The command center at El Camino Health was in operation for an unprecedented 72 days on the Mountain View campus and fully activated within 24 hours of the first patient with COVID-19 arriving in the emergency room.
“When we first learned that a patient tested positive, and because we already had a pandemic plan in place for SARS and Ebola, we were able to activate our containment plans immediately,” says Cheryl Reinking, chief nursing officer.
Using the Hospital Incident Command System (HICS), a designated hospital conference room is equipped to serve as a command center during times of crisis. This command center was activated for the COVID-19 pandemic and stocked with necessary equipment, supplies and a television to help the team stay abreast of current news related to the pandemic. Relevant staff roles were identified and put into place including a planning sections chief, logistics section chief, operations section chief, and incident commander. The team also utilized infection prevention nurses to communicate with Santa Clara County officials and the Centers for Disease Control and Prevention (CDC) to ensure directives and protocols were kept updated.
“The model works like this: incident command leads the team, planning thinks about what you need, logistics acquires what you need, and operations ensures the plan is effectively implemented,” explains Steve Weirauch, environmental health and safety manager. “The command center allowed us to centralize operations and streamline communication.”
One of the first tasks was to identify units in the hospital to serve as isolation and containment areas and have the ability to increase the number of these containment units as more patients with COVID-19 came into the hospital. The labor pool also operated out of the command center, which allowed the team to reallocate staff to areas experiencing an increase in patients from those areas that were not seeing many patients. Members of the El Camino Hospital Auxiliary were asked not to come into the hospital during this time for their protection, so the labor pool assigned staff to cover the important tasks performed by these valued volunteers.
El Camino Health saw one of the first known COVID-19 patients in the state. As a result, the hospital was ahead of the demand for personal protective equipment (PPE) and established a more than adequate supply, which soon was on backorder elsewhere around the country.
“The command center’s role was to educate staff on every new bit of information, while properly managing our resources,” explains Cheryl. “Even though they are clinicians, people felt vulnerable and scared, so we kept reviewing requirements and educating them to make them feel secure and safe giving care.”
Having the ability to do testing in-house at the hospital was a game changer. It allowed the command center to better allocate resources and helped put staff at ease because they knew in an hour, not days, whether the patient they were caring for had the virus. In the beginning, it would take four days to get test results to determine if a patient was positive for COVID-19. That meant they had to be isolated in a containment unit until the results came back.
When the number of patients with COVID-19 and the volume of calls from within the organization decreased, the decision to discontinue the command center was made.
“We have specific criteria in place that will trigger us to reinstitute the command center immediately, should it become necessary,” explains Cheryl. “For instance, if we see an increase in patients that require isolation and one of our containment units fills with COVID-19 patients, we would likely re-engage the command center.”
Operating the command center for such an extended period of time was sometimes stressful with guidance from authorities changing so rapidly. It required near constant monitoring because what was being done one day, might be very different the next.
“I told everyone involved in the command center that I am so grateful to work at El Camino Health because of the staff and our ability to work together,” says Steve. “We are very committed to doing the right thing and if I had to do this again, I would want to do it with this great group of people.”