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by Terri Hogan
Senior Staff Writer
Since the first COVID-19 patient arrived in mid-March, MedStar Montgomery Medical Center has treated hundreds of “very sick” patients, hospital president T.J. Senker said, with staff working around the clock and learning as they go.
“It’s very much a curious disease,” he said.
Senker described the first few weeks as “an intense, all-out sprint.”
“It’s important to know that this is the center of the COVID-19 front,” he said. “Montgomery County is a hotspot, along with Prince George’s County.”
The past three months have been a challenge for MedStar Montgomery Medical Center (MMMC) and Senker, but he said he could not be prouder of the work being done at the hospital, which is operating at a level he calls unprecedented.
A long three months
Although MedStar Montgomery caregivers now have a better understanding of the disease and its treatment, they continue to participate in research and clinical trials to learn even more.
Clinical teams have done an outstanding job of managing both volumes and complexity of COVID patients, he said, deploying novel treatments and participating in research studies, including the Mayo Clinic convalescent plasma trial.
Senker said they have had to test new ways to treat patients — clinically and pharmaceutically — as well as find innovative ways to protect the health of the patients and caregivers.
One example is moving medical equipment outside patients’ rooms, using longer tubes and hoses, so the staff does not have to go inside the rooms as often.
Another is the use of iPads so that patients are able to communicate with their families since no visitors are allowed.
Testing was an initial challenge, both the availability and turnaround time for results.
Over time, that has significantly improved.
“We now have onsite testing and results for all inpatients within an hour,” he said.
The hospital continually plans for disaster events, including weather emergencies and mass casualties.
“We put a lot of work into dealing with whatever comes — communicating within the organization, obtaining the necessary resources and the execution,” Senker said.
He said he was part of MedStar system-wide planning calls eight weeks before the first coronavirus patients arrived, even though it was not yet known how MedStar Montgomery would be impacted.
“You just plan for the worst-case scenario and hope you never have to see it,” Senker said.
That early planning enabled the hospital to get a good jump on the situation in terms of preparing more negative pressure rooms needed to prevent the spread of the virus from one area to another, creating a dedicated entrance for possible COVID-19 patients in the emergency department, and obtaining equipment, he said.
Senker said MedStar staff watched as the situation in New York escalated and saw its resources were overrun.
Modeling showed that MedStar Montgomery needed to increase the number of intensive care beds, which it did.
“But what we didn’t plan for was while the COVID-19 cases increased, virtually everyone else stopped coming to the emergency room,” Senker said. “As a result, the original bed estimate was inflated.”
The state’s concern for capacity led to the installation of tents outside of many hospitals, including MedStar Montgomery.
The first tent was a green Army-style tent that was never used. Then, a semi-permanent structure was installed, featuring a 10-bed self-contained unit, complete with medical gasses, a nurses station and bathrooms.
“Fortunately, we haven’t come close to needing to use that,” Senker said.
MedStar Montgomery has been able to accept patients from nearby hospitals that were at capacity.
“We have only transported one patient out,” Senker said. “We’ve really been self-sufficient.”
He said some staff members have tested positive for COVID-19, although it is hard to pinpoint if they contracted it at the hospital or elsewhere.
He said the cases have been spread out and there have been no outbreaks in any particular unit.
“Every single COVID-19 patient comes through the emergency department, but there has not been one case of an associate there,” he said. “That speaks to the efficacy of PPE.”
Senker said the hospital has enough personal protective equipment (PPE), a benefit of being part of the large MedStar organization, with its strong supply chain.
Looking ahead, Senker said MedStar medical staff hopes to start scheduling elective surgeries as soon as they can, although safely treating the COIVD-19 patients remains the first priority.
They have redeployed staff to other areas of the hospital, so there will be a gradual reopening, starting with less susceptible outpatient cases, following strict protocols.
Senker has high praise for the MedStar Montgomery associates.
“Really, the folks we have here are incredible,” he said. “They are dealing with the same things that everyone else is personally — worrying about family members, social distancing and quarantine — yet come here where they are put on the front line and do a phenomenal job. I could not be prouder of the whole team.”
He also reiterates that the hospital is a safe place and reminds people to use the emergency department for emergency conditions.
“You should not wait on things that you would not have waited on before,” he said. “We’re concerned about heart problems and strokes, where deferring care is obviously not good.”
He said there are many protocols in place to ensure everyone’s safety, including disinfectant, personal protective equipment, social distancing and a reduced volume of traffic.
“Obviously, there is COVID-19 here, but I have never felt safer in this hospital,” he said.
Senker is also grateful to the community for its support, including first responders and other essential workers, those who have delivered meals and cards to the hospital staff, the military flyover and police salute, and those who have contributed financially.
“We are a not-for-profit organization,” he said. “We turned off our elective procedures, which is our primary driver of revenue.”
He added: “One of our greatest strengths is community partnerships. Some of those are new, but some go way back, like Sandy Spring Bank. They recently donated $600,000 to support community hospitals, including MMMC, in the fight against COVID-19. We are extremely grateful for that.”
MedStar Montgomery Medical Center numbers as of June 1:
First patient presented for testing on March 6; first positive test was the following week
Tested 1,330 presenting patients, with just under 30 percent positivity rate. Many positive patients have been discharged as outpatients from the emergency department, requiring no hospitalization
209 inpatients have been discharged home to their families; the 200th discharge was on May 29
At peak in early May, over 60 COVID-19-positive patients were being treated in-house; cases as of June 1 were about one-third of that
Expanded the 12-bed Intensive Care Unit (ICU) to 30 beds and consistently ran 27-plus ICU beds in April and May
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