HOSPITAL HEAD RECOUNTS CHALLENGES, LESSONS FROM PANDEMIC
BY BENJAMIN FANG
In the 35 years that Jaclyn Mucaria has worked in hospitals, the first wave of the COVID-19 pandemic was the worst crisis she had ever faced. Mucaria, president of NewYork-Presbyterian Queens, said her hospital was overrun with COVID-19 patients. Queens was an epicenter of the outbreak, and because no one knew much about the disease at the time, they didn’t know how many patients would be coming in.
“It was very unpredictable,” she said. “Everyday, we were trying to do something different.”
One of the first decisions Mucaria made was to create more negative pressure rooms and make sure positive patients were all in one area. The goal, Mucaria said, was to test them, get them out of the emergency room as quickly as possible, and get them onto a patient floor.
The hospital president also had to increase ICU beds. At one point, about one in every five patients needed ICU beds, which meant converting recovery and procedure rooms and other spaces into mini-ICUs.
“That was not easy,” she said. “We had to bring in ventilators and critical care staffing.”
After elective surgeries were cancelled due to the pandemic, Mucaria said that freed anesthesia machines and recovery rooms for ICUs. It took a lot of teamwork to get them up to code, especially with the negative pressure. At the Flushing hospital, the staff set up a tent outside the emergency department to screen patients.
Mucaria noted that the Emergency Department was not large enough to accommodate the number of patients. When the Emergency Department was backlogged, the hospital would call the FDNY and EMS to ask them to take patients elsewhere. EMS would give the Flushing site two-hour blocks to direct patients, but if a sick person arrived on their own, the hospital couldn’t turn them away.
Toward the end of the first wave, Mucaria said they even had to convert the cafeteria into a space for 20 beds just to add more capacity.
“Unlike a department store or a restaurant that posts a sign on maximum capacity and locks the door,” she said, “we can’t lock the doors.”
NewYork-Presbyterian Queens set up a command center in the boardroom that was manned 24 hours a day, seven days a week. They worked closely with the hospital system to move equipment, PPE and staff back and forth across facilities.
“It was really comforting to know that we were part of a larger enterprise,” Mucaria said.
From a staffing perspective, Mucaria said the hospital set up recharge rooms so the staff could unwind from the stress. They also set up hotel accommodations for people who did not want to go home and possibly spread the virus to their families.
Buses were arranged to pick up and drop off staff members who did not want to ride mass transit. The hospital also provided mental health resources for its team.
“This was very mentally draining and challenging,” Mucaria said.