Internal Medicine, Infection Control, and Occupational Health Services

Abstract

The Department of Medicine played a seminal role in managing the crisis from the COVID-19 pandemic at Saint Barnabas Hospital (SBH) Health System that started in mid-March and reached its zenith in New York City in mid-late April 2020. Internal medicine, under normal circumstances, deals with a wide range of diseases and disproportionate impact from social determinants of health. The COVID-19 crisis completely upended the very systematic process of caring for this broad range of patients. Within a relatively short period of time – days to weeks – it required an almost complete reconfiguration of staffing, roles, and methods of communication to allow effective care for a large number of very sick patients. This chapter documents how Internal Medicine implemented those changes rapidly and the dynamic modifications that were made throughout the initial surge as the crisis took hold, to ultimately work efficiently and effectively in the fight against COVID-19. Specifically, the number of beds capable of caring for COVID-19 patients dramatically increased and multiple administrative spaces were transformed into clinical wards. The number of hospitalists progressively and rapidly increased leading to two COVID-19 services run by primary care physicians and additional services led by oncology, cardiology, and gastroenterology specialists, alongside a multidisciplinary COVID-19 Treatment Committee that made institutional recommendations about treatments. As many practices were standardized throughout the institution optimizing patient care and likely preventing many patients from requiring mechanical ventilation.