Name: TMC hospitals go into Phase 2 surge plans as ICU capacity exceeds 100 percent
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TMC hospitals go into Phase 2 surge plans as ICU capacity exceeds 100 percent

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This is a carousel. Use Next and Previous buttons to navigateWith the number of intensive-care patients now exceeding capacity, Texas Medical Center hospitals have begun implementing COVID-19 surge plans that leaders thought might not be necessary after numbers fell far short of projections in April and May.The hospitals this week began opening additional beds — both intensive care and regular floor beds, some new, some converted — to accommodate a surge in COVID-19 patients that has grown exponentially in the past two weeks. The actions followed the hospitals’ collective ICU bed volume topping 100 percent capacity Wednesday.“It’s actually possible that we could become the next New York City,” said Roberta Schwartz, president of Houston Methodist Hospital. “I can’t believe we’re now staring down the barrel of that gun.”Schwartz noted that Methodist’s COVID-19 volumes are expected to approach 600 by the end of the week; its high dating back a month or more was about 260. Memorial Hermann hit 719 cases Wednesday; it was in the mid-150s in mid-May.The numbers are disturbing throughout the Houston region and the state. The region’s rate has more than doubled since May 31 and Texas’ count on Wednesday hit another all-time high — more than 8,000 new cases. Its rolling average for new cases has now increased for 22 consecutive days.Officials at Methodist, Memorial Hermann and CHI St. Luke’s hospital systems, the medical center’s three major private adult hospitals, all said they are opening new units or converting regular patient care beds to ICU and non-ICU beds dedicated to the care of patients with COVID-19. They also said they are beginning to reschedule less urgent inpatient surgeries and procedures, something they had been loathe to again begin doing.TMC leaders denied that going above 100 percent for the first time during the pandemic suggests they’re in crisis. They noted that ICU units want capacity to be between 90 percent and 95 percent and that it is not that difficult to flex up or down because of sudden influxes of patients. It is not uncommon during active flu seasons, they said.But in those cases, volumes typically drop back down quickly. There is little hope of that happening now.For that reason, the hospital leaders pleaded with Houston residents, particularly during the July 4th weekend, to wear masks and practice greater social distancing.“Houstonians need to think of a face mask the same way they think of seat belts,” said Dr. Paul Klotman, president of Baylor College of Medicine. “When you get in car, the first thing you do is buckle your seat belt, not question the number of available trauma beds. If you hate wearing a mask, you’re really going to hate being intubated.”On HoustonChronicle.com:More for youKlotman said the surge response now invoked is “a little stressful but not a problem.” But he added that if TMC hospitals have to go to the next-level surge phase, it will be “a big deal, potentially crippling.”The medical center, which boasts 1,330 ICU beds under base operations, had 1,350 such patients in house Wednesday. Full invocation of its first phase of expanding would provide 373 additional ICU beds. A second phase, if necessary, would provide another 504.The implementation of surge planning was noted in a TMC dashboard slide posted Wednesday that noted ICU capacity had hit 102 percent. A slide last week showed medical center hospitals ICU were at 100 percent, but it represented a rounding up — there were still five beds open. On Wednesday, there were 20 more patients in intensive care than capacity.COVID-19 patients comprise 480 of the 1,350 ICU patients.The Harris Health System, the county’s safety-net health care network, had already implemented the initial phase of its surge response and expect by early next week to have completed a second phase that involves limiting patient activities at some of its outpatient clinics to virtual care and imaging in order to move staff to support patient care at its Ben Taub and Lyndon B. Johnson hospitals.Because it is so overloaded, the system has been transferring patients in greater and greater numbers. LBJ and Ben Taub together have sent 33 patients to other hospitals in the last 24 hours and were working on 15 more Wednesday morning. The 48 patients represent 10 percent of the two hospitals’ combined regular adult acute care beds (ICU and medical/surgical beds).In the past week, the two hospitals have transferred patients to CHI St. Luke’s, Houston Methodist, Memorial Hermann, HCA Houston Healthcare, St. Joseph, the University of Texas Medical Branch in Galveston, UT MD Anderson Cancer Center and, most notably, Texas Children’s. The transfers to Texas Children’s were all adults, highly unusual for a pediatric hospitals.TMC hospitals’ invoking of surge plans comes a week after Gov. Greg Abbott expressed displeasure to executives about the mixed message of hospital leaders assuring the public they could manage the spike and the TMC dashboard showing ICU occupancy at near-full capacity. TMC leaders subsequently removed the slides for a few days while they sought to make them less confusing.Klotman argued that converting beds is not that difficult because intensive care can be provided anywhere — it just requires continuous monitoring of vital signs; access to intravenous treatment; a 1:1 or 1:2 nurse-patient ratio; and the availability of airway support. Other hospital officials noted it is not always easy to make such adjustments.HCA, which is not part of the medical center, said in a statement it still has ICU capacity. But it acknowledged that “this crisis is evolving and we are vigilantly assessing our resources and taking action.”After flattening the curve in May, Houston and Texas are experiencing their worst spikes of the COVID-19 pandemic. The state rolling average for new cases is now at 6,157 and the Houston region again added more than 2,000 cases Wednesday.The Texas Medical Center dashboard includes information from seven hospital systems — St. Luke’s, Methodist, Memorial Hermann, Texas Children’s, MD Anderson, Harris Health and UTMB. Numbers are drawn from all their facilities, not just the ones in the complex south of downtown.Michael Morris contributed to this report.todd.ackerman@chron.com

This is a carousel. Use Next and Previous buttons to navigateWith the number of intensive-care patients now exceeding capacity, Texas Medical Center hospitals have begun implementing COVID-19 surge plans that leaders thought might not be necessary after numbers fell far short of projections in April and May.The hospitals this week began opening additional beds — both intensive care and regular floor beds, some new, some converted — to accommodate a surge in COVID-19 patients that has grown exponentially in the past two weeks. The actions followed the hospitals’ collective ICU bed volume...

TMC hospitals go into Phase 2 surge plans as ICU capacity exceeds 100 percent

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