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 2020 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 Janet, 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. The PPE Stewards would also be charged with listening to caregivers about PPE needs and helping to educate them on how to safely put on and remove PPE. PPE Stewards served 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 Centers,’ so we just had the Stewards wear the backpacks and added ‘PPE Steward’ to it,” said Janet.
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. 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 oversaw adherence to CDC guidance related to PPE supplies and tracks usage.
The head of each task force at each facility was familiarly known as lead PPE Steward – a role that Janet held at Sky Ridge Medical Center during 2020.
This person made sure staff were familiar with guidance changes, policy, regulatory updates and safe use of PPE, and was responsible for the daily sign out of PPE based on staff tasks and patient population. They also educated 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-19 patients.