An Historic Record — a Hospital in a COVID-19 HotSpot in the Spring of 2020: Einstein’s Chronicle

When Einstein Medical Center Philadelphia found itself in a hot zone for COVID-19, starting in March 2020, necessity required a multi-faceted response of both improvising and planning with steady nerves.  The North Philadelphia hospital took steps reflecting rapid adjustments that hospitals across the country had to take.

  • Ken Levitan

    Einstein quickly established an Incident Command Center, with HSX board member Ken Levitan leading the center and coordinating Einstein’s daily response to the pandemic.  In addition to his role as chief administrative officer at the medical center, Ken “assumed the rather soldierly title of ‘incident commander,’” as Philadelphia magazine put it in lengthy, inside coverage of the first month of Einstein’s response to the outbreak.

    The command center, set up by Einstein’s CEO, Barry Freedman, is an established tool when normal operation of a hospital is impacted and the hospital sets in place rapid mobilization, prompt decision-making and coordination of personnel, procurement of added equipment/supplies, and special messaging to manage the crisis.  Command centers are based on the principles of the Hospital Emergency Incident Command System (HEICS), the national standard for medical facilities to manage response during catastrophic events.  As such, Einstein’s center provided a structure and designated group of leaders for the health network’s clinical, administrative, facilities, operations, human resources, legal, and safety areas.  And, it managed communications to employees, patients, families, and visitors. 
     
  • Entering a period in which it would see thousands of patients suspected of coronavirus infection, the hospital had to make quick conversions.  In an especially busy stretch of just 72 hours of the surge in April, Einstein created two new critical-care units for COVID-19 patients, to supplement its existing 48 critical-care beds.

    Because the hospital was mandated to postpone elective surgeries, it was able to use its short-procedure pre- and post-operative recovery unit and the post-anesthesiology care unit for this prompt intensive-care expansion.  Working night and day in that stretch, Einstein mounted an effort that required the team to:
     
    • convert short-use anesthesia machines to serve as ventilators

    • establish negative air pressure in the converted rooms

    • enclose a nurse station with positive air flow

    • install walls and add barriers and lighting.
     

    Einstein's ICU.
    Photo courtesy of Philadelphia magazine.

    The hospital retrained nurses, and staff members took on exceptional duties beyond their normal clinical areas.  Volunteers went to retail stores and bought video-equipped baby monitors so that the staff could observe patients in their rooms from the nursing station.
     
  • As reported in the Philadephia magazine piece, some 40 people ranging from accounting staff to doctors contined to staff the command center team throughout these adjustments and ramp-ups.  On the COVID units, tubes snaked into patient rooms through cracks in doors for I.V. pumps and feeding.  The hospital was running through a years worth of personal protective equipment in a month and had to depend on volunteers to make new masks and other protective gear, as the hospital competed on a wildly unregulated open market for additional supplies.  And, the medical center had to fight for adequate enough testing resources to be able to discharge patients. 

    Einstein’s experience became a historic document and illustration of the core weeks of 2020 COVID-19 outbreak at acute-care hospitals.

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