Over the last three months, teams across Mass General Brigham (MGB) and the Brigham have been planning to ensure we can effectively and safely care for patients during a surge. Plans address how we will adjust our operations when patient levels reach 25 percent, 50 percent or 100 percent of our peak patient level during the initial surge, which at the Brigham was 197 inpatients.

This week, Kate Evangelista, DNP, CRNA, NEA-BC, associate chief nursing officer for Perioperative Areas, Hugh Flanagan, MD, executive medical director of Anesthesiology, Perioperative and Pain Medicine, and David Keyes, director of Administration and Finance, share details about our plans for the Operating Room (OR) and Procedural teams.

What are you anticipating will be the key challenges for OR and Procedural teams if we get a second surge?

From left: Kate Evangelista, Hugh Flanagan and David Keyes

Flanagan: Our goal is to continue taking care of our surgical and procedural patients throughout a second surge so that they do not need to delay access to care. We anticipate two challenges here. First, patients may be reluctant to come into the hospital for care due to fear of contracting COVID-19. Maintaining patient confidence will be very important. This is where our Safe Care Commitment can make a real difference.

Keyes: Second, we’ll be challenged by the need to balance our resources to care for COVID and non-COVID patients. We have specialized staff in the ORs and procedural areas who are well-equipped to take care of COVID patients, but are also essential for treating our surgical and procedural patients. We’ll work closely with our inpatient leadership team to accommodate both patient populations.

What are the key lessons we learned during the initial surge that have influenced our planning for a second surge?

Evangelista: The initial surge reminded us that the Brigham is full of brilliant, dedicated teams who are great in a crisis. Our surgical teams identified patients who needed to be treated as soon as possible. Our infection control experts helped us create improved protocols for taking care of those patients, regardless of COVID status. And our Materials Management team monitored supply levels to contribute to the safest possible environment for everyone in our community. We truly were stronger together.

Keyes: One of the reasons we decreased surgical volume during the initial surge was to conserve PPE. We are feeling more confident in our supply chain at this time. One of the things that was clear during the initial surge was how important it is to make decisions based on data and the advice of knowledgeable experts. This will be equally important during a second surge.

What is most important for all Brigham staff to know about the second surge plan for OR/Procedural?

Flanagan: Many of our patients need to come to the Brigham because of our expertise and the severity of their illness. Delaying care could be harmful to their health. So, our plan is focused on helping them feel safe enough to come for the surgery or procedure they need, and then deliver that treatment in a safe and caring environment.

Evangelista: Our surge plan includes robust and transparent communications at both the local and hospital level to reach out to our patients and staff to address their concerns and questions. It also includes protocols and competencies for patient care that were developed and refined during the initial surge. We are confident that this plan will enable us to safely care for our surgical and procedural patients should we experience another surge.