Health Crisis Management in Acute Care Hospitals

In the USA, the COVID-19 crisis came as an unpleasant surprise and a shock to many healthcare systems and hospitals, especially in the crisis epicenter, New York City. The Bronx was one of the hardest hit boroughs of New York City, with significant negative impact of the COVID-19 pandemic on its indigent population. SBH Health System (formerly known as St. Barnabas Hospital) is an integrated system of an acute care hospital, ambulatory care center, trauma center, dialysis center, stroke center and other services and facilities, serving the community of the Bronx. The story of SBH in preparing for and managing the rapidly escalating surge of severely ill patients is a treasure of lessons in health crisis preparedness and management at all levels: clinical, administrative, financial, etc. These lessons can be used for other acute care hospital settings and other potential health crises that may arise in the future. Within a short 3 weeks, SBH increased its in-patient capacity by 50%. However, during the same short time, it increased its critical care capacity by over 500%, providing critical care to severely ill patients on ventilators. This book chronicles the situation step by step and describes how this accomplishment was done. Accounts from the frontline health workers and from the clinical and administrative leaders describe important aspects of crisis management, such as team building, multi-departmental coordination, effective communications, dynamic decision-making in response to rapidly changing situations, keeping up the morale and caring for the healthcare workers and managing the supply chain. The uniqueness of the experience of SBH is enhanced by the fact that SBH is a low budget safety net hospital serving the poorest population in New York City. The worldwide trend is toward tighter healthcare budgets with demands for higher efficiency and productivity. There is a lot to be learnedfrom the SBH health crisis management, including how efficient management, team building, management of limited resources and collaborative workplace culture make the foundation of success in the face of the crisis of the century. This unique text serves as a how to guide for implementing skills necessary for crisis management. Lessons from the success of SBH in tackling the dramatically fast unfolding crisis are utilized in a clear and concise manner. Such lessons may benefit other health systems and hospitals in planning and preparing for similar crises.