HCA Healthcare colleague Janet Garrett, and a multidisciplinary group of colleagues rushed to their hospital, SkyRidge Medical Center (Lone Tree, CO), on a Saturday in March for an urgent meeting. COVID-19 cases were surging and they needed to develop a program that would help them provide personal protective equipment (PPE) to keep caregivers and support staff safe. And they needed to do it fast.
“We were in the beginning of our surge and had to create a PPE task force, determine what units would become COVID units and how we would store and safely distribute PPE and educate nurses about the constantly changing protocols. All in 6 hours,” said Garrett, who serves as the hospital’s director of performance improvement and quality. “It was a wild ride, but we came together and figured it out as a team.”
One concern was how they would make all the necessary PPE accessible to colleagues and physicians. They created a new role, PPE Stewards, who would be responsible for distributing the correct PPE on each floor as well as hearing from caregivers about PPE needs and helping to educate them on how to safely put on and remove PPE. PPE Stewards would also serve as one of the main sources of information for educating on the different levels of PPE and its appropriateness to different tasks.
Janet and her team had the idea to repurpose patient discharge bags, which PPE Stewards used to carry and distribute gowns, gloves masks, etc. as they made their rounds from floor to floor. “It was perfect because the bags were already branded ‘Sky Ridge Medical Center’, so we just had the Stewards wear the backpacks and added ‘PPE Steward’ to it,” said Garrett.
Inside the bags were N95 masks and gowns in every size, as well as cleaning supplies. These bags were then distributed to nurses daily to ensure that everyone who needed PPE received it – and allowed Garrett and her team to track exactly how much PPE they had and how fast they were using it.
This was crucial because early on in the pandemic, global supply chain disruptions, rapidly changing guidelines from the Centers for Disease Control and Prevention (CDC) and surges in COVID-positive and suspected COVID-positive patients were taxing hospitals’ PPE supplies, and it was critical to be able to gauge how long current supplies would last. At its peak, HCA Healthcare hospitals were using 230,000 pieces of PPE a day, up from an average of 150,000 pre-pandemic.
To address these issues and ensure that hospitals maintained a supply of PPE that was sufficient for future surges and until global supply chains stabilized, HCA Healthcare leadership created a multidisciplinary PPE task force comprised of the chief medical officer and nursing, quality, infection prevention, administration, education and department leaders at each of its 186 hospitals. The task force oversees adherence to CDC guidance related to PPE supplies and tracks usage.
The head of each task force at each facility is familiarly known as lead PPE Steward. Garrett holds this role at Sky Ridge Medical Center.
This person makes sure staff are familiar with guidance changes, policy, regulatory updates and safe use of PPE, and is responsible for the daily sign out of PPE based on staff tasks and patient population. They also educate colleagues on proper donning and doffing techniques for PPE, which became especially critical when the use of certain types of PPE, such as N95 masks, increased significantly because of COVID patients.
“The PPE Steward is a vital role to ensure and maintain a safe and healthy environment for staff, physicians, patients and visitors. It is paramount to deliver safe and effective care,” said Mark Brown, chief nursing officer, Good Samaritan Hospital (San Jose, CA).
As a result, facilities focused on proper use of PPE and minimizing waste. One example is Tulane Medical Center (New Orleans, LA). Susanne Walker, supply chain clinical resource director, took on the role of PPE Steward, and her leadership is credited with helping to maintain supplies of PPE to help ensure caregivers would continue to be protected as COVID-19 cases began to surge.
“We all want to provide safe quality care within our facilities, and meeting the critical needs of our patients and caregivers during this pandemic and global supply shortage was extremely challenging,” Walker said. “But it also made me very proud to be part of a team and company that puts safety first and has the ability to leverage and shift resources to meet the needs of everything from PPE to cleaning products and medical equipment.”
Many of the HCA Healthcare colleagues who have taken on the role of PPE Stewards have seen firsthand the value it brings and have felt the appreciation of their co-workers. They wear the new hat of PPE Steward with pride.
“Ensuring our Southern Hills family has the protective equipment they need to care for our community is imperative,” said Kelli Wray, assistant chief nursing officer, Southern Hills Hospital and Medical Center (Las Vegas, NV). “I feel proud to serve as PPE Steward because I know if our team doesn’t have to worry about PPE they can better focus on what really matters: our patients.”
“Our clinical caregivers inspire me daily. Stepping into the role of PPE Steward has given me the opportunity to see first-hand how amazing they are in their compassion and bravery during COVID-19,” said Wendy McClain, director of business development, West Valley Medical Center (Caldwell, ID). “I am thankful I can be a part of supporting this exceptional team.”
At Sky Ridge Medical Center, while they’ve seen a drop in cases, the program that Garrett helped set up still monitors PPE needs and usage and she still makes the rounds to provide any needed education. The work and safeguards that have been established make sure that staff can rest assured that HCA Healthcare is prepared to provide patients, staff and visitors the necessary PPE to keep them safe now and for months to come.
Founded in 1968, Nashville-based HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising more than 2,000 sites of care, including 186 hospitals, surgery centers, freestanding ERs, urgent care centers, and physician clinics, in 21 states and the United Kingdom.