The possibility of increased emergency department (ED) visits related to the COVID-19 pandemic presented a unique challenge at Yavapai Regional Medical Center (YRMC) in Prescott, Arizona.
To manage the influx of patients and limit exposing clinicians, support staff and other patients to the virus, the hospital used managed IT services from Cerner ITWorks℠ so it could establish off-site screening and care rooms (OSCRs) in tents adjacent to the EDs on both of its campuses.
Maintaining clinician workflows
“The OSCR tents were requested on March 19, and our IT department was tasked with a one-week timeline to equip both tents with network connectivity and devices for patient care and communication to the main buildings,” said Rob Barth, RN, MSN, CEN, director of emergency services. “Our advanced team worked around the clock to stand-up these two OSCRs, communicate with all stakeholders, develop processes and training, and perform a lot of troubleshooting.”
There was also a need for additional patient registration locations and a telecommunication process to support virtual visits with physicians located inside the main building or working remotely.
“Our advanced team worked tirelessly around the clock to stand-up these two OSCRs, communicate with all stakeholders, develop processes and training, and perform a lot of troubleshooting.” – Rob Barth
YRMC leaders wanted to provide ED staff with all the essentials to maintain their existing workflows as closely as possible. The team outfitted each tent with equipment to admit patients, collect specimens, document care and discharge stable patients. Mobile carts outfitted with virtual-enabled devices allowed physicians in the ED to communicate remotely with clinicians and patients in the tents.
“We were trying to maintain a similar process as we normally would, and using the carts was a simple, streamlined and user-friendly solution so we could minimize friction in a challenging and high-stress situation,” Barth said.
Providing high-quality care while reducing exposure
In the first two weeks, clinicians evaluated and discharged approximately 350 patients. Just two clinicians staffed each tent, reducing exposure and eliminating potential contact with other patients in the waiting room, registration staff, ancillary support staff, environmental services and physicians.
As of April 23, YRMC has reported a positive COVID-19 test result rate of 3.24%.
“We’ve also eliminated physician contact with these patients by close to 100%, while ensuring they’re still effectively seen and treated by a physician,” Barth said.
Recognizing the power of teamwork in a crisis
Cerner ITWorks associates partnered with YRMC engineers to ensure adequate power supply was available to run multiple essential devices and printers.
“The OSCR tents required a cohesive effort across multiple IT teams to achieve a successful implementation on a short timeline.” – Tim Roberts
“Our Cerner support was invaluable in terms of laying fiber optic cables through existing conduits under our roadways, and that was easier said than done,” Barth said. “They’ve been amazing for any request, which included Wi-Fi hotspots, workstations-on-wheels, laptops, printers, phones and iPad carts for telemedicine.”
Another Cerner application team helped YRMC configure specimen collection printers in the tents. Other support included updating scripts to automatically print demographic labels and wristbands upon registration.
“The OSCR tents required a cohesive effort across multiple IT teams to achieve a successful implementation on a short timeline,” said Tim Roberts, CHCIO, chief information officer.
Providers at the OSCR tents continue to see patients and expand their capabilities as YRMC staff prepares for an anticipated surge in COVID-19 cases in late April.
More like this:
Pediatric hospital leads the way in providing COVID-19 care - 3-minute read