Stony Brook Medicine (SBM) has been at the forefront of efforts to identify and contain the international pandemic in Suffolk County.
SBM activated a Hospital Incident Command Center (HICS) that meets twice a day (virtually) to hear reports from nearly every hospital and ambulatory department. This is helping us provide the best possible patient care, use state-of-the art techniques to protect our healthcare providers, feed the supply chain, properly allocate bed needs, ensure proper staffing, and establish and maintain the best isolation procedures and more.
Stony Brook University Hospital (SBUH) created three units comprising of 45 beds in total in the last three weeks for persons under investigation (PUI), with another 16 bedded unit which will be completed shortly. We have greatly increased our capacity for overflow bed needs and are actively working to significantly expand ICU and stepdown bed capacity. This creates new negative pressure and isolation room resources within SBUH.
We’ve also created a forward triage and treatment area, moving incoming patients away from our main emergency room, with signage instructing persons with influenza-like illnesses (ILI, which includes COVID-19) to divert to the appropriate triage area. This new area is staffed with board-certified emergency medicine physicians and emergency medicine nurses who can safely screen persons with ILI and obtain respiratory pathogen point of contact testing (if needed), SARS-CoV2 testing, and provide proper advice and follow up.
SBM established relationships with two commercial laboratories to which we send our patient samples, as well as the New York State Department of Health Wadsworth Laboratories. We are also working to validate instrumentation to ensure capability to perform internal testing. Testing is the key to mitigating the epidemic, and on-site, point-of-contact testing will greatly improve our handling of PUIs and patients with documented COVID-19.
We have enlisted numerous volunteers from the ranks of our learners (graduate, medical and nursing students) who stand ready to help when our patient numbers climb above our capacity. We also have support of many MD/PhD and PhD graduate students from our basic science and clinical departments who have volunteered to assist with our laboratory response to the need for testing. For in-house testing, we are prioritizing work assignments to those students who have relevant lab experience with the techniques needed to perform PCR assays of the type required to assess the presence of SARS-CoV2, the Coronavirus causing COVID-19.
Telehealth is becoming a critical component in combatting COVID-19 nationwide. At Stony Brook Medicine, our experience with telehealth predates the current coronavirus pandemic and has been used to serve the psychiatry and neurology services in several settings. We are increasing telemedicine services and to date, more than 500 SBM healthcare professionals are ready to see patients virtually. Expanded services for family medicine, pediatrics and general medicine began March 18 and were well received.
As part of our efforts to reduce the spread of coronavirus to patients and staff, Stony Brook Medicine has postponed elective surgeries and procedures. Urgent procedures or operations necessary to preserve life and function will not be postponed. We have also established and implemented place policies on ambulatory care (consolidating), triaging of dental care patients (only acute and emergency patients will be seen), and on the definitions of essential and non-essential personnel under the current conditions, allowing, with supervisor approval, non-essential personnel to work from home.