Medical facilities prepare for COVID-19 surge Remain open for normal care

Photos: Randi Pierce and Pagosa Springs Medical Center
Pagosa Springs Medical Center has made several changes to its facility and procedures to continue to treat patients and prepare for the possibility of COVID-positive patients. Among those changes are, screening everyone who enters the facility and, creating an area within the lobby for patients with potential COVID-19 symptoms to be treated. Top: An existing trauma room within the Emergency Department could be converted to treat two patients needing intensive care if necessary.

By Randi Pierce
Staff Writer
Multiple local medical facilities are in the midst of a balancing act, remaining open and available for normal medical care while also preparing to treat patients who test positive for COVID-19.
Two medical facilities — Pagosa Springs Medical Center (PSMC) and Pagosa Medical Group (PMG) — continue to work with the state and region to prepare for a surge of patients needing a higher level of care than they can receive at home.
Models show that surge could come around May.
“So what the newest projections for us are that we would expect to have at least five COVID-positive patients in our hospital by the first week of May, and then from then on, it’s supposed to increase,” said PSMC CEO Dr. Rhonda Webb Wednesday.
Webb added that she believes social distancing means there will be less of a surge and PSMC may never surge above its capacity, but pointed out that if the numbers pan out, there will be cases in the hospital.
To help prepare, PSMC has transitioned to a combination of in-person, phone and video visits and has made changes at its facility to lessen the risk of exposure to those who may have COVID-19.
The changes at PSMC begin outside the facility, where a tent now provides screening for anyone entering the building. The screening includes having your temperature taken and answering questions related to common COVID-19 symptoms.
Webb explained that all PSMC employees are screened in their vehicles before entering the facility.
After being screened, those entering the facility must have a mask and are generally sent into the building via one of two ways: through a doorway to the clinic or through another entrance to an area set up to treat anyone with “suspicious” symptoms that could be COVID-19, Webb explained.
Ambulances can still access via the Emergency Department entrance and cancer patients can go through a separate entrance, indicated PSMC’s chief operating officer, Kathee Douglas on April 8.
“That really is working out well,” Webb said Wednesday.
Webb noted that PSMC continues to do labs, see chronic and acute patients, and PSMC EMS continues to respond to emergencies.
“People still need to have their chronic conditions taken care of, even with all of this,” Webb said.
People should not be surprised if their doctor or medic has more personal protective equipment on than prior to the pandemic, Webb indicated, noting that it is to protect them, with first responders across the nation contracting COVID-19.
Inside the facility, PSMC personnel have installed plastic barriers to help reduce the contact between staff and patients and has acquired a system to help clean some masks for reuse.
PSMC currently has 10 beds and is licensed for 11, explained Webb and Douglas.
In a surge, PSMC could expand to upward of 20 beds, including two ICU beds.
Douglas explained that, in a surge, PSMC could have two intensive care patients in a room with a ventilator and piped oxygen.
Webb expressed that PSMC is not seeing health care facilities overwhelmed, meaning PSMC will still work to send the sickest patients to other facilities for treatment.
PMG is also implementing changes to protect current patient needs with the possibility the facility may also be needed to treat COVID-positive patients.
PMG has applied to be a tier 2 alternative care site and submitted a surge plan to the state, indicated Dr. Dave Shaeffer and Dr. Amber Reiss-Holt, who own the practice.
Shaeffer reported to The SUN Wednesday that two people from the state health department toured the site last week, adding that the state is focusing on tier 1 sites currently, then will focus on the tier 2 sites.
If approved, Shaeffer said, the state would help coordinate getting more personal protective equipment, oxygen and other needed supplies, and would coordinate additional resources such as added personnel if the need arises.
In the meantime, PMG continues to see regular and acute patients while using telehealth as much as possible, Shaeffer said.
Shaeffer and Reiss-Holt relayed that they have worked to cut down the number of people in the facility, even removing chairs from the waiting area.
Shaeffer noted if people need to be seen in person, they are taken directly to the treatment area, with Reiss-Holt explaining staffing changes mean a patient comes into contact with fewer people over the course of their visit.
Shaeffer explained PMG is still doing urgent procedures that could mean a bad outcome if delayed, but that PMG’s overall patient visits have decreased.

This story was posted on April 16, 2020.