Hospital carries out first Covid-19 dry run

St Bernard’s Hospital carried out a Covid-19 dry run yesterday to test the resilience of its systems and state of preparedness should it receive an influx of coronavirus patients.

The simulation was organised by the Director of Nursing and Ambulance Services, Sandie Gracia and Clinical Nurse Manager Gizelle Tosso.

“Today we had a scenario where we had a surge of Covid-19 patients, we had 11 patients arriving all at one time,” said Ms Gracia.

“Some were referred from the Primary Care Centre, some came via ambulance and some were a walk-in.”

“This was to test how we would deal with that surge and how quick, clinically, we could process the person through the system and get them seen.”

The dry run follows a tabletop exercise which took place two weeks ago where the health care professionals were able to identify various factors including the ability to call on/call up experts for advice and the need to reinstate the processes associated with the use of PPE.

The simulation started at 9.30am and was finished by 11.45am. No outcome such as discharged healthy or death of patients were determined during the simulation.

The first patient arrived at 10am and then intervals of patients every half hour or so with more than one patient arriving at the same time.

“It was a large surge of patients but not anything out of the usual we would get through accident and emergency at any ordinary time without the Covid,” said Ms Gracia.

Volunteers who had recently undertaken training with the GHA to assist should they be required during the Covid-19 pandemic played the role of ‘patient’ in the exercise.

Each were given a script and had to act the part, be it that of a young person, an elderly person or a pregnant person.

“They knew more or less the patient part they were playing and their roles and I think they acted very well,” said Ms Gracia.
“It was a true-life existence where you get all types of patients, some are demanding, some are more sick than others.”

During the simulation some of the ‘patients’ were admitted to the hospital with some being admitted to the Intensive Care Unit and placed on ventilators.

The simulation brought together over 20 health care professionals, including doctors, nurses, ambulance crew, hospital attendants, laboratory technicians, radiography and some members of the call centre to test resilience there to ensure that the operators get the right clinician at the right time to tend to the patient.

“The general feedback was good,” said Ms Gracia.

“Obviously there is room for improvement but the general feedback was that we are well prepared for whatever comes our way.”

As patients arrived at the hospital, each were triaged.

“They are triaged when they come in and they therefore are treated for the triage category they are in and they are placed in the department which is most appropriate for them,” said Ms Tosso.
“Wherever they may be coming from.”

“You triage the severity of their symptoms.”

Ms Gracia added: “You look at their vital observations, how short of breath they are, how alert they are, how they are responding.”

Dry runs have often in the past been carried out from a clinical perspective to test the clinical skills of the hospital.

“I think, from a clinical background, it is always good to observe and go back to evaluate what you have put in place so there are always things we can enhance and make better in clinical preparedness going forward and that flags up good practices as well,” said Ms Gracia.

“So maybe things we thought would work on a tabletop exercise we have to tweak so it works in real life scenarios.”

Both Ms Gracia and Ms Tosso thanked the volunteers for taking part in the simulation.

“It was definitely very helpful to have a live exercise where you actually have the patients coming in,” said Ms Tosso.

The next step is to analyse the observations made from the dry run, to flag up good practice and to share information on the progress of preparation.

This process has already commenced and a gap analysis will be conducted based on both the hospital’s response and preparedness. An action plan will then be drafted based on this information.

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