Monument Health continues to prepare for COVID-19 West River spread

Monument Health Spearfish Hospital and its staff are preparing for an influx of patients who would need treatment for COVID-19. Pioneer photo by Mark Watson

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SPEARFISH — As coronavirus continues its spread across the state, hospitals are bracing for the influx of patients who will need care for the most serious effects of the disease it causes, called COVID-19.

Thomas Worsley, president of the organization’s Spearfish hospital and Hills markets, said Monday that the health group has been actively monitoring and preparing for a COVID-19 outbreak in the Black Hills for the last several weeks.

“As you can imagine, it’s a challenge to prepare for something that you’re not entirely sure what the timeline is going to be, when it’s going to impact our community,” he said. “There’s many variables that we’re learning by the day.”

Worsley said officials with Monument have collaborated with their partners at the Mayo Clinic to get an idea of what those in Western South Dakota could expect in the coming weeks. Additionally, he said hospital officials have been monitoring and studying other parts of the state and surrounding states which have had community spread of COVID-19 to learn about best methodologies to prevent spread.

“We have been doing a number of different scenario plans and those plans have varying levels and speed of community spread,” Worsley said, to put into place numerous possible strategic plans that could be initiated depending on the level of need at the time, including staffing, procedures, medical equipment, communication, and more. “We have several different teams that are all working on several different tracts of preparation.”

“We are reliant upon computer generated models to give us estimates in terms of what we expect the potential hospitalizations to be, and those estimates would indicate that not only in Spearfish and in Rapid City, but across the state and the country, that we have insufficient number of hospital beds to be able to respond to this type of pandemic,” Worsley said. “So, a lot of our preparation has been, ‘OK, how are we going to care for these patients in the event that we need to look at alternative locations, if we need to look at alternative or increased number of staff members, we’ve looked at how can we mobilize physicians that perhaps work in other areas that would be able to help us.”

Monument, like every healthcare system, Worsley said, is looking to source and stretch all available resources to handle the incoming flux of patients, and particularly precious equipment like respirators which have been both vital to treat hospitalized COVID-19 patients, and under available in recent weeks.

The hospital is currently at its normal bed capacity, which is 24, not including the labor and delivery ward beds.

Carrie Donovan, the local emergency preparedness leader with Monument Health, who partners with the infection control leadership, said the hospital has been sending some tests to the Mayo Clinic for testing.

“Right now, we’re splitting our testing between those medium- and high-priority tests going to the South Dakota Department of Health, and then our low-priority tests going to Mayo Clinic,” she said. “That takes some of the burden off the Department of Health but gives us our most needed test results faster.”

Donovan said Monument is following the testing guidelines laid out by the Department of Health.

“So far, we haven’t done a huge number of tests in our area,” she said.

Since March 12, Monument Health Spearfish Hospital has collected 18 COVID-19 tests.

Surge planning is underway, Donovan said.

“Surge planning is built in phases with specific triggers,” she said. “So were we to have a certain number of cases requiring a certain resource, that would trigger a next level of planning. So it’s a series of tiered responses based on specific triggers.”

The system allows healthcare professionals to expand and contract capacities and resources as the area’s needs change.

Worsley said that while some national models have indicated that up to 30% of the population is at risk of infection, Monument does not have a mechanism to estimate what impact is expect for the Northern Hills.

“If it did become serious, and there did have to be hospitalizations, there’s no doubt that it would absolutely test our system, and we would have to really invoke our surge plan to take care of all these patients,” Worsley said. “It would not have to be as high as these national estimates of 30% to really have a significant impact on us.”

Monument Health has launched a COVID-19 nurse triage line to connect patients with nurses who can assess symptoms and work with providers to determine if testing is needed.

However, drive-up sampling will only be done if a doctor or healthcare professional has specifically ordered it. To qualify for the drive-up swab, a patient must be preregistered and have proper identification.

The order and preregistration can be obtained by telephone with the COVID-19 Nurse Triage Line or the patient’s Monument Health Clinic. The phone number is (800) 279-1466.

Worsley said that Monument has trained its clinical providers to interact with their patients virtually.

“The intent is for those patients that don’t necessarily need to come into the clinic on a urgent bases, that they could communicate with their providers from home and really support the social distancing which has been a recommendation at all levels,” he said. “We believe that it (social distancing) is an effective way to decrease and slow down community transmission (of COVID-19). So all of our efforts are in support of that.”

Worsley said people should reach out via telephone to their clinic or regular provider if they believe they should be evaluated for any health concern, not necessarily only related to COVID-19, and their healthcare professionals can advise them how to proceed.

“We have not closed down our taking care of the community; we are very committed, and we will continue to be committed to doing that,” he said.

In addition to taking advantage of the warm weather outside, exercise, healthy diet, Worsley said it’s important to take care of one another while practicing social distancing.

“We are blessed and fortunate to be able to live in an age where technology is all around us … any opportunity to call and check on friends, family, coworkers, acquaintances, and using technology to stay connected is one of the top ways that we can make sure that we practice self-care as well as caring for each other,” he said.

Worsley thanked the city of Spearfish for its generosity during this difficult time. He said people have provided ordered food and childcare for the healthcare professionals on the front lines of the pandemic.

“The city has been incredibly generous in terms of offering up support for our caregivers that perhaps may need to work additional hours and are being stretched in different directions than what we’ve seen,” Worsley said. 

Tuesday, Monument Health announced that it would close its hospitals and clinics to visitors beginning today. Some exceptions to the policy include patients in Labor & Delivery, Neonatal Intensive Care Unit and Pediatrics, as well as children in the Emergency Department, where patients will continue to be allowed one visitor at a time. In addition, patients in hospice care or receiving end-of-life treatment will be allowed special exceptions to this visitor policy.

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