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Surge Protection: H1N1 Milwaukee

Surge Protection: H1N1 Milwaukee

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Surge Protection: H1N1 Milwaukee

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  1. Surge Protection: H1N1 Milwaukee Mary Geoghan RN, MSM Marlene Melzer-Lange MD Nandita Nanchal Marc Gorelick MD, MSE

  2. Aim • Evaluate the effects of an H1N1 surge plan developed for a pediatric emergency department

  3. Background • Milwaukee experienced an early surge of H1N1 compared to the rest of the country • April 29, 2009 mayor announced H1N1 case in Milwaukee on TV • Census 25% over seasonal norms • Hospital-wide surge plan developed in summer 2009

  4. Hospital Surge Planners • ED nursing and medical leadership • Pharmacy • Laboratory • Public Relations • Infectious Diseases • Occupational Health • Hospital Executive Leadership • Human Resources • CMO link to Milwaukee Health Department Consortium on H1N1

  5. Surge Plan • Opened 18 room area above ED (ortho clinic during the day) during non-clinic hours—”ED 3” • Contingency staffing (RN, MD, care partners, registration staff) • Ability to screen patients with ILI-like illnesses to “ED 3” • Planned for 3 other potential areas including a trailer if surge increased

  6. ED 3 Intake, Waiting Room EDTC Triage

  7. 0700 7-9 0800 1 1000 11 2 1400 13 1600 1700 3 11 2300 0100 1 8 0200 0700 Spring Surge main ED 22 rooms ED 2 7 rooms MD staffing RN staffing MD/AHP staffing RN staffing extended hours during surge weekend only

  8. 0700 7-9 0800 1 1000 11 2 1400 13 1600 1700 3 11 2300 0100 1 8 0200 0700 Fall Surge main ED 22 rooms ED 2 7 rooms ED 3 18 rooms MD staffing RN staffing MD/AHP staffing RN staffing MD/AHP staffing RN staffing 2 2 2 extended hours during surge weekend only

  9. Monthly Census

  10. Measures Compared* • ED flow metrics • Patient/Family satisfaction scores • Staff satisfaction and feedback via a survey administered to RN’s, Care Partners, PA’s, Nurse Practitioners, and Physicians *for the two different surges

  11. Results

  12. Patient and Family Satisfaction • “Excellent” • 34% Spring 48% in Fall

  13. ED Staff Satisfaction* * Very Good and Excellent

  14. Conclusion • A comprehensive surge plan mitigates the impact of excess patient volume on: • ED Flow • Patient and Staff Satisfaction • Sustainability over an extended period of time

  15. Physician Staffing • ED has physician staffing by MCW faculty • Worked with Dept of Peds financial administrator to develop physician payment • Needed CHW & MCW Credentialing for each provider • Already had CHW Medical Staff category for general pediatrics credentials • Approached those other MCW peds faculty who would have expertise in respiratory/flu complaints (allergy, pulmonary)