Q: How can you assure the community that our hospital is prepared for another surge in COVID-19 cases?
Dr. Michael Shea, ICU Medical Director & EOC Physician Lead, Maui Health: Our Emergency Operations Center (EOC) team has been working behind the scenes for months to develop a plan that prepares us for a surge in COVID-19 cases on Maui that is very likely to happen.
The Maui Health EOC is a team of physicians, nurses, infection control specialists, administrators and other experts who have been working together to develop a surge plan that ensures we are prepared for an increase in COVID patients, while maintaining a safe environment for our employees, patients and community. The EOC has been working with every hospital department to define roles, increase capacity, maintain open and transparent communication and ensure that all care teams are engaged and ready to step into action when needed. This is important because whether clinical or non-clinical, from doctors and nurses to security and social workers, everyone at Maui Health plays a critical role in protecting our island’s residents and visitors. Additionally, we are in constant communication with county officials, including Mayor Michael Victorino, and the Hawaii Department of Health, on any potential community issues that we can help with and that may impact hospital operations or our ability to provide the best medical care for our community.
Some areas of focus for the surge plan include bed availability, personal protective equipment supply levels and ongoing sourcing, adequate inventory in our pharmacy for COVID-related care and for day-to-day patient care needs, staffing levels and physician needs based on surge levels and patient acuity, and a plan of action for the quick reopening and expansion of our warm (COVID) units within an hour if needed. As an example, at Maui Memorial Medical Center, we can increase our bed capacity from our licensed 219 beds to more than 300 beds with the potential to increase our bed count even further with medical-grade patient care tents, if necessary. We are also working with state and local governments on a plan if we have a surge large enough to require help outside hospital walls. PPE is also essential in our surge planning and we continually strive to have at least 60 days or more of inventory on hand. We typically reach and sustain these levels but have the ability to utilize the Kaiser Permanente national supply chain to increase our supplies, if needed.
Additionally, the enhanced safety protocols that we put into place will remain to protect our employees, providers and patients. This includes temperature/symptom checks for everyone that enters the hospital, universal masking that includes masking patients, COVID testing requirement for all admitted patients and for patients before an elective procedure/surgery, enhanced cleaning and disinfecting protocols, no-visitor policy (with the exception of pediatrics, OB patients, special needs patients and special circumstances around end-of-life compassionate visits), appropriate PPE for all employees and providers, isolated areas (warm units) for any suspected or positive cases, and appropriate social distancing in public areas like waiting rooms. These are just some of the examples of how Maui Health is working to protect the health and wellness of our community.
Q: I read that Maui Memorial was over 100 percent capacity with zero COVID cases in the hospital. How can we prepare for a surge in COVID cases if our hospital is already overwhelmed?
Dr. Michael Shea, ICU Medical Director & EOC Physician Lead, Maui Health: We are aware of this rumor and glad to be able to provide accurate information and clarify what a hospital census is and how Maui Memorial Medical Center operates. First and foremost, I want to make it very clear that as of July 15, Maui Memorial Medical Center is NOT at max, exceeding capacity nor overwhelmed, and it hasn’t been. Our inpatient capacity, or census, is at pre-COVID levels now, which is and always has been typical of what we would normally manage in our day-to-day operations. In general, it is really important to understand that a census is a snapshot in time and that it is a very fluid number, as the movement of patients (admitted, discharged, etc.) is constantly occurring through the day, and this is typical of every hospital across the state and throughout this country. As the island’s only hospital, our census fluctuates constantly, but we always make accommodations and provide the room necessary to care for all our patients. The Emergency Department census has also seen an increase in patients, but we are still below our typical ED census (down 40 percent from normal). Our teams are highly trained, and we have the staffing and bed capacity necessary to care for all patients who need safe, compassionate, expert care, no matter our census.
* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on the first and third Thursdays of the month. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.