Published June 13, 2020 10:38AM
The magnitude of change at Gisborne Hospital last month was unparalleled for staff and patients, says a senior doctor who helped with the hospital’s response to Covid-19.
“If you ask any clinician in the world, they will say that this was a pivotal moment in medicine,” physician head of department Dr Alyssa Thompson said.
“This pandemic and the response here and around the world will change how care is delivered in the future — be it in the way we build hospitals or the way we work with patients.”
From late March, Gisborne Hospital was divided into green and red zones to help ensure the safety of patients and staff by reducing the risk of transmission of Covid-19.
The move called for a rapid redesign of treatment spaces and staff rosters, as well as decisions on what equipment to prioritise for each area.
“We had to look at absolutely every component of healthcare a patient would physically come into contact with,” Dr Thompson said.
The simplest description is that one hospital became two — the green zone for regular patients and the red zone for patients with suspected or confirmed Covid-19.
“We were tasked with ensuring that patients could be treated and protected whichever pathway they were on.
“At that time we didn’t know how many people we were going to get.
“How do you prepare for that scenario against an unseen enemy that could be everywhere or nowhere?”
Dr Thompson said in the lead-up to, and during that time, she and other department heads were watching their international colleagues cope with the horrific spread of Covid-19.
Those department heads and other key specialists formed a Covid-19 response group which met over the Zoom platform.
From there they formed the plan to reconfigure the hospital.
Everywhere in the hospital — from the entranceway to the intensive care unit, from maternity to theatre — extensive changes were made.
Treatment spaces were redesigned to host one type of patient or another.
For example, negative pressure areas were allocated only for people with or suspected of having Covid-19. The intensive care unit was separated in two. Regular wards were prepped to receive patients requiring intensive care.
At the same time, staff were reallocated to areas of need while equipment, including beds, monitors, pumps, and ventilators, were also moved to relevant areas of need.
Next to the regular Gisborne Hospital theatre, the endoscopy suite was renovated so it could be used for operations on people who might have Covid-19.
Dr Thompson said when planning for the human flow of patients through the hospital during this time it was essential to think about the space between patients, corridors and facilities, and to erect barriers between them.
“There were countless other logistical considerations built into the design — from deliveries and patient transfers to storage and ventilation.”
The changes were so rapid that in some cases policies that normally accompany a change to standard operating procedures were being written at the same time the physical changes were occurring.
Staff cooperation intensified to such new levels the result was enduring working relationships, she said.
The result of the accelerated plan meant within days of starting, staff had transformed Gisborne Hospital to a safe place for staff and patients with any kind of illness.
As with any overhaul of a complex environment and processes, a huge range of staff were needed.
Dr Thompson said she was merely a minor cog in the very human machine that created the change.
From doctors to orderlies, healthcare assistants to nurses, catering staff to administrators — every member of the Hauora Tairawhiti team was involved.
“Each one of us felt like we were one of the five million people in the Unite Against Covid plan. Like everyone else, we felt we had a role to play.”
Hauora Tairawhiti chief executive Jim Green said the scale and magnitude of Gisborne Hospital’s reconfiguration was probably incomparable to anything most staff would have ever seen while working in New Zealand.
“Hospital reconfigurations usually happen with a much longer lead-in time and without the impending threat of a virus sweeping through.
“Our staff were tasked with establishing a hospital that could continue operating in this new world while continuing to do their jobs by caring for sick people and keeping patients and themselves safe.
“I know I speak for everyone across the district when I say we are all truly grateful for the countless hours and considerations that went into reconfiguring the hospital so staff could keep people who may have had Covid-19 away from those who needed to seek medical treatment for other reasons.
Thank you one and all.”
MERELY A MINOR COG IN A VERY HUMAN MACHINE: That is how Gisborne Hospital physician head of department Dr Alyssa Thompson described her role in the massive logistical challenge the Covid-19 pandemic presented at Gisborne Hospital. Picture by Paul Rickard