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, Paul Chen, MD, MBA, director of clinical operations, Department of Emergency Medicine, shares details about our Emergency Department (ED) plans.

What are you anticipating will be the key challenges for the ED if we get a second surge? 

Paul Chen, MD, MBA

Chen: During the first wave, we experienced a decline in ED patient volume related to the statewide lockdown. We don’t expect to have the same decrease during a second surge, so our biggest challenge will be caring for our COVID patients in addition to our non-COVID patients.

As the virus spreads across our communities, another key challenge will be keeping our caregivers and staff healthy so they can come to work and care for our patients. Fortunately, our personal protective equipment (PPE) supply chain appears to be in a better place, so we’re confident that with our PPE supply and protocols, we can protect our staff and patients.

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

Chen: During the first wave, the teamwork and resolve of the Brigham really shined through. We truly demonstrated that we’re stronger together, and this will serve us will in a second surge. We have also learned more about how to care for patients with COVID. We know more about effective treatments, and which patients need ventilators. We’ve also learned more about how the virus spreads and developed infection control strategies, for instance our masking and eyewear protocols. All of this knowledge will help us better care for our patients in a second surge.

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

Chen: The Emergency Department is the front door for many patients who come to the Brigham, and we are dedicated to providing the best care to all of our patients. The first phase of our ED expansion project will also come online in December, which will provide a significant improvement in the care environment. We’re confident that we are well coordinated with other departments across the hospital, which will allow us to continue to provide safe and compassionate care for all of our patients.