“We owe it to the broader community to help in this manner,” said Stephen Ruoss, MD, medical director of Stanford Medicine’s Transfer Center. “Stanford Medicine has robust services supported by numerous and well-trained staff to care for patients, and an obligation to provide those services to care for patients when other hospitals become overwhelmed.”
Although some of the transferred patients had COVID-19, most were hospitalized with other conditions.
“Around Thanksgiving, when the numbers of hospitalized COVID-19 patients started to increase, some of the other hospitals in the county started to experience difficulties,” said Rudy Arthofer, MHA, RN, associate chief nursing officer of inpatient access, capacity, and throughput and efficiency. “At that time, the medical director for the county asked hospitals to work on a way to level the patient load across institutions.”
Daily meetings to assess capacity
“We have daily meetings with representatives from other medical institutions where we assess each hospital’s capacity, staffing levels and patient care needs,” Ruoss said. “This helps us match up needs with our availability and capacity and level out the patient mix on that day. Of course, the next day those needs can be entirely different. Maybe there is a greater need for surgical care, or for available ICU beds or for other types of care. So we discuss that and come up with a plan for the day.”
To expedite the transfer process, Stanford Medicine waives the typical insurance clearance process and other administrative steps normally completed when a patient moves from one facility to another.
Of 548 transfers from Nov. 1 to Jan. 5, 47 patients had COVID-19, and 494 had other conditions. (Seven had been exposed to someone with COVID-19 but their infection status at the time of transfer was unknown.) Of the transfers, 135 were within Santa Clara County.
Early in the pandemic, Stanford Medicine accepted transfers from hospitals in Southern California’s Imperial Valley, Ruoss noted. “The hospitals in that region didn’t have the capacity to care for the number of patients they were admitting, so several — some very sick — patients were transported from their emergency departments to Stanford for care. We were happy to accept them. It was what we should do, and what we did."
"'Absolutely. We're going to do it.'"
Now the crisis has moved closer to home. Hospitals in San Jose and other parts of the South Bay have requested aid, which Stanford has been able to offer.
“Physicians don’t have to accept these additional patients,” Arthofer said. “They already have their own workload. But, universally, the response of our staff has been ‘Absolutely. We’re going to do it because it’s the right thing to do.’”
“Here at Stanford we’ve planned for years to have the capability to respond to disasters involving lots of patients, and there are many people here devoted to the idea of maintaining our flexibility and capacity in the face of disaster,” Ruoss said. “Sadly, now we have one. It’s a slow-moving disaster, but it is a disaster. And we are willing and capable to step up and provide the help.”