Pandemic Care Through Collaboration: Lessons From a COVID-19 Field Hospital

Amy W Baughman; Ronald E Hirschberg; Larissa J Lucas; Elliot D Suarez; Deanna Stockmann; Stacy Hutton Johnson; Matthew M Hutter; Deborah J Murphy; Regan H Marsh; Ryan W Thompson; Giles W Boland; Jeanette Ives Erickson; Kerri Palamara

doi:10.1016/j.jamda.2020.09.003

Pandemic Care Through Collaboration: Lessons From a COVID-19 Field Hospital

J Am Med Dir Assoc. 2020 Nov;21(11):1563-1567. doi: 10.1016/j.jamda.2020.09.003. Epub 2020 Sep 8.

Authors

Affiliations

¹ Boston Hope Field Hospital, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA. Electronic address: awbaughman@mgh.harvard.edu.
² Boston Hope Field Hospital, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA.
³ Boston Hope Field Hospital, Boston, MA, USA; North Shore Physicians Group, Boston, MA, USA.
⁴ Boston Hope Field Hospital, Boston, MA, USA; Atrius Health, Newton, MA, USA.
⁵ Boston Hope Field Hospital, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA.
⁶ Boston Hope Field Hospital, Boston, MA, USA; Spaulding Rehabilitation Hospital, Boston, MA, USA.
⁷ Boston Hope Field Hospital, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA.
⁸ Massachusetts General Hospital, Boston, MA, USA.

Abstract

During the surge of Coronavirus Disease 2019 (COVID-19) infections in March and April 2020, many skilled-nursing facilities in the Boston area closed to COVID-19 post-acute admissions because of infection control concerns and staffing shortages. Local government and health care leaders collaborated to establish a 1000-bed field hospital for patients with COVID-19, with 500 respite beds for the undomiciled and 500 post-acute care (PAC) beds within 9 days. The PAC hospital provided care for 394 patients over 7 weeks, from April 10 to June 2, 2020. In this report, we describe our implementation strategy, including organization structure, admissions criteria, and clinical services. Partnership with government, military, and local health care organizations was essential for logistical and medical support. In addition, dynamic workflows necessitated clear communication pathways, clinical operations expertise, and highly adaptable staff.

Keywords: Boston Hope; Coronavirus (COVID-19); alternative care site (ACS); field hospital; post-acute care.

MeSH terms

Aged
Betacoronavirus
Boston / epidemiology
COVID-19
Cooperative Behavior*
Coronavirus Infections / epidemiology*
Female
Humans
Male
Middle Aged
Mobile Health Units / organization & administration*
Pandemics*
Personnel Staffing and Scheduling / organization & administration
Pneumonia, Viral / epidemiology*
SARS-CoV-2
Skilled Nursing Facilities
Subacute Care