\u201cThis particular event shows how we were able to roll out and scale up our preparedness structure, and anticipate some of today\u2019s challenges,\u201d said Dr. Brad Greenberg, head of the hospital\u2019s emergency preparedness.<\/p>\n
While having an emergency preparedness framework in place is fairly common for hospitals, Greenberg said, \u201chaving a large group of folks that have been involved (together) for such a long time is kind of uncommon.\u201d<\/p>\n By the end of February, the infection control committee had started looking at the COVID-19 pandemic as a potential threat and began coordinating with the emergency preparedness command, said Dr. Erin Philpott, head of the hospital\u2019s infection control. The hospital\u2019s CEO and leadership put out a call in mid-March to hospital staff that it was an \u201call hands on deck situation,\u201d she said.<\/p>\n \u201cEveryone has been focused on COVID-19 at some level,\u201d Philpott said. \u201cIt\u2019s a hospital-wide effort to keep it organized and running.\u201d<\/p>\n To date, the hospital\u2019s coronavirus response command structure consists of 30 to 35 people, Greenberg said. The structure is divided into pods spanning finance, human resources, logistics and more \u2013 providing a span of control and communication that is manageable to everyone involved, he said.<\/p>\n One of the first challenges for the response team was how to establish testing for the virus. They created a telephone hotline for virus-related questions, and physicians could arrange to have people come in to get tested via car. By mid-March<\/a>, the hospital was offering three weekly drive-thru testing days in the parking lot.<\/p>\n \u201cThere was a lot of difficulty with testing early,\u201d Greenberg said, referencing the nationwide shortage of tests.<\/p>\n Early on in its response, the hospital also coordinated with San Juan County\u2019s emergency management team, local law enforcement, first responders and public officials. Together, they formed a joint information center to disseminate information to the public and to have the same kind of messaging.<\/p>\n Greenberg said the coronavirus response has also been a regional effort, involving communication with Mercy Regional Medical Center in Durango, Southwest Memorial Hospital in Cortez, the Navajo Nation and the state of New Mexico.<\/p>\n \u201cWe\u2019re doing a lot of work and collaboration to make it clear we\u2019re working together for the benefit of the Four Corners,\u201d he said.<\/p>\n Robin Malara, an Intensive Care Unit nurse for the past seven years, said she\u2019s known preparations around the hospital\u2019s COVID-19 response have been going on in the background since January.<\/p>\n She said staff members have been getting daily communication from the hospital\u2019s education department and from the physicians in charge of the response as well as information from the hospital\u2019s upper management by email or video statements.<\/p>\n \u201cWe\u2019ve been getting more communication as things have ramped up,\u201d she said. \u201cIt has been changing fast.\u201d<\/p>\n One of the biggest changes Malara said she\u2019s seen the hospital make is staffing and minimizing exposure to the virus. She said the hospital was divided into separate areas for patients who may have been exposed to the coronavirus and those who haven\u2019t been exposed.<\/p>\n The division of the hospital into COVID and non-COVID areas happened in about half a day, Greenberg said, a transition he credits to the flexibility of the hospital\u2019s incident command system.<\/p>\n \u201cWe can take in information, rapidly adjust and then act,\u201d he said.<\/p>\n The hospital has also taken additional steps to ensure staff and front-line workers are well-protected.<\/p>\n \u201cThere\u2019s a daily check-in when we come into the hospital to make sure we\u2019re healthy,\u201d Malara said. \u201cThey take our temperature and ask about symptoms that are common with the coronavirus.\u201d<\/p>\n The hospital postponed elective procedures and limited services because of the pandemic and, as a result, saw a decline in revenue. In response, the hospital announced in early April<\/a> that senior staff were reducing salaries; select employees would be furloughed; and staff members were asked to take voluntary pay reductions.<\/p>\n Over the course of the pandemic response, San Juan Regional has received an outpouring of support from the community, in the form of donated personal protective equipment, hand-sewn masks, food for medical workers and support staff, and financial donations, Greenberg said.<\/p>\n \u201cThe hospital has secured a significant amount of (personal protective equipment),\u201d said Dr. David Devitre, who has worked at SJRMC for 10 years, including in the ICU and emergency room. \u201cI definitely feel well-protected going in and out of the hospital and seeing patients in our PPE.\u201d<\/p>\n As of Thursday morning, San Juan County had 339 positive cases out of 2,216 total tests completed with 22 deaths related to the virus, according to the state\u2019s Department of Health data<\/a>. San Juan Regional Medical Center had 21 positive inpatients and had received more than 2,000 calls on its COVID-19 hotline.<\/p>\n Medical professionals at all levels of the hospital emphasized the importance of social distancing to keep the number of cases and deaths as low as possible. Greenberg and others said social distancing has been important in making sure the health care system was not overwhelmed.<\/p>\n \u201cBeing on the front lines and seeing what this disease has the possibility of doing to young people in their 30s to 50s, when they die right in front of your face after being stable, minimizing the spread of the disease is very important, especially since we don\u2019t have a standard cure, treatment or even vaccine,\u201d Devitre said.<\/p>\n