CEO Claudio Fort says hospital is “ok for now” on PPE
By Polly Mikula
On April 2, Governor Phil Scott announced new steps in the state’s plan to prepare for a surge in Covid-19 cases, and in turn, the need for additional hospital and medical capacity.
“While we hope we will not need this extra capacity, our modeling indicates we must be prepared for a significant surge in medical care to treat Covid-19 patients. We are taking these steps to ensure we are as prepared as possible for what could come,” Scott said.
The plan added 950 beds, at surge sites, to the 662 currently available beds throughout the state. Rutland Regional Medical Center added 100-150 of those and constructed the site at Castleton University’s Spartan Arena.
“Rutland is proud to support these efforts to address increased medical need due to Covid-19,” said Claudio Fort, president and chief executive officer of Rutland Regional Medical Center. “Our teams are working closely with all of our health care partners to protect our staff and keep our communities safe.”
It was a regional effort. Firefighters from City of Rutland Fire Department and Rutland Town Fire Department laid down the floor at Spartan Arena.
“It takes a community, and we thank these first responders for stepping up and ‘stomping’ that floor,” RRMC wrote on its Facebook page.
While earlier in April the surge sites seemed prudent, by the end of the month it seemed unlikely that they’d be utilized.
Before RRMC would have a need to utilize the Spartan Area surge location, it would first open up other areas of the hospital: “Once we exceeded the capacity within the hospital we’ll move to alternative care sites outside the hospital,” said Fort.
When the hospital converts a section, wing or floor, to handle more Covid-19 patients, it converts the space to be a “negative pressure area,” explained Tom Rounds, RN and director of the RRMC Emergency Department, during an interview with Tom Donahue of BROC on PEGTV. To create a negative pressure area “machines draw down the pressure in that space and exhaust it out of the building,” he said, which helps protect the other patients and the staff from airborne pathogens and helps to reduce the spread of the virus.
PPE
When asked how RRMC was with personal protective equipment (PPE), Fort said: “We are ok right now, the problem is we don’t know how big this fight is going to be and how long this duration is going to be, so here at Rutland Regional Medical center we’ve put in place some conservation measures and these are changing rapidly. The national Center for Disease Control has changed their recommendations for this to allow us to safely reuse these masks,” he said.
“We starting conserving our PPE early on so we would have it when we need it. Our team also was proactive with the supply chain, we started to source and acquire PPE early so we weren’t as hard hit as others,” he said, adding “We also had a great response from our community including John Casella and Paul Gallo who had stocks of N95 masks that they donated to RRMC early on. But the big thing is that we haven’t seen the spike that we’ve prepared for in worst case scenarios.”
“It could still happen, so we need to be vigilant,” Fort added in the broadcast call-in, April 16.
Medical evaluations, testing
On Monday, April 6, RRMC set up a tent outside that is able to screen patience in a “split flow,” said Rounds. “We’ve opened up our ambulance bay… and turned it into a respiratory evaluation unit,” he said. “We have the ability to do chest x-rays there, screen patients, provide care and some patients might be able to receive treatment right there without ever having to come into the core of the emergency department.”
RRMC also has a tent set up at the Allen Street entrance where people who have had a test ordered by a primary care doctor (who confirmed the likelihood of their symptoms being Covid-19) can simply drive up and get tested. “They don’t have to exit their car, we’re collecting the specimen and those specimens are sent off to the Mayo Clinic,” Rounds said. If someone is sick in the hospital (as an in-patient or a healthcare worker) their tests are shuttled to Dartmouth three times per day “so we can turn those results around quicker,” Rounds explained.
Testing is now available for all people experiencing symptoms, but you do still need to get a doctor’s referral, you can’t just drive up to be tested, Rounds emphasized.
“Everything we’re doing is to ensure that the hospital is there for you when you need it, so if you are having an medical emergency you should call 911 or come to the ER,” Fort added. “We have not seen transmission of Covid-19 to our staff or other patience at the hospital, so I think that’s one evidence-based outcome to say that we’ve done a good job to contain this and to protect our patients and our staff at the hospital so I think you’re probably safer going into the hospital than some other businesses because the people at the hospital, the clinicians, have been doing this for six weeks non-stop and we have policies and processes and procedures to make sure we keep you safe.”
What’s next?
“We plan to keep the alternative care centers up through the end of May, then go from there,” said Fort. “We’ll see how the data looks and the Vermont curve is going, what the state recommends as we’re working in collaboration.”
“We’ve been lucky, but if a senior living center gets hit, then we could still have a spike,” Fort said. There are actually two alternative care sites, he explained: one at Spartan Arena for non-Covid patients and the other at Mendon Mountain View Lodge where up to 40 Covid positive patients could be cared for.
“This pandemic will have fundamentally changed medicine as we know it,” said Dr. Rick A. Hildebrant, chief medical information officer and medical director for hospital medicine at RRMC. “Telemedicine is a tool we now have and it’s not going away.”
Facilities will have to change in the future as well hospitals, he contineud. “The capability for negative pressure space is limited. RRMC has actually greater than most, but we still don’t have enough. When the next virus comes we need to be prepared… There will be another virus, we need to change and prepare for that… we’re going to be stocking PPE for the next pandemic.”
Hildebrant and Fort also emphasized the importance of working with community partners, like UVM, regional primary care physicians, visiting nurses, nursing facilities and so many more.
