Safety, access to care, top priorities as YNHH eases into transformation

transformation

Tara Smith and her Environmental Services coworkers play a critical role in YNHH’s transformation process, which includes new cleaning procedures for inpatient and ambulatory areas to reduce the risk of COVID-19 transmission.


With the number of COVID-19 inpatients continuing to decline overall, Yale New Haven Hospital is in transformation mode, ramping up other clinical services and addressing the needs of patients whose care was deferred when the pandemic began.

“The work our staff and physicians have engaged in to meet the needs of patients across the spectrum of clinical services has required us to carefully re-think so many parts of our systems of care,” said Cynthia Sparer, senior vice president, Operations, and executive director, Yale New Haven Children’s Hospital. “This process is not a recovery to pre-COVID-19 times, but rather a transformation to a new paradigm for all of us.”

During this transformation process, the hospital is working through challenges that include identifying appropriate space, both on our hospital campuses and at our off-site locations. The hospital is also working to provide effective, coordinated and safe care, and ensure a streamlined COVID-19 screening and testing process and availability and appropriate use of PPE, Sparer said.

In terms of identifying appropriate care space, YNHH is transitioning into a facility that can continue to manage COVID-19 patients, while maximizing capacity to care for all patients. To meet the ongoing demand for intensive care areas, North Pavilion floors 12, 14 and 15 will continue as COVID-19 ICUs. For discharged COVID-19 patients experiencing respiratory difficulties during recovery, the Winchester Chest Clinic will expand its Dana Building space.

For non-COVID patients, the hospital is gradually reopening inpatient, ambulatory and procedural areas. Inpatient units are being restructured as part of a comprehensive approach to capacity and bed planning.

At press time, operating rooms and procedural areas were functioning at approximately 65 percent of normal capacity, and continue to prioritize cases on a clinical basis in conjunction with clinical leadership. Old Saybrook Medical Center, Shoreline Surgery Center, North Haven Endoscopy and the Norwalk Pediatric Specialty Center are resuming services this month.

After a successful pilot program, Yale New Haven Health System has increased the number of breast imaging procedures. Extended hours, including evenings and weekends, are available for breast and ultrasound imaging appointments. By adopting post-COVID operational efficiencies, YNHH’s CT use is nearing pre-COVID levels. Laboratory draw stations have also been returning to operation using a phased approach.

Expanded safety measures have been critical components of Yale New Haven’s transformation. In addition to screening for COVID-19 symptoms at all hospital entrances, changes include pre-service screening and COVID-19 testing for all patients scheduled for surgical or medical procedures; new cleaning procedures for ambulatory areas, including between each patient encounter; and revised patient flows to avoid registration lines and waiting room use. A successful, pilot voluntary testing program for patient-facing employees at YNHH is being expanded to asymptomatic employees throughout the health system.

Expanded safety measures have been critical components of Yale New Haven’s transformation. In addition to screening for COVID-19 symptoms at all hospital entrances, changes include pre-service screening and COVID-19 testing for all patients scheduled for surgical or medical procedures; new cleaning procedures for ambulatory areas, including between each patient encounter; and revised patient flows to avoid registration lines and waiting room use. A successful, pilot voluntary testing program for patient-facing employees at YNHH is being expanded to asymptomatic employees throughout the health system.

Other important safety measures focus on social distancing and infection prevention. Departments throughout YNHHS have collaborated to produce “social distancing kits” for ambulatory and other areas. Kits include floor markers, signs, waiting room standards and information about cleaning protocols. YNHHS continues to expand the use of technology for telehealth visits, electronic check-in and patient self-scheduling.

Other infection prevention measures include the use of Plexiglas barriers in select areas and signage with reminders about wearing masks and properly washing hands. Employees are being reminded to self-monitor for fever twice a day, and not to report to work if experiencing any COVID-19 symptoms.

“As we begin to reopen sites that had been closed and increase patient volume at our many other sites, it will be extremely important to convey a sense of safety and well-being to our patients,” Sparer said. “Many of our patients are concerned about returning for care. Our goal is to make sure they feel safe and in great hands, thanks to our outstanding providers and staff.”

Watch for future communications about transformation plans, in employee newsletters, on the intranet and from your department leaders.