One key reason to #FlattenTheCurve in #COVID19 is b/c it’s hard / impossible to deliver great care when overloaded. Some reflections on how #interhospital #transfers could help (more) in #hotspots 1/10

When a hospital is in #COVID19 overload, it‘s hard to deliver great care. This includes high-quality nursing, PT, vent mgmt, family engagement, AND the always-difficult question of who, when, how, and where to transfer 2/10

Indeed, as we are seeing in #COVID19, a few hospitals in #hotspots are drowning, while other nearby hospitals are willing to help, but everyone wonders why things aren’t working out 3/10

In my conversations with clinicians and leaders around SE Michigan, I’m struck by how much people agree that better #transfers could help #LevelTheLoad, but nobody is quite sure how to make it happen 4/10

Clinicians in the #hotspot say they need help. Clinicians at other hospitals want to help. Our VA is even open to civilians. Yet numbers suggest not enough #transfers are happening 5/10

This suggests that we should be building stronger pathways BETWEEN hospitals as aggressively (or even more aggressively) than we are building additional capacity WITHIN hospitals 6/10

We should also be ASKING for, and offering, HELP sooner than usual. But that is antithetical to our professional, cultural, institutional, and economic instinct to say “I got this” #wellness 7/10

During #COVID19, it therefore seems sensible to pro-actively #LevelTheLoad—eg, have 10 regional hospitals share capacity BEFORE overload—than have 2 hospitals overloaded at 150% and 8 at 50% and reactively #transfer on the “back end” 8/10

I (and others) will write more about how to do this practically later. For now, thanks to the busy docs, nurses, leaders, and policymakers who spoke with me over the last week… you know who you are 9/10

Happy Easter. Be well, and take care of each other 10/10