In 2019, the State of Maryland set up a 250-bed field hospital in less than 4 weeks as a strategy to reduce the burden of COVID-19 on existing facilities. In order to provide healthcare services, the State had to develop a streamlined approach to rapidly provide high-quality full-time staff, and this study describes the operation in detail. To recruit 65 full-time equivalents (FTE) providers to give inpatient care as well as outpatient services such as mass testing, mass vaccination, and monoclonal antibody infusion treatment, a strategy was needed to ensure quality assurance and efficiency. This involved the development of multidisciplinary teams to address the 8 steps of recruitment including conducting a human resources needs assessment, traditional and non-traditional mass outreach, technology-driven candidate tracking, pre-interview screening, interviewing to identify aligned goals, credentialing and occupational health screening, and focused onboarding.
Experience and team discussion among the medical and nursing leadership were used to guide the staff readiness strategy; early engagement of staff, establish the identity and culture of the field hospital, develop a team-based rounding model, training sessions using best practices, and be adaptable to the needs of the community and the dynamic nature of the pandemic.
Since field hospitals are make-shift and temporary facilities, it is important to reduce staff turnover and to ensure staff retention as best as possible. Strategies highlighted in this study include safety protocols and renumeration as well as more specific strategies such as prioritizing the safety of personnel and provider well-being, provide financial stability, ensure cross-training, and offer opportunities for professional growth and leadership.
Although the model has some drawbacks, it has proven to meet its mission providing 1495 inpatients encounters and a total of 6754 occupied bed days. It provides an urgent (but not immediate) strategy for future pandemics or other disease outbreaks.
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