Here in New York, Gov. Cuomo is ordering hospitals to increase “managed bed capacity” by 25-50%. I’m wondering how exactly.
Some guesses:
Cancel elective surgery and turn all those recovery room beds into “managed beds”.
Assign nurses to ER beds and make people stay in the ER.
***edit: I was trying to make a joke with this one. Come to find out I’m not funny***
Tell women to stop having babies (not so sure about this one)
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Build actual new capacity in a tent outside in the parking lot.
We are creeping up in some critical capacity thresholds and it seems like a simple solution to just say “increase capacity”. How can we do it in on such short notice?
Thanks!
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You have it mostly right. It means transforming regular rooms into ER rooms, adding more beds to existing rooms, turning utility rooms (even closets) into patient rooms, rolling beds into hallways… the same sorts of things you would do in your house if you suddenly found out 30 people were coming for the holidays instead of the usual 10. And yeah, there are even mobile trailers and tents in parking lots here and there, or at least there can be if needed.
It’s ugly and temporary, but what else are they gonna do?
(Also it’s not really “short notice”, since there was a panic back in March and April, and then a lot of the emergency capacity wasn’t ever needed, so hospitals have all had practice lately. Remember when they set up beds in Javits, and the emergency ship?)
Probably a combo of all of those except the maternity one. They probably also squeeze extra beds in wherever they can. It’s basically making covid beds the top priority, over storage space, over proper space to move around in, over rooms that have been moved to telecommute, over conference rooms, etc.
Hallways, offices, storage rooms, conference rooms, classrooms, all can be converted into additional space for beds. Staff & equipment to make these places into functional treatment areas is probably much harder than finding places to put the beds.
They all sound good except the babies one. Those who will be giving birth the next few months have been pregnant. Those who will be giving birth in December got pregnant around the beginning of the pandemic. Telling people to stop procreating in general has never/will never work 🤷🏼♀️
It has to do with licensing. A hospital may be licensed to have 100 beds. By normal regulations, that’s how many patients that hospital can safely and efficiently handle with supplies and personnel. Any more than 100 patients, and they will start transferring patients somewhere else, or diverting ambulances to other nearby hospitals. It’s important to note that a bed in terms of capacity is not the same as the number of actual hospital beds in the building. For capacity purposes, a “bed” is the IV machine, heart/vitals monitor, oxygen, an actual bed, a nurse, etc.
Increasing the bed capacity 25% means that the 100 bed hospital can now have 125 patients. You hit the nail on the head with some of the ways hospitals may choose to accomplish this (except the pregnant woman thing). The hospital likely already has a few extra beds (just the bed) around anyway, and can improvise to add more. They’ll likely defer elective procedures to expand their capacity as well.
We open units, call in staff, and get traveler employees. We have the ability to line the halls with beds, the research towers, the OR pre op and post op areas, anything really.
Or even open tent hospitals in parking garages and sports stadiums.
We also cancel unnecessary admissions and surgeries, then float that staff to take patients. Nurse managers, charge nurses, nursing supervisors, physician chiefs, anyone, can be floated from administration to do bedside care.
We are often not actually limited by physical beds, but staffed beds. When people say hospitals are out of beds, a lot of the time they are actually out of staff.
My hospital has three “emergency” units. So we can technically go to 130% capacity if we open and staff these units. Most of the time, they would be a huge waste of money and resources. This is why they are not always open.
We almost always open one by this time of year for respiratory season. So in November or December, “travelers” are sent to hospitals. These are contracted employees that only work there for times of increases census.
This is how we increase our capacity
Edit: I forgot like the hugest part. We get critical staffing pay to sign up to work extra. So I make I think an extra $25-30 *an hour*
I’ve seen some photos of temporary beds being placed in between the more commonly placed hospital beds with portable curtains placed in between.
Hospital worker here. Here’s a few things that I’ve seen -.
-Cancel elective surgeries and use the admission areas as well as the ORs.
-Cancel other non-surgical day procedures.
-There are usually areas in a hospital that were designed to take beds, but are surplus in normal operation and are instead used for training, physio, or any number of non-essential things. These can be converted back to bedded areas.
-Agree with other hospitals to take patients needing a service that you normally provide, freeing up those beds at your hospital.
I’ve never seen patients receiving treatment in a corridor or parking lot. Sometimes you’ll see patients in beds in corridors who have come from the emergency department who are waiting for a inpatient space.
Just throwing extra beds into existing areas as well. One of the ICUs I cover increased capacity by just putting in extra beds from 18 beds to 30. Staffing remained the same.
One hospital I worked at stored a few dozen beds in the basement and pulled them out as needed. We had beds in the hallway when capacity got high. This happened because our hospital building was way too small to serve our community and they kept it going by adding portables. It has since been torn down and replaced with a much larger facility.
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