OPERATING ROOM Clinical-Supply Chain
knockdown, comeback Rebounding in care, safety and supply systems in ongoing pandemic by Ebony Smith
and other essential healthcare providers continuing to combat obstacles in patient care, supply management and infection control in their settings. On one hand, the situation looks brighter, with more vaccine shots in arms to slow the spread of the SARS-CoV-2 virus, which causes COVID-19. On the other hand, the pandemic shows no apparent signs of ending, with variants detected in several locations, relaxing public health safety mea- sures, rising infection cases and increased care needs.
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This all, of course, strikes a blow to the health and well-being of healthcare work- ers, patients and families, as well as the stability and bottom line of hospital and healthcare operations.
Frontline workforce hit, help First, for example, ICU physicians and staff remain stretched thin in many areas across the U.S.
The George Washington University
reported, “analysis shows that ICU doc- tors in…209 counties will be taking care of more than 24 severely ill patients at one time. Typically, an ICU doctor will care for half that number of patients or less at the same time—and, at 24 or higher, hospitals will have to quickly organize and train non- ICU providers to step in and help provide care…Hospitals can create a new COVID-19 unit by taking over an underused fl oor or wing, but they have more diffi culty fi nd ing trained doctors and others to fill in when health care workers get sick or must quarantine.” 1
At Baptist Medical Center, part of Baptist Health Care System in San Antonio, TX, adding more capacity to care for patients with COVID-19 increased pressure on staff, supplies and equipment, explains the hospi- tal’s Critical Care Director Connie Thigpen, MBA, RN, a recipient of a 2021 Circle of
oving on in the second year of the COVID-19 crisis, you see hospi- tals, intensive care units (ICUs)
Excellence award from the American Association of Critical-Care Nurses.2 “My ICU quickly expan-
ded from 30 to 56 beds,” Thigpen indicated. “We had a few supplemental staff in the form of crisis nurses when we started
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• Shifts that did not allow time to discon- nect, while taking on more responsibilities when managing patients with COVID
• Emotional and physical stress and exhaustion
• Inability to provide psycho-social care to patients and families
Connie Thigpen
to hit those peaks, but not enough to keep our staffi ng loads the same as before the pandemic. Instead of the usual one to two patients per ICU nurse, we were all provid- ing care to four COVID-19 patients each in the ICU.
“In addition to the expected PPE-related
issues, other material items quickly became issues,” she continued. “We took over an 18-bed post-anesthesia care unit and reopened a closed unit that was once an eightbed I. e were challenged to fi nd the additional beds, fl ow meters, suction heads, monitoring cables, and all the basic components needed to set up a room to receive a patient. And that is not even touch- ing on ventilators, hi fl ows, and bipaps. Whenever we placed equipment orders, we faced extraordinarily long wait times for delivery.” Medical workers continue to endure extended responsibilities and hours caring for such critically ill patients in environ- ments heightened by infection risk. Asilinn La Brie, RN, BSN, MBA, Senior Consultant in Business & Clinical Optimi- zation, Cardinal Health, points to several conditions healthcare staff have faced dur- ing care and the pandemic, including: • “Working with the fear of becoming infected – and exposing others
• Shortage of critical per- sonal protective equip- ment (PPE)
• Elevated workloads and high patient-nurse ratios
• Fewer support staff and maybe even fewer on- call staff
16 May 2021 • HEALTHCARE PURCHASING NEWS •
hpnonline.com Asilinn La Brie
• Protocols frequently changing; some new cleaning protocols placing greater burden on clinicians and requiring them to take on additional duties.” Health and wellness support, conse- quently, has transpired as a need among healthcare personnel to help cope in the crisis.
For example, “A new article in The Joint Commission Journal on Quality and Patient Safety…details how Montefiore Medical Center – located in the Bronx, the borough hardest hit by COVID-19 in New York City – implemented various mental health services to mitigate and treat psychological distress among staff. Interventions implemented during the pandemic included: • Psychoeducational resources (including invited presentations, grand rounds and web-based resources)
• Telephone support line • Staff Support Centers (SSCs) • Clinical treatment program • Parenting skills and support groups • Team support sessions • Peer support outreach • Mental health and wellness programs • Clergy support,” addressed The Joint Commission.”3
PPE access plummets, pivots Safeguarding medical teams from COVID- 19 and other infections within healthcare settings requires ongoing focus on PPE. That means maintaining a steady fl ow of supply for all staff at all times. The pan- demic, however, has caused major breaks in the supply chain. “Healthcare systems worldwide have
worked under challenging conditions during the COVID-19 crisis,” emphasized
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