COVID-19

REDi Healthcare Coalition

The REDi Healthcare Coalition remains activated in response to the novel Coronavirus (COVID-19) outbreak. REDi has been in response since January 2020 supporting partners in and around the 19 counties and 4 tribes of eastern Washington.

Current Situation


Healthcare System Capacity - Proclamation from Governor Inslee Regarding Healthcare Coalition Tracking Healthcare Status

On November 25, 2020 Governor Inslee issued Proclamation 20-24.2 Requirements for Non-Urgent Medical and Dental Procedures, effective December 3, 2020, extending the State of Emergency for all Washington State counties and prohibiting all non-urgent health care and dental services, procedures, and surgeries, unless those facilities act in good faith and with reasonable clinical judgment to meet and follow the procedures and criteria provided in the proclamation.

Each health care and dental facility is expected to develop and maintain an expansion and contraction of care plan that is congruent with the community COVID-19 assessment, consistent with the clinical and operational capabilities and capacities of the organization, and responsive to the criteria provided.

Expansion and contraction of care plans should be operationalized based on the standards of care that are in effect in the health care facility’s relevant geography as determined by that region’s regional healthcare coalition.

In accordance with the Governor's Proclamation 20-24.2 Requirements for Non-Urgent Medical and Dental Procedures, the Healthcare Coalitions have been tracking the ongoing status of healthcare by care phase according to the three standards of care (National Academy of Medicine definitions correlated to each operational phase):

  • Conventional capacity definition: The spaces, staff, and supplies (resources) used are consistent with daily practices within the institution.
    • Conventional Care Phase – All appropriate clinical care can be provided.
  • Contingency capacity definition: The spaces, staff, and supplies used are not consistent with daily practices but provide care that is functionally equivalent to usual patient care.
    • Contingency Care Phase – All appropriate clinical care can be provided so long as there is sufficient access to PPE and, for hospitals, surge capacity is at least 20%.
  • Crisis capacity definition: Adaptive spaces, staff and supplies used are not consistent with usual standards of care but provide sufficiency of care in the context of a catastrophic disaster (i.e. Provide the best possible care to patients given the circumstances and resources available).
    • Crisis Care Phase – All emergent and urgent care shall be provided; elective care, that the postponement of which for more than 90 days would, in the judgement of the clinician, cause harm; the full suite of family planning services and procedures, newborn care, infant and pediatric vaccinations, and other preventive care, such as annual flu vaccinations, can continue.

REDi is continuing to track Healthcare System Readiness metrics using daily WA Health, REDi HCC Situation Reports, and WATrac data. Adequate bed capacity, staffing, and supplies in the healthcare system to handle a surge in COVID-19 cases will be measured by percentage of staffed beds occupied by patients (hospital census relative to licensed beds) and percentage of staffed beds occupied by COVID-19 patients.

Every Tuesday the REDi HCC surveys eastern Washington hospitals, hospice, long-term care, skilled nursing, ambulatory surgical centers, outpatient clinics, and urgent care facilities through the Situational Awareness Response Process (SARP). Results of this survey continue to indicate that most healthcare facilities are continuing to experience a shortage of resources, space and staffing, despite support with resource coordination from REDi, local health jurisdictions, and the state Department of Health. Limited capacity continues to be dependent on limited healthcare staffing and other staffing challenges. All REDi healthcare organizations should continue to participate in the SARP survey and encourage other healthcare organizations within the region to also contribute to help paint an accurate picture of healthcare capacity. To contribute to and/or view this data, please sign up three emergency points of contact from your organization. Any healthcare partner, including optometry or dental, can sign up.

Data provided through the SARP survey to track the operating conditions for space, staff, and resources/supplies of healthcare facilities is being reviewed at the state level to help determine which phase Washington state is in as a whole. As of May 19, 2020, in coordination with the Washington State Hospital Association (WSHA), the Department of Health (DOH), WA Healthcare Response Management Team, and the three WA Healthcare Coalitions there was consensus that, we as a whole state, are currently in a contingency care phase.


What's the REDi Healthcare Coalition doing during COVID-19?

In accordance with our mission, we are committed to serving the healthcare system to support patient care outcomes during COVID-19. REDi objectives remain focused on monitoring and supporting medical surge capability, convening partners to share situational awareness, and information sharing. All response actions taken and services provided by the REDi HCC support the following response objectives that were developed by REDi partners in February. The Coalition plans to remain activated through the duration of the COVID-19 outbreak and/or once all REDi healthcare facilities report "conventional" status for staffing, resources, and space in accordance with the National Academy of Medicine definitions for the operational phases (conventional, contingency, and crisis).

The REDi HCC continues to remain activated to support healthcare through situational awareness, data collection and sharing (e.g., WA Health), resource coordination, WATrac administration and support, coordination call requests, 24/7 duty officer services, and information sharing:

Objective #1: Create a common operational picture among REDi partners.

