With a rapid increase in COVID-19 patients, on August 20, leaders at Kootenai Health made the decision to convert the hospital’s largest conference room in its Health Resource Center into a patient care area dedicated to COVID-19 patients. Late Monday afternoon, seven patients were moved into the Health Resource Center COVID-19 unit. It can accommodate up to 22 patients in a common, ward setting.
Numerous teams worked around the clock to ensure the space meets necessary measures for patient and staff safety and infection prevention. Additionally, separate rooms in the Health Resource Center are being used to provide monoclonal antibody therapy to COVID-19 patients who are not hospitalized.
The need to begin providing care to patients in the Health Resource Center COVID-19 unit and alter other standards of care in the hospital prompted Kootenai Health to request that the state activate Crisis Standards of Care.
Prior to requesting implementation of Crisis Standards of Care, a health care organization must exhaust all other possible resources. Throughout the pandemic, Kootenai Health has stretched existing staff, hired additional contract nurses, expanded bed capacity, canceled elective surgeries and adjusted contingency levels of care to accommodate the COVID-19 patient surges and volume demands. Although Kootenai is scheduled to receive additional staffing from the Department of Defense and ACI Federal, which provides health care staffing on behalf of the federal government, the current surge will still require Crisis Standards of Care.
Kootenai Health leaders participate on the Idaho Crisis Standards of Care taskforce, and on Monday, Sept. 6, Kootenai submitted a request to the state to activate Crisis Standards of Care. That morning, Kootenai started the day with 113 COVID-19 patients; 39 of those were in critical care and 21 were on ventilators.
Crisis standards of care are guidelines that help health care providers decide how to deliver the best care possible under extraordinary circumstances when it is no longer possible to provide all patients the level of care they would receive under normal circumstances. The goal of crisis standards of care is to extend care to as many patients as possible and save as many lives as possible.
Crisis Standards of Care follow a continuum. Initially, they can mean patients are receiving care in a place they would not be receiving care otherwise, such as a hospital room that was not initially built for their specific need, or a classroom that has been converted to a patient care area. They can also mean that hospital staff members such as nurses are providing care to more patients than they would normally care for and monitoring vital signs less frequently than normal. Only in extreme instances will hospital care teams need to make decisions about who will or will not receive needed resources. Hospitals such as Kootenai Health have a multi-disciplinary ethics committee that has established protocols to guide decision-making when extreme circumstances require decisions about the provision of care.
According to Panhandle Health District, the rate of those who are fully vaccinated in Kootenai County among people age 12 and older is approximately 40%. According to the Centers for Disease Control and Prevention, the U.S. rate for that same population is 53%. Few area businesses require masking, children – including those not yet old enough to be vaccinated – return to school today with no masking requirements at area public schools, and local COVID-19 case counts continue to climb.
Kootenai Health and its medical staff members continue to implore community leaders and citizens to add their efforts to the cause. They are asking every individual and family to do their part to prevent and slow the spread of COVID-19. Please get vaccinated for COVID-19, wear a mask when out in public, avoid optional large gatherings, practice social distancing and wash or sanitize your hands frequently.