-
https://d1y502jg6fpugt.cloudfront.net/13418/archive/files/5e43c45dc9acae4911728f9b0bad12e8.pdf?Expires=1712793600&Signature=R7dJSdmgtpGAaLfSUsoPgrrlqIM5EjBmYpzoJ2WO-p2e2Zzs8-iBGp3BzsF3Ij7STm3EwYa4fJ3eKAzFcS%7EQl4RcofkXmV4F3szfn-danXlMBq%7EMJBjy83Q0Xi-MmXet6mz4aMBy516-qRPAQkT6nsAVg3unNn65AlxJLv6wBiQOliAaZn7ioyijwmUk95oAyVLaKDEgPeg1pCnhYKlaPXFfQG9lSWw3A-0glAy4WVfVTCS7%7Es396JTpLkTdESsKy7cw0C7398p5kZMS4NN7MuSSlxJJirKIuZlkD1BDtHNc4EIB4iIoafWyZ%7EnpieKWVYawehrWcBLILQk-V1uYrg__&Key-Pair-Id=K6UGZS9ZTDSZM
5bfb62194b04f33211ce75d0094771ac
PDF Text
Text
COVID-19 Inpatient Cohorting Team
Lauren Clark, MSN, RN; Sandra Sanchez, DNP, RN; Cynthia Phelan, DNP, RN; Lauge Sokol-Hessner, MD; Kendra Bruce, MSN, RN; Susan DeSanto-Madeya, PhD, RN, FAAN
Beth Israel Deaconess Medical Center
Introduction: March 2020
The Process
Access database with all COVID-19 positive patients
Medical Chart Review: Is this patient cohortable or not?
• Massachusetts experienced a rapid rise in COVID-related hospitalizations.
• Beth Israel Deaconess Medical Center quickly recognized the need for additional
available beds to meet the influx of patients who either had COVID-19 or were suspected
to have COVID-19.
• BIDMC’s HICS team response was initiated, offering a clear escalation path and decisionmaking structure for the assessment of physical space and surge capacity.
Can cohort
Find available bed on COVID unit
Verify cohort status with resource RN
Place bed request in teletracking
• Private room allocation was a particularly relevant and high priority.
• Cohorting team was developed and implemented to appropriately cohort COVID-positive
patients in semiprivate rooms
Cohorting Team Objective
1. Preserve resources
2. Maintained surge capacity
3. Ensure patient safety
The Cohorting Team
4 clinical cardiac nurses:
1 CCU (cardiac ICU) RN
1 Farr 8 (cardiac surgery) RN
2 Farr 5 (cardiac medicine) RNs
Cannot cohort
Place patient attribute in teletracking
Reassess next shift or day (depending on
rationale)
Results/Progress to Date at BIDMC- Boston (Spring 2020 Surge)
Total COVID+ patients hospitalized
600
Total COVID+ patients evaluated
546
Total COVID+ patients cohorted
366
COVID+ Always cohortable
236
COVID+ Always NOT cohortable
180
COVID+ cohortable status changed*
*due to clinical instability, behavioral issues, other
130
criteria
Total Beds Opened Up Due to Cohorting
183
For more information, contact:
Lauren Clark, MSN, RN. lszablak@bidmc.harvard.edu
�COVID-19 Inpatient Cohorting Team
Lauren Clark, MSN, RN; Sandra Sanchez, DNP, RN; Cynthia Phelan, DNP, RN; Lauge Sokol-Hessner, MD; Kendra Bruce, MSN, RN; and Susan DeSanto-Madeya, PhD, RN, FAAN
Beth Israel Deaconess Medical Center
Continued Progress to Date & Lessons Learned
Work in Siloes (Cohorting Team, Transfer Center, floors)
NO standard way of communicating between all workflows
NO standard language/communication for patients
cohorting
Wasted time & resources targeting patients, finding beds
Resources were already limited, as the Cohorting Team
also provided clinical support to Medsurg Surge Areas
PDSA Cycles
With Transfer Center Leadership to develop standard shared
responsibility between cohorting team & Bed Management
Based on feedback from resource nurses re: communication
strategies
With HICS leadership re: standardizing escalation process for
patients refusing to cohort
Collaborative Approach
Standard Communication with Resource Nurses
Real-time Communication with Transfer Center via
Teletracking
Standard Cohorting Team Handoff between shifts
Standard Patient-Facing Documents for cohorting
Standard Escalation Process for patients refusing to
cohort
Next Steps
Cohorting Policy created, accessible via PPGD (Guideline #BI-COV-60)
Cohorting Team manuscript published in Nursing Management Journal, May 2021. doi: 10.1097/01.NUMA.0000737624.29748.4e
Cohorting Team has evolved into the Isolation Management Resource Team, which remobilized during the second COVID-19 Fall/Winter surge
–
This role has expanded to include appropriate isolation of every patients every day.
For more information, contact:
Lauren Clark, MSN, RN. lszablak@bidmc.harvard.edu
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Silverman Symposium
Description
An account of the resource
Each year the Silverman Symposium poster session offers BIDMC staff and affiliates the opportunity to share experiences and learn about efforts to improve Quality and Safety.
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Silverman Poster
Primary Contact
If you would like more information about this project, contact this person. Make email address clickable.
Lauren Clark (<a href="mailto:lclark4@bidmc.harvard.edu" target="_blank" rel="noreferrer noopener">lclark4@bidmc.harvard.edu</a>)
Project Team
Lauren Clark
Sandra Sanchez
Cynthia Phelan
Lauge Sokol-Hessner
Kendra Bruce
Susan DeSanto-Madeya
BIDMC Location
The BIDMC location where the poster team resides if identified in spreadsheet. If not identified, choose BIDMC.
BIDMC
Department
Any departments listed on the poster or identified in the spreadsheet.
Cardiac Nursing
Cardiac Medicine
Cardiac Surgery
Cardiac ICU
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
COVID-19 Inpatient Cohorting Team
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Format
The file format, physical medium, or dimensions of the resource
pdf
Effectiveness
Efficiency
Safety
Timeliness