  • Supporting WATrac incident alerts and notifications, bed and agency updating, command center, patient tracking.
    • A WATrac Command Center Room can be opened to support situational awareness for the duration of the COVID-19 response.
    • Hospitals and Skilled Nursing Facilities are asked to update bed availability and agency status according to the WATrac Regional Use Expectations. Other agencies (e.g., PH, EM, and EMS) are highly encouraged to utilize WATrac to support patient placement, tracking, and movement activities.
  • Running the Situational Awareness Response Process (SARP): Data is due from all REDi healthcare organizations in eastern WA by 11 a.m. on Tuesdays and Fridays.
  • Supporting WA Health and other data dashboards.
  • Maintaining a 24/7 Agency Contact List.
  • Sharing information regarding Coalition activities, response resources, planning meetings, etc. through our REDiLINK newsletter and website. To opt-in for newsletters, complete this opt-in form.
  • Facilitating Weekly Regional COVID-19 Updates meeting where leads from local health jurisdictions (public health), emergency management, EMS, and healthcare share local, regional, and statewide updates; develop situational awareness; highlight any critical data points; and discuss the implications the data has on decision-making.

Objective #2: Support regional healthcare system resiliency and medical surge.

Objective #3: Manage regional resource coordination.

Objective #4: Support a consistent state-wide response.

  • Offering Coordination Calls as needed; requested via phone call to the REDi HCC Duty Officer.
  • Staffing the 24/7 Duty Officer line for healthcare emergencies (509-362-0041).
  • Attending local, regional, and statewide calls regarding COVID as a liaison to provide regional and statewide updates and listen to local updates from partners.

As an emergency response organization, the REDi Healthcare Coalition (HCC) maintains a 24/7/365 duty officer and provides response functions to assist partners during emergencies affecting the healthcare community. For details about the duty officer and the REDi Healthcare Coalition response function, please reference this handout and the REDi Response page.


Information Sharing

The REDi HCC team monitors the WA Health and DOH COVID-19 dashboards for data that is accurate and relevant to our eastern Washington partners, which may also be included in REDi Situation Report.

The WA DOH is continuing to ask healthcare to use their PPE in the yellow zone (contingency) since there is not enough in the state for healthcare to use their PPE in the standard way. REDi HCC is continuing to share CDC guidance on use of PPE, including strategies for optimizing use of PPE, as well as WA DOH new resources on conservation as well as prioritization of allocation.

Please direct specific questions regarding potential COVID-19 cases to your local health jurisdiction at the county level. REDi is more than happy to provide introductions to public health partners if needed. For updated information regarding COVID-19 please visit the WA State Department of Health's website or the CDC website.

If there are any major disruptions or changes to the operational status of your organization, please contact the REDi HCC Duty Officer at (509) 362-0041.


COVID-19 Data Dashboards

1. WA State Department of Health COVID-19 Dashboard

  • The Department of Health and Microsoft's AI for Health team have partnered to create these interactive data dashboards. Simple data summary tables are also available.
  • Dashboard displays available:
    • Current status: confirmed cases, hospitalizations, and deaths by county
    • Epidemiologic curves
    • Cumulative counts
    • Demographics: confirmed cases, hospitalizations, and deaths by sex, age, race/ethnicity
    • Testing by date and county
    • COVID-like illness hospitalizations by date, sex, age group

2. WA State COVID-19 Risk Assessment Dashboard

  • This dashboard provides an overview of data used to determine whether it’s safe for a county to enter a new phase of reopening. Key metrics were developed for five risk assessment areas: COVID-19 activity, testing, healthcare system readiness, case investigations and contact tracing, and the protection of populations at higher risk. The metric goals are targets, not hard line measures. The targets reflect recommendations from the Washington State Department of Health. Each contributes to reducing risk of disease transmission, and are to be considered in whole. Where one target is not fully achieved, actions taken with a different target may offset the overall risk.
  • Dashboard displays available:
    • Phase and Risk Assessment
    • COVID-19 Disease Activity
    • Testing Capacity
    • Healthcare system Readiness
    • Case Investigations and Contact Tracing
    • Populations at Higher Risk

3.REDi Healthcare Coalition Hospital Dashboard

  • This data is pulled from WA Health and displays data by region (eastern WA), catchment (Spokane, Tri-Cities, and Wenatchee), county, and facility. As such, this dashboard is only available to the partners inputting data into WA Health and appropriate jurisdictional authorities.
  • Dashboard displays available:
    • % of licensed beds occupied by patients (hospital census relative to licensed beds);
    • % of licensed beds occupied by suspected and confirmed COVID-19 patients;
    • bed occupancy over time;
    • % of acute care beds occupied;
    • % of ICU beds occupied;
    • % of admitted patients vs COVID patients; and
    • % of ventilators in use.

4. REDi HCC Situational Awareness Response Process Dashboard

  • View the current healthcare system status regarding space, staff, resources, incident command implementation, and mitigation by county, catchment (Spokane, Tri-Cities, Wenatchee) and organization type. The status of each is associated with the crisis standards of care definitions for conventional, contingency, and crisis capacity.
  • You must sign up 3 emergency points of contact from your organization to be able to receive the REDi Situation Reports (currently twice per week) that include the link to and most relevant data from this dashboard.

COVID-19 Resources

As resources become available, we share them in our REDiLINK Newsletter and post them in our Resource Library. Below are a few COVID-specific resources.

ASPR TRACIE

CDC

CMS

General

Long-Term Care Facilities

National Emerging Special Pathogens Training and Education Center (NETEC)

Proclamations and Releases:

WA DOH