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, Kelly Fanning, MBA, vice president for Ambulatory Services and Patient Experience at the Brigham, shares details about our Ambulatory plans.
What are you anticipating will be the key challenges for Ambulatory Services if we get a second surge?
Fanning: In a second surge, we will continue to see patients in the Ambulatory setting as clinically appropriate, whether they are COVID-suspected/positive or not. Our practices have been delivering care to all types of patients for some time now, so we are experienced at providing care safely.
We recognize, though, that some patients may be fearful about coming in for care in a clinical setting where we are also caring for patients with COVID-19. We’ll provide virtual care when it’s clinically appropriate and aligns with the patient’s desires and expectations. And we’ll maintain our current Safe Care Commitment protocols to ensure we can continue to safely see all patients in our clinical spaces.
What are the key lessons the Ambulatory team learned during the initial surge that have influenced Ambulatory’s planning for a second surge?
Fanning: During the initial surge, Ambulatory volume declined significantly. Virtual visits became a larger portion of overall care. Many members of our Ambulatory staff pivoted to support key COVID operations at the hospital and testing and scheduling sites. Their work was foundational in helping us operationalize key COVID processes.
We learned that we can both effectively deliver virtual care and rely on our Ambulatory staff to provide safe in-person care. These lessons have informed our Ambulatory second surge plan, which projects only a slight decline in the overall volume of care and significant virtual visit volume.
What is most important for Brigham staff to know about the second surge plan for Ambulatory Services?
Fanning: The Ambulatory surge plan maps out how we will maintain the ability to offer both in-person and virtual care for our patients, COVID-positive and otherwise. Building on the tremendous work our teams have done over the past few months, our plan lays out our policies and processes to ensure we consistently screen, clean and protect. Our leadership team will work to ensure our practices continue to have access to the necessary personal protective equipment (PPE), technology and guidance that supports them in executing this plan as COVID volume increases.
As we intend to continue Ambulatory care during a surge, we are mindful that this contributes to a staffing challenge for other groups who will not be able to rely on Ambulatory staff for help as they did during the initial surge. We are confident, though, that because of our shared goals and commitment to teamwork across the Brigham, we will continue to provide world-class care regardless of what COVID may bring.