Table Of ContentHealth Crisis
Management in
Acute Care Hospitals
Lessons Learned
from COVID-19 and Beyond
Ridwan Shabsigh
Editor
123
Health Crisis Management in Acute Care Hospitals
Ridwan Shabsigh
Editor
Health Crisis Management
in Acute Care Hospitals
Lessons Learned from COVID-19
and Beyond
Editor
Ridwan Shabsigh
Department of Surgery
SBH Health System
Bronx, NY, USA
Department of Urology
Weill Cornell Medical College of Cornell University
New York, NY, USA
CUNY School of Medicine
New York, NY, USA
ISBN 978-3-030-95805-3 ISBN 978-3-030-95806-0 (eBook)
https://doi.org/10.1007/978-3-030-95806-0
© SBH Health System 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
This book is wholeheartedly dedicated, as a
humble gesture of love, respect, and
appreciation, to all healthcare workers
around the entire world, who worked
tirelessly to help patients and save lives
during the overwhelming COVID-19
pandemic.
Tribute
The editor and the authors of this book pay
sincere tribute to all healthcare workers who
lost their lives during the COVID-19
pandemic, and to their families and loved
ones. Special tribute is given to the five
heroes of the SBH Health System family, who
lost their lives during the COVID-19
pandemic:
Warren Bates, technician,
telecommunications
Corazon Espinosa, RN, registered nurse,
psychiatry
Maria Grace E. Laureta, RN, registered
nurse, ICU
Nelson Then, EKG technician, radiology
Ronald Verrier, MD, critical care surgeon
and director of general surgery
residency program
We commend and honor their dedication to
healthcare and their commitment to
improving the lives of so many. Our thoughts
and best wishes go to their families and
loved ones.
Foreword
It would not be over-optimistic to state that, out of the suffering of millions of peo-
ple, the sadness over the loss of so many lives, the economic harm, and the sociopo-
litical disruption, all brought about by the COVID-19 pandemic, we emerged more
resilient and better capable of handling future health crises than ever in the history
of humankind. This optimism is fully justified by the richness of the lessons learned
from the crisis, the immense improvements made to healthcare systems all over the
world, and the great advancements in medical science, such as the ability to rapidly
develop and distribute new testing technology, novel vaccines, and therapeutics. It
is well established that acute-care hospitals stand at the frontline of healthcare deliv-
ery in peacetime; however, during times of disaster, the proper functioning of an
acute-care hospital is a major indispensable part of a successful response to a health
crisis. Currently, hospitals need to plan and prepare for a number of scenarios
including future surges of COVID-19, new variants of it, other future infectious/
viral pandemics, or any other public health crises. Such planning and preparation
could benefit tremendously from the rich lessons learned during the COVID-19
pandemic over the past 2 years.
This book brings together the rich experiences of the SBH Health System, pre-
sented in 20 chapters. The various chapters include frontline healthcare workers’
accounts and case studies, in addition to charts, figures, tables, boxes, and vignettes.
The need for such practical guidance and the timeliness of this book cannot be over-
stated. It is our hope that this book will energize worldwide dialogue and advance
the establishment of best practices for the improvement of any hospital system’s
ability to enhance their preparedness and management of any and all future
health crises.
SBH Health System David Perlstein
Bronx, NY, USA
vii
Prologue
The COVID-19 crisis came as an unpleasant surprise and a shock to many health-
care systems and hospitals especially in the crisis epicenter of New York City. The
Bronx was one of the hardest-hit boroughs of New York City with significant nega-
tive impact of the COVID-19 pandemic on its indigent population. SBH Health
System (formerly known as St. Barnabas Hospital) is an integrated system of an
acute-care hospital, ambulatory care center, trauma center, dialysis center, stroke
center, and other services and facilities serving the community of the Bronx. The
story of SBH in preparing for and managing the rapidly escalating surge of severely
ill patients at the onset of the COVID-19 crisis is a treasure of lessons in health crisis
preparedness and management at all levels, clinical, administrative, and financial.
