utilization of staffed beds will help patients! AZ and WA have tech heavy lines – others don’t. This can be done on a shoestring.
Regions have stayed in lockstep with BID calls or a group text sharing bed availability daily. Awareness & immediate utilization of staffed beds will help patients! AZ and WA have tech heavy lines – others don’t. This can be done on a shoestring.
Tip 8: Healthcare is relationships. Make friends!
You must all function as a single system: loan materials, problem solve, load-level patients. You know the CNO, or Head of ED – start small and then work your way up to the C-suite. Share phone numbers. It will pay off. @karynbaum
You must all function as a single system: loan materials, problem solve, load-level patients. You know the CNO, or Head of ED – start small and then work your way up to the C-suite. Share phone numbers. It will pay off. @karynbaum
Tip 9: Incremental improvement is still improvement
Don’t try to “boil the ocean”-all changes count, from upgrading the form used to collect data to new electronic bed boards. Listen to your customers for easy wins. People will respond & you gain credibility. @karynbaum
Don’t try to “boil the ocean”-all changes count, from upgrading the form used to collect data to new electronic bed boards. Listen to your customers for easy wins. People will respond & you gain credibility. @karynbaum
Tip 10: Teamwork, teamwork, teamwork.
Include multiple professions in the design and running of this effort. Nobody should be alone. Call specialists, nursing, social work, EMT all have important roles to play and lenses to provide; spreading work around lightens the burden.
Include multiple professions in the design and running of this effort. Nobody should be alone. Call specialists, nursing, social work, EMT all have important roles to play and lenses to provide; spreading work around lightens the burden.
Who are we? We run (or ran) four large statewide placement centers for patients needing beds. It’s been rewarding work, but we also know it’s hard. We are all here for each other right now.
Arizona’s Surge Line has a lot of useful information in their @NEJM_Catalyst paper and on their website. Any one of us are happy to hear from anyone at any time (hm, what did I just do?) if you have questions or need to bounce ideas back and forth. Our DMs are open!
Stay safe, follow the science, #GetVaccinated, and thank you all for your work!
#medtwitter
#RNtwitter
#COVID19
#ICU
#medtwitter
#RNtwitter
#COVID19
#ICU
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Please consider retweeting to get the word out!
Please consider retweeting to get the word out!
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