When the COVID-19 pandemic struck last year, teams across the Brigham rapidly mobilized to convert most of the Shapiro Cardiovascular Center and parts of the Braunwald Tower into specialized units dedicated to the care of COVID-19 patients — a transformation that required scores of patients and staff to temporarily relocate from their home units.
As the Brigham’s COVID-19 census began to subside earlier this year, a multidisciplinary team started implementing a long-term inpatient bed plan to unravel those temporary changes and return patients and staff to their original locations or newly designated home units.
After three months and more than 340 bed moves, the Brigham’s long-term bed plan was completed on June 3. The seamless execution was a testament to the collaboration of a large multidisciplinary planning team and their partners on inpatient units, hospital leaders said.
The transition also represents one of the biggest moves of patients and staff in the Brigham’s history.
“It’s difficult to describe the massive amount of coordination and collaboration that needed to happen behind the scenes to make these moves possible. From the residency leadership to staff on the units, so many people went above and beyond to ensure patient safety remained at the heart of every step we took,” said Sheila Harris, vice president of Patient Access Services. “I am so proud of how everyone came together to overcome the many challenges and achieve a safe, seamless move.”
Charles A. Morris, MD, MPH, deputy chief medical officer, agreed.
“In all my years at the Brigham, I can’t recall a project of this scope that was executed so smoothly. The team moved hundreds of patients across dozens of care areas, and did so in seamless fashion, all while the hospital was seeing an extraordinarily high volume of patients,” Morris said. “Their masterful execution allowed us to continue the critical work of meeting the needs of those in our beds as we moved beyond the COVID surge.”
‘It Was Like the Game Tetris’
The bed plan was created with input from key stakeholders to maximize quality and efficiency of care delivery, match bed allocation to service volume, facilitate regionalization, improve geographic clinical integration and maximize flexibility, among other objectives.
One especially complex challenge the team navigated was conducting the moves as the hospital’s medical and surgical census returned to pre-pandemic levels.
“It wasn’t like the move at the beginning of the pandemic, when essentially you had all these empty pods because volume in other areas was low,” said S.E. Chang, manager of Inpatient and Clinical Services Projects. “As COVID was ramping down, everything else just went straight up, so it was much harder to move people.”
To maximize safety and minimize disruption, the project team used a phased approach, moving 10 to 20 patients per day during a unit move. They worked closely with affected units to ensure areas were sufficiently staffed during the transition, as well as with the Admitting team to safely manage census and admissions.
“Ultimately, it was like the game Tetris,” Chang said. “We’d move one area, which then allowed us to move another and another. We did a lot of careful planning to really sequence that out in a safe, efficient manner.”
In addition to coordinating closely with nursing and physician leadership on the units, the teams worked with staff from Biomedical Engineering, Central Transport and Equipment Services, eCare, Engineering, Environmental Services, Food Services, IS, Materials Management, Patient Care Services, Pharmacy, Police and Security, and Respiratory Therapy, among others.
Karen Reilly, DNP, MBA, RN, associate chief nurse for Critical Care, Cardiovascular and Surgical Services, commended those involved for their extraordinary work.
“It was an incredible amount of teamwork. No one department could have done this on their own,” she said. “It just goes to show how committed people were to making this happen, and the thoughtfulness that went into planning every detail to ensure we had the right staffing, supplies, equipment, technology, layout, monitoring and so forth to care for the patient population and support the staff when we moved them.”
Reilly also applauded staff on the units for their dedication and adaptability amid so much transition.
“They were amazing. When it was their day to move, they would rise to the occasion,” she said. “They knew it was going to be challenging, but they’d say, ‘Let’s figure it out’ because they understood why we needed to do this.”