Clinician and administrative leaders at UW Medical Center-Northwest, a member of the UW Medicine family connected to the University of Washington, and located in Seattle, have been pioneering some very innovative processes designed to protect the safety of the clinicians and other staffers at their facility, as well as to optimize the use of personal protective equipment (PPE) there.
On Wednesday, April 8, the network MSNBC aired a segment in which an MSNBC reporter toured the facility and interviewed several clinicians (who were not named). As one clinician noted, in giving the tour, “What we’ve done here is to separate our hospital into ‘hot’ and ‘cold zones,’ in order to protect everyone.” Showing the reporter an area in the ICU, the clinician said that “What we’ve done right here is really cocooned the nursing station with some protective plastic, with some windows that we can still see what’s going on, on the floor.” That area is the “hot zone” in which COVID-19 patients are cared for.
As the reporter noted, “Before going into the hot zone, [clinicians] suit up, and when leaving, they take off all their [personal protective] equipment, all under the watchful eye of an observer, who makes sure they’re doing it correctly. They call this person a ‘dofficer,’ to play off the word ‘doffing,’ which means to take off equipment.”
And, he asked a UW-Northwest physician, “What does that extra set of eyes mean?” “You can be sure that you’re doing it correctly, you’re doing the steps in order,” the physician said. “A lot of times in healthcare, we’re doing things that are very rushed, and unfortunately, it makes it easy to contaminate ourselves.”
As the reporter noted, “The hot zones also help to conserve valuable protective gear, like masks and gowns, because they don’t have to take them off between patients. UW has also converted some floors of the hospital to negative pressure, to prevent spreading infection.” As a result, “If there are any aerosols that are generated, those aerosols don’t go back out into the staff areas, they leave the building,” a clinician noted.
That negative airflow means doors must remain closed, so nurses are using baby monitors to help keep an eye on patients.
“How big of a difference do you think these changes have made?” the reporter asked. “I think it’s made a huge difference,” a clinician stated. “And even just from the standpoint of staff morale, we do think it makes for a safer work environment; that’s been a top priority.
“No doubt, that has made for some difficult weeks, with some patients dying, but they’ve also been able to celebrate some patients getting off their ventilators,” the MSNBC reporter noted.. “I just can’t tell you how much the staff and others celebrate, when that happens,” one physician said. “We’re actually thinking of playing music overhead, when that happens.
Then MSNBC’s Ayman Mohyeldin interviewed Vin Gupta, M.D., MPA, M.Sc., an affiliate assistant professor of health metrics sciences at the University of Washington, whose primary research interest is in development assistant for health and clinical work in pulmonary and critical care medicine.
“Should other hospitals look into adopting them as well, are you trying to set up best practices as well, for other hospitals?” Mohyeldin asked. “I work for another hospital in Seattle, and the leadership at other hospitals are looking at doing what they’ve done at Northwest Hospital. And it’s incredible what they’ve done, because they saw some of the greatest concentration of critically ill COVID-positive patients, so what they’ve done—I’ve seen it emulated across the city and the country,” Dr. Gupta said. “And there have been a lot of conference calls, zoom calls, across the city and the country, informal sharing of best practices. It’s been incredible to see what we’ve been able to do as critical care providers sharing best practices.”
Then Mohyeldin followed up, “So much of our country’s attitude right now is about the projections and the models, this morning, the U of Washington refined its model, projecting fewer than 1,000 deaths in Washington state, obviously a very hopeful projection, and we certainly hope that does materialize much lower than what we had been anticipating. What does this tell you, and what should other states take away from that, if in fact that projection of a lower death count does in fact hold?”
“You know, I’ve been amazed by our leadership here, both at the lower level, Mayor Jenny Durkin, and certainly at the state level, with Governor [Jay] Inslee; and there’s been humility,” Gupta said. “They’ve been willing to learn, to adapt, to changing realities, and the proof is in the pudding in terms of the policies they’ve put into place. They were active when it came to enforcing social distancing; they elevated public health officials to be messaging on these important policies that are often unclear; this is unfamiliar terrain for Americans, for anybody to socially distance themselves from others. And so I thought they were really responsive to changing realities. We got testing live as quickly as possible, we leveraged big tech, we leveraged non-profit organizations, all through their guiding hand. And so really, they showed leadership and humility to understand the changing landscape and to respond, and embraced that. That’s why we are where we are in terms of these new projections, and I think they’ve shown what should be done more broadly, across the country.”
