Report: Pandemic left EDs overwhelmed, challenged to maintain standards of care

A new report from Johns Hopkins Center for Health Security found that emergency departments in New York City hospitals were overwhelmed and struggled to maintain conventional standards of care during the COVID-19 pandemic.

The report, “Crisis Standards of Care: Lessons from New York City Hospitals’ COVID-19 Experience: The Emergency Medicine Perspective”, looked at New York City emergency departments’ experiences between April and June 2020, the beginning of the unprecedented surge of COVID-19 patients.

By virtually convening a meeting of New York City emergency physicians, researchers were able to identify what went wrong and what went right during the crisis to better prepare for future crises.

The report found that despite the National Academy of Medicine outlining “crisis standards of care” (CSC) in 2009, the COVDI-19 pandemic in NYC was the first time a transition to CSC was implemented by hospitals on a large and prolonged scale.

Emergency physicians reported that there was no patient load-balancing from one hospital system to another and that no CSC declaration was formally announced by hospital, state, or city officials. Additionally, the doctors reported, hospitals and healthcare systems were taken by surprise by the pandemic, and most hospital administrators and clinicians were not familiar with CSC principles or best practices.

Doctors reported on the call that their hospital or healthcare system did not have a CSC plan that was ready to be used and that the secrecy surrounding the severity of the crisis hampered any implementation of CSC.

Other issues the physicians on the call discussed were shortages of staff and critical equipment and supplies; emergency department staff being deployed in other areas of the hospital because ED patient volume dropped; and emergency healthcare workers being furloughed or laid off because of low ED patient volumes.