Katherine Olofson, MS, PA-C
PA-C
Northwell Health, United States
Disclosure information not submitted.
Alison Corley, MS, PA-C
MS, PA-C
Northwell Health, United States
Disclosure information not submitted.
Garry Ritter, MS, PA-C
MS, PA-C
Northwell Health, United States
Disclosure information not submitted.
Rafael Barrera, MD, FCCM, FCCP, FACN
Attending Physician
Long Island Jewish Medical Center, United States
Disclosure information not submitted.
Title: Application of Tiered Staffing Model During SARS-COV2 Crisis, the PA Perspective
Introduction:
The training and work of Physician Assistants (PAs) made them natural candidates to be deployed for the patient care crisis during the COVID-19 pandemic. Long Island Jewish Medical Center is a 584-bed teaching hospital in Queens, New York, which was the epicenter of the first wave of the COVID pandemic. The hospital saw the second-highest number of COVID patients in the country in the spring of 2020. LIJMC has a total of 48 ICU beds. During the height of the pandemic the ICU division was operating at 375% capacity, the single busiest day with 172 ICU patients requiring mechanical ventilation. With a surge in ICU patients, the hospital rapidly increased the number of ICUs and needed to quickly find critical care trained providers to staff these units. The Surgical/SICU PAs at LIJ have a unique model of training that lent to the staffing of all COVID-19 ICUs.
Methods:
At most other hospitals in our healthcare system, ICU PAs are separate in their training from those working on surgical floors. Instead of 3 critical care PAs in the surgery department staffing the ICU, there are 16 critical care trained PAs in the LIJMC Surgery Department, who staff both the floor and ICU in a rotating schedule. All PAs take Fundamentals of Critical Care Support and Ultrasound courses. The Society of Critical Care Medicine recommend a tiered staffing model for hospitals whose existing ICU bed capacity was overwhelmed secondary to COVID-19. Individual pods were run by a critical care trained ACP (Surgical PA) and a non-ICU physician. Non-ICU physicians were pediatric or head and neck surgeons, surgical oncologists and hospitalists. Medical residents from various sub-specialties were also deployed to work alongside the Surgical PAs and provide assistance. Due to the internal medicine resident curriculum, these residents were not trained in most procedures and unable to independently manage these critically ill patients.
Conclusion:
PAs in COVID ICUs allowed physicians to be physically present for less time and allowed multiple ICUs to be overseen by a single attending.The surgical PAs at LIJMC are a great example of how a staff of 16 critical care trained providers who rotate between floors and surgical ICU provided an immeasurable contribution in both experience and leadership caring for patients during the COVID-19 surge.