key: cord-0941244-bn4vv1pi
authors: Locke, Cameron J.; Koo, Benjamin; Baron, Sarah W.; Shapiro, Jared; Pacifico, Jessica
title: Creation of a medical ward from non‐clinical space amidst the Covid‐19 pandemic
date: 2021-03-18
journal: J Eval Clin Pract
DOI: 10.1111/jep.13560
sha: 21e483f25707fd2750732f0e41dd29d116c2f050
doc_id: 941244
cord_uid: bn4vv1pi

INTRODUCTION: Hospitals were mandated to dramatically increase capacity during the Covid‐19 crisis in New York City. Conversion of non‐clinical space into medical units designated for Covid‐19 patients became necessary to accommodate this mandate. METHODS: Non‐clinical space was converted into medical units at multiple campuses of a large academic hospital system over 1 week. The conversion required construction to deliver basic care including oxygen supplementation. Creation of provider workspaces, handwashing areas, and colour‐coded infection control zones was prioritized. Selection criteria were created with a workflow to determine appropriate patients for transfer into converted space. Staffing of converted space shifted as hospitalizations surged. RESULTS: The unit was open for 18 days and accommodated 170 unique patients. Five patients (2.9%) required transfer to a higher level of care. There were no respiratory arrests, cardiac arrests, or deaths in the new unit. CONCLUSION: Converting non‐clinical space to a medical unit was accomplished quickly with staffing, workflow for appropriate patients, few patients who returned to a higher level of care, and no respiratory or cardiac arrests or deaths on the unit.

We describe here the steps taken to convert non-clinical space into a functioning medical unit including the physical alterations of the space, methods by which we selected appropriate patients, the staffing model, and patient outcomes. In addition to patient beds, equipment and workspace in the Grand Hall was identified for doctors, nurses, and other staff. Delineated workstations included computers, label printers, printers, and telephones. Sinks and hand sanitising stations were installed at all entrances. Tablets for video interpreters, electrocardiogram machines, portable oxygen tanks, a crash cart and personal protective equipment (PPE) stations were acquired. Three smaller adjacent conference rooms became a satellite pharmacy, a clean utility room, and a break room.

Colour-coded infection control zones were outlined throughout the space, which included three zones: green (no patient contact; no PPE other than clean mask, that is, work room and break room); yellow (some patient interaction via transport or ambulation; PPE donned and doffed here, full PPE if directly in contact with patient); and red (areas of direct patient care; full PPE required, Figure 2 ). Patient transport to and from the Grand Hall was restricted to one entrance to minimize the use of public hallways (Figure 1 ). 

The converted unit expanded hospital capacity, freeing beds on traditional units to facilitate patient flow out of the emergency department and intensive care units. As overall hospital census decreased, the unit closed to patient care but is prepared for reactivation if necessary. As Covid-19 cases remain significant across the United States and the world, many medical centres continue to face the possibility of demand far exceeding hospital capacity. Rapid conversion of nonclinical spaces into patient care areas is feasible and can be accomplished safely with careful planning and interdisciplinary cooperation.

The authors declare no conflict of interest.

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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