Help Hospital Medicine Prepare
We are all completely swamped trying to get clinical services prepared for COVID-19, and many of us are in the midst of significant community transmission, and in many cases COVID-19 positive patients. While there is a fair amount of guidance from the CDC and our State Department’s of Public Health for hospital’s, in general, I am not aware of best practices specifically for hospitalist programs that will need to absorb the burden of many of these cases, alongside our critical care, ED, and other colleagues. Even though Hospital Medicine is a particularly young specialty, no one has faced such a crisis at such a large, truly wordwide scale, in the recent past. This means that we need to draw from best practices in emergency management, and apply those principles specifically to Hospital Medicine.
Hospital Medicine has unique needs – how to triage and assign COVID-19 positive patients in such a way to limit potential transmission and to optimize utilization of PPE, best practices on up-staffing plans and the how to best estimate the rate of inpatient volume increases, how to manage growing hospitalist absences and rapidly onboard non-hospitalist Medical Staff that you will be re-purposing to care for inpatients on your service, how to ensure continuity of your program if your physician leadership is out of commission due to illness or for other reasons, what components are important in a COVID-19 ventilator-eligibility plan, how to consider working with trainees including interns and residents when managing an increasing number of COVID-19 patients, and what your clinicians need to know about the clinical features, high-risk co-morbidities, and treatments.
We are overdue for a Hospital Medicine COVID-19 Toolkit, and here I have tried to put together what I have considered and worked on to prepare my program for this likely impending crisis. This is not a time for each all of us to think through these problems in isolation. The collective wisdom of hospitalists will surely help so many of us to better prepare for the pandemic. Please help us all prepare and share your lessons with your colleagues.
One other note – this crisis has reminded me how lucky I am to be part of such wonderful colleagues throughout the field of Hospital Medicine. I don’t think I have ever experienced such a degree of professional commitment, work ethic, volunteerism, team work and professionalism as I have in the last several days.
All of your efforts are so appreciated – good luck and stay healthy.