We continue to fine-tune our daily planning strategies and tactics based on the fluid nature of the COVID-19 outbreak. We are working to ensure that our health care system resources and capabilities are strong enough to meet the ongoing needs of our community and a potential spread of COVID-19. I wanted to take a moment to provide you with a high-level status report of our planning and our available resources.

I would like to begin with a note of high praise to our community. We have been provided offers of support from every corner of Sheridan County. Local industry and individuals in their homes have committed resources to work on the production of personal protective equipment, such as masks and gowns for our health care teams and for patients.

Building contractors and commercial cleaning companies have provided hepa filtrated air scrubbers in the event that we must convert non-clinical spaces into negative pressure patient rooms. We have had offers from our local hotels and other off-site facilities to support our efforts to take care of the community, should the need arise for additional space.

We have been contacted by nearly every restaurant and food supplier to assist in any way that they can. Distilleries are exploring the production of hand sanitizer. Breweries have offered to raise funds in support of protective equipment for our health care team. Foundations have stepped forward to provide relief in the procurement of supplies.

Our county commissioners along with the mayor and the city of Sheridan, have offered vital resources to support the care of patients. We have seen a local auto mechanic shop delivering groceries to immunosuppressed patients. I could go on and on with the outpouring of support we have received, and when we have gotten through this together, we will owe a large debt of gratitude to the Sheridan community. In the meantime, I want to say thank you to everyone for your prayers and kindness and know that we are all in this together.

I would encourage everyone to take very seriously the guidance we have received around social distancing and self-isolation. These measures although extreme, may ultimately save lives and allow us to truly care for the people who will need us at the hospital in the coming days.

With regard to our status in a variety of areas, I would like to share the following:

COVID-19 testing: We continue to coordinate with Public Health and state officials to test for COVID-19. As of my writing this letter, we have tested 172 patients. We have received results on 116 of them, three of which were positive and we continue to await results on the remaining 56. Our testing process is very sound and scalable should the need arise to test more patients. We continue to request test kits to meet the demand of our community; so far we have had enough test kits to meet the current demand based upon testing protocols and algorithms established by the CDC.

We encourage our community to continue to utilize the COVID-19 number on the hospital website 307-672-1004 to determine if testing is appropriate. For patients age 12 and younger, please call Northeast Wyoming Pediatrics at 307-675-5555. This helps ensure that our health care system is able to utilize our resources at the appropriate level to continue to meet everyone’s needs. As of today, we are not testing patients without symptoms.

Health care system capacity:

Health care team: Current staff levels are meeting the needs of patients in the hospital and those seeking services and advice at the Emergency Department, clinics and testing sites. We have established a robust health care system staffing pool to meet future and projected demand. These staffing projections are based on modeling of COVID-19 admissions at Sheridan Memorial Hospital over time, taking into consideration bed capacity and PPE burn rates. Our nutritional services, laundry, IT and facilities personnel along with our physicians, advance practice providers, respiratory therapists, nurses, housekeepers, dieticians, pharmacists, therapists, technologists, CNAs and other support staff have been outstanding in their willingness to go where the need takes them. We are so thankful for this extremely skilled team. We will move heaven and earth to make sure they have the resources they need to do their jobs safely and care for our community.

Personal protective equipment: We are conserving PPE to ensure the safety of patients and staff. As of today, we have sufficient resources; however, management of these resources is extremely important and dependent upon our rate of usage for patient demand. We are coordinating at local, state and federal levels to ensure we continue to have access to these resources in the event that community spread of COVID-19 occurs. Again, we are appreciative of all of the local support we continue to see to meet our needs. Please share our appreciation with everyone.

Emergency services: Our Emergency Department team has done an amazing job taking care of people who are in need of everyday emergency care. They are also fielding hundreds of screening phone calls associated with symptomatic patients, triaging them and/or referring them to one of our testing locations.

Hospital inpatient facilities: As of today, we have converted 53 inpatient beds to negative pressure rooms and have plans and capabilities to convert 25 more beds to negative pressure. Negative room pressure is an isolation technique used to prevent cross-contamination from room to room to isolate patients with contagious diseases such as COVID-19. Our response for negative pressure conversion meets CDC recommendations. Additionally, we have 15 beds that are located in positive pressure rooms.

Outpatient ancillary services: We have limited ancillary services to those deemed necessary, only with orders from your physician or advanced practice provider. These might include services such as a diagnostic mammography, diagnostic catheterization, diagnostic X-ray, diagnostic endoscopy and diagnostic blood work to name a few. Updated information on services is available on our website or by calling your provider.

Physician clinic services: If you have questions regarding your care, please reach out to our clinics by phone. We are reaching out to screen patients with scheduled appointments to ensure the safety of people coming to the hospital.

Hospital visitation: As of March 24 at 7 a.m., we have increased our restrictions for visitation to the hospital. Further guidance can be found on the hospital website.

Given the amount of new information that is coming out by the hour and the rate of change we are experiencing; we are encouraging our employees to escalate everything to your supervisor, manager or directly to Incident Command. Our Incident Command team is meeting at 8:30 a.m. and 4 p.m., seven days per week and as necessary. We are also conducting daily incident command debriefs accessible by conference call at 11:30 a.m. coordinated with our daily safety brief.

As we approach our work today and every day going forward, it is important to keep in mind that we must keep a close eye on the health and capacity of our teams to assure we are all at the top of our game, supporting one another, leading with humility and being respectful of everyone. The way we lead through these challenging times is every bit as important as the critical actions we will take in the days to come.

Originally printed in The Sheridan Press
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