As a system, Houston Methodist implemented a no-visitor rule in late March with compassionate exceptions made for situations including delivering mothers and end-of-life patients, according to a March 27 release from Houston Methodist.
In addition, Barber shared how the hospital has changed protocols, adapted staffing and freed up beds to prepare for an influx of patients believed to have the new coronavirus disease.
"We'll continue to say everything we can do as a community to flatten that curve by appropriate social distancing is really helping to make sure that the health care delivery system is in a position to be able to manage the influx of patients," Barber said. "We are well-positioned right now."
Numbering beds
Barber said the Willowbrook Hospital has dedicated one of its two intensive care units for caring for positive COVID-19 patients as well as a 36-bed medical-surgery floor and part of a second 36-bed medical-surgery floor. Dedicated units include distinct units for patients testing positive for the coronavirus, persons under investigation—those believed to be positive for the coronavirus but awaiting test results—and non-COVID-19 patients, he said.
Patients entering the Willowbrook Hospital's emergency room are screened, and if they have COVID-19-like symptoms, they will be screened into a tented area to be tested for the coronavirus, Barber said.
"Many of those patients are able to be tested and taken care of and discharged home, because as we know COVID doesn't require hospitalization for everybody, so we are doing that triage process and obviously discharging many patients home with the appropriate instructions that if you become more sick, please reach back out to us," Barber said.
As a whole, the Houston Methodist hospital system also has a highly infectious disease unit housed at its St. Catherine Hospital, a continuing care hospital located in Katy, Barber said.
"We have a highly infectious disease unit that we actually created several years ago when Ebola came around. We made an investment in creating a 20-bed infectious disease unit," he said. "We intentionally did that in our long-term acute care hospital, which we keep separate from our main hospitals. We're in the process of expanding that to 22 more beds."
Barber said the hospital system collectively has about 150 patients who are positive for COVID-19 with 300 prepared ICU beds alone at Houston Methodist Hospital in the Texas Medical Center. Another 150 beds could be added across the hospital system as demand continues to rise, he said.
"We also transfer patients down to the [Texas] Medical Center," he said. "We are doing a combination of keeping patients here [at Willowbrook] and also transferring patients to main Methodist as well as our highly infectious disease unit for COVID-positive patients."
Additionally, patients can access virtual urgent care online, which enables patients experiencing COVID-19 symptoms or wanting to avoid catching germs to connect with a virtual urgent care provider 24/7, according to Houston Methodist's website.
"We're actually doing into the thousands of virtual visits really daily now, which I think that's one thing that will never change after COVID," Barber said. "I think the world of virtual health care visits will in some ways never go back to the way it was before, which in some ways is actually a good thing, because medicine does need to progress in some of those areas where virtual visits are appropriate."
Equipment supply
In addition to the capacity to add more beds, Barber said he believes the hospital's supply chain for personal protective equipment is in good shape to handle demand currently across the system's eight hospitals.
"We are in great shape for our personal protective equipment. We have a great inventory and a great supply chain ... of that coming in," Barber said. "We've really as COVID came about started preparations for this at this point now a month ago, so I think that that all is paying off."
To make the most of PPE and practice social distancing, Barber said professionals are staying in their offices to minimize contact and holding meetings virtually. Staff on the front lines in patient care areas are then being equipped with PPE.
Barber also said the hospital has an ample number of ventilators, although he did not provide the exact number as of April 7.
Staff changes
Barber said the Willowbrook Hospital has no staffing shortages currently, as the hospital is not doing any elective procedures, which has freed up staff to help out elsewhere in the hospital. For those in designated COVID-19 units, the hospital has also increased its training, with a great deal of effort being around proper use of PPE.
"Part of that is obviously for the safety of patients, but it's also very focused on freeing up those health care workers so they can focus on our COVID-positive patients and our patients under investigation. Obviously with that census growing, we're putting more efforts to train those employees," Barber said. "We've put more training into making sure that they understand what kind of masks, what kind of gowns to wear at the appropriate time."
Houston Methodist has also adapted its pay to offer paid time off for staff missing work for exposure to the coronavirus, provided complimentary meals—from the hospital and community organizations—and maintains daily briefings with employees to keep them informed, he said.
"We really focus on our people, really every day but especially during a time like this," Barber said.