This book draws lessons from the success of SBH Health System in tackling the
dramatically fast unfolding pandemic from the perspective of the system as a whole
and from each of the specific departments which all played a significant role in
managing the local crisis of the largest threat to human health the world has seen in
recent years. Such lessons may benefit us and other health systems and hospitals
elsewhere in planning and preparing for similar crises in the future.
Within a short 3-week period, the SBH Health System increased its in-patient
capacity by 50%. However, during the same short time span, it increased its critical
care capacity by more than 500%, providing critical care to severely ill patients on
ventilators. This book chronicles step by step the drastic adaptations that were made
and describes how this incredible accomplishment was undertaken in such a short
time, to ultimately save the lives of many patients. Accounts from the frontline
healthcare workers and clinical and administrative leaders alike describe important
aspects of crisis management, such as team building, multi-departmental coordina-
tion, effective communications, dynamic decision-making in response to rapidly
changing situations, keeping up the morale, caring for the healthcare workers them-
selves, and managing the supply chain and essential resources.
Case studies are presented from positive and negative experiences to draw les-
sons on what worked and what didn’t and how challenges were addressed. This is a
prescriptive book in a “how it works” and “how to do it” style. The fact that the book
is authored by those who worked directly in the field, witnessing firsthand the
ix
x Prologue
distressing reality of the clinical devastation caused by the rapid surge in the pan-
demic and living every decision and adaptation every day that dynamically changed
the provision of care helping minimize loss of life, makes for a unique perspective.
The uniqueness of the experience of SBH Health System is enhanced by the fact
that it is a capital-constrained “safety net” hospital serving the poorest population in
New York City. The worldwide trend is toward tighter healthcare budgets with
demands for higher efficiency and productivity. Within this low-budget safety-net
hospital, we faced unique and often amplified challenges. There is a lot to be learned
from the SBH Health System crisis management, including how efficient manage-
ment, team building, management of limited resources, and collaborative workplace
culture make the foundation of success in the face of the crisis of the century.
Many senior healthcare administrators, chairpersons of clinical departments, and
frontline workers are eager to learn lessons from health systems that experienced
the severe surge of such an unprecedented crisis. From this book the reader will
learn how to effectively plan and prepare for a health crisis in a speedy and efficient
manner. Such planning and preparation involve clinical departments, critical care
teams, nursing, respiratory therapy, physical therapy, nutrition, pharmacy, labora-
tory, information technology, facilities, biomedical engineering, supply chain,
senior administration, and others. Therefore, healthcare workers at all levels will be
eager to learn about the procedures, policies, and operations that were implemented
in the successful crisis management at SBH Health System. Similarly, this book
will be of interest to public health officials and planners, disaster management plan-
ners and educators, healthcare educators, and universities that teach public health
administration and planning to learn how capital-constrained healthcare systems
can adapt and cope with such a health crisis. The book also touches on the recovery
from a health crisis and the “new norm” emerging from the COVID-19 pandemic.
We hope this book provides useful lessons to ultimately help improve patient care
when confronting health crises.
Ridwan Shabsigh
Acknowledgments and Appreciations
As editor-in-chief of this book, I would like to express my highest acknowledgment
and warmest appreciation to a number of individuals who worked hard to help bring
this work to completion. My dear friends and colleagues at SBH Health System
helped tremendously as effective chapter authors and co-authors. They shared their
firsthand experiences from the COVID-19 pandemic and presented valuable lessons
learned for the planning, preparation, and management of future health crises.
Without them and their passionate efforts, this book would have never been possible.
My special appreciation goes to Dr. Joanne (Jo) Nettleship and her team for their
exceptional efforts in critically editing and effectively finalizing this work in the
face of tight production timelines and delivery deadlines. The hard work of Dr.
Nettleship brought high quality and professionalism into the production of this book.
Ridwan Shabsigh
xi
