Maximizing occupancy and providing services to patients in need of inpatient psychiatric hospitalization has always been an operational priority for hospital leadership. Prior to COVID-19, I have seen a lot of dual occupancy patient rooms, which is helpful for patients who are suicidal or desire social interactions. I have also seen a lot of variability in terms of how patients enter the unit upon admission, and the design of that patient flow. Collectively, providers were not as focused on planning for a significant infectious disease pandemic, as that seemed more abstract and theoretical. As we all know now, that is no longer an academic exercise.
Maximizing occupancy and managing the safety and security of patient flow upon admission looks different in COVID times. If only we would have considered a pandemic in previous designs. But, how would we have known the impact this would have had on us, or hospital teams, our patients, and patient families? We can do better going forward since we all learn from mistakes, challenges, fears, and points of frustration.
From lessons learned, there are new implications for patient population-specific proportion of single vs. dual occupancy rooms. There are definitely implications for bringing patients straight onto a general unit and exposing infection and risk to the general population of patients and staff. There are implications for the location of triaging and assessing patients before admission. There are implications for patient belongings, and ancillary team member’s entry points, functions, and locations of such support spaces. By controlling this patient flow better, we can leverage this thinking to also control security and safety issues related to highly aggressive patients or patients who are at risk for elopement. We can turn this “problem” into an opportunity for minimizing other risks as well.
How else can we learn from challenges to our hospitals and staff? We turn it into a strength going forward.
