Planning for a Surge: Now and in the Future

More than two months into the COVID-19 pandemic, we’re fortunate that we have not seen a large influx of COVID-19-positive patients filling up our hospital beds.

But we still need to be prepared now and into the future—we’ve been working on a surge plan, should we need it.

“I truly hope we never need the type of surge plan we’re developing,” said Mike Abbott, senior vice president of hospital operations at CMC, who has been overseeing the planning efforts. “Still, the effort that has gone into this plan will pay dividends as we continue to enhance our operational continuity.”

Teams at each of our hospitals have worked diligently and coordinated efforts so we can provide the best care if there were a surge of patients at any of our hospitals.

The plan for the system has three parts:

Identifying Bed Space

COVID-19-positive patients will be co-located (placed in the same unit on the same floor). Once that unit is full, another COVID unit will be established and filled. In conjunction with this, we have a triage and transfer plan if we need to move patients between facilities. The goal is to keep as many positive patients together in one area of the hospital as possible.

Dottie Garner, M.D., and Michael Wiid, M.D., are leading the surge team in planning for the COVID units at CMC and providing guidance for caring for COVID patients at each hospital.

Other elements of our plan to increase bed space in a surge include:

• Transforming office space and shell space into additional beds
• Relying on space available at other Carilion hospital facilities if beds in one hospital are filled
• Partnering with other organizations in the Roanoke Valley that have offered bed space for patients if an influx overwhelms our resources in the most extreme circumstances

“We’ve thought about adding beds in an incremental way,” said Marty Misicko, vice president of Facilities and Property Management and a member of the surge planning team. “That will allow us to thoughtfully pivot as this situation evolves.”

Developing a Staffing Plan

The surge plan team has developed plans for how to staff additional beds and support our patients. These include things like establishing COVID-19 temporary or disaster privileges for our providers, which would allow us to shift them into alternative roles in different locations as needs change.

“Many of our providers throughout the system—doctors and advanced clinical practitioners—have skill sets that would enable them to quickly assist in an emergency situation,” said Tracey Criss, M.D., vice president of Medical Staff Affairs. “What we focused on in our planning was a systematic way to redeploy those individuals to help our patients and our community.”

Early on in the pandemic, we also established a coordinated staffing office to redeploy support staff where they are most essential.

“We’ve worked to develop an abbreviated cross-training program and have put numerous staff through this program,” said Meg Scheaffel, chief nursing officer. “This allows us to be more flexible in the future as patient volumes may surge.”

Managing Supplies and Equipment

The team has worked hand in hand with TSG, Clinical Engineering, Materials Management and others to make sure we are ready to handle a rise in patients, including:

• Supplies (from PPE to pharmaceuticals)
• Equipment (from beds to ventilators)
• Technology (from computers to establishing new beds in Epic)

Though this surge planning is happening during the COVID-19 pandemic, it has also helped to prepare us for other threats, like fires, floods or a bad flu season, which are even more commonplace.

“This pandemic has shown us time and time again just how important teamwork is,” said Mike. “Developing this plan was no exception. This system-wide effort by many has positioned us well for the future, no matter what threat we face.”

For more information on our surge planning, contact Mike Abbott at mgabbott@carilionclinic.org.