UHealth Confronts the Pandemic with Innovative New Processes and Protections

In the early months of the pandemic, every day presented a new challenge – beginning with creating a coronavirus ICU at UHealth Tower out of “a very non-traditional ICU environment,” said Joseph Falise, M.S.N., R.N., nurse manager for the cardiovascular ICU, neuro ICU and COVID ICU.

 

Careful training, specialized monitors, plenty of personal protective equipment, and a raft of new processes succeeded in protecting patients and staff. “We had an all-out effort on everyone’s part to make sure the nurses were safe,” Falise said.

 

UHealth Tower has confronted the pandemic by essentially creating a COVID hospital and a non-COVID hospital within its walls, said Tanira B.D. Ferreira, M.D., FCCP, chief medical officer of University of Miami Hospital and Clinics. Separate floors are designated exclusively for COVID cases, as needed. “The moment COVID goes back up, we are able to accommodate these cases,” said Dr. Ferreira. “We have a very comprehensive surge plan that allows us to have two-in-one hospitals.”

 

Dr. Ferreira was one of three authors featured in the New England Journal of Medicine for her expertise in managing elective surgeries during COVID-19 surges. The article presented a mock scenario in which a hospital’s census was higher than 90% of capacity, with almost all ICU beds occupied, more than half by patients with COVID-19.

 

UHealth’s planned approach was to proceed with scheduled elective surgical procedures but defer new cases when needed if bed availability was limited. “The scenario in the article was very similar to what we experienced here in Miami in June and July,” Dr. Ferreira said. “Throughout the second spike of the pandemic, UHealth Tower was able to run full, almost normal hospital operations and at the same time manage the COVID-19 surge. In essence, we created a way in our surge plan for the hospital to manage COVID-19 and non-COVID-19 patients safely and effectively within the same facility.”

 

In response to the pandemic UM has also conducted extensive research to develop diagnostic tests, antibody therapies, and vaccines to fight the virus.

 

Health care workers’ fear at the beginning of the pandemic gave way to confidence as they successfully took extensive precautions and adapted new procedures to confront a challenge none of them had seen before. With no visitors permitted at the hospital, communicating with families has been central to the team’s challenge. Doctors, nurses, and patient experience representatives have been calling patients’ families every day, and some families that don’t have any devices have been provided hospital i-Pads in the lobby to talk to their relatives.

 

“Is it still exhausting?” Falise asked. “Yes, it’s still exhausting. It’s all about adapting as we learn more about the virus, and it’s about making ourselves comfortable as well as making the patients comfortable.”

 

Educating patients and providing occupational therapy have made it possible for the Tower to send patients home sooner. Respiratory therapists, physical therapists, and environmental services have all contributed to the hospital’s strength in caring for patients and protecting staff.

 

The health system’s ambulatory operations also had to make fundamental adjustments as non-essential care was cut back and patients delayed other visits. The acceleration of virtual visits provided important, safe options for patients, and telehealth will continue to be a major part of the health system’s medical care moving forward. 

 

The hard-working, now exceptionally experienced health care workers at UHealth Tower and throughout South Florida are prepared for increases in COVID-19 cases – or the next virus.

 

“It’s a constant state of readiness,” Falise said. “We have put certain things in place that will be with us forever.”