Healthcare providers under strain; new policies at Milwaukee-area hospitals amid COVID-19 pandemic

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MILWAUKEE -- As the number of COVID-19 cases increases, so will the need for hospitalizations. That's already putting a strain on the medical community, as there are only so many hospital beds, doctors and protective equipment to go around.

With personal protection equipment like masks in short supply, supply chain experts say there is a very tight window to keep up with demand which is why medical professionals are doing their best to use what they have on-hand to keep themselves and others safe.

A recent Harvard study looked at hospital capacity estimates nationwide and found that even if half of the nation's hospital beds were emptied, the system would need at least three times more bends to care for patients.

Dr. Mark Kaufman

"There's no doubt that COVID-19 is coming in a wave, and the real question is just how fast that wave is going to come and how tall it's going to be," said Dr. Mark Kaufman, chief medical officer with the Wisconsin Hospital Association.

That's why health experts say social distancing is so important to keep infection rates as low as possible, extended over a long period of time -- ideally more than a year.

"It's a better match for the critical care needs of the patients and the hospital resources needed to take care of them," Kaufman said. "Everybody is trying to stretch their current supplies."

On Thursday, March 19, President Donald Trump and Vice President Mike Pence said the federal government is progressing in its efforts to get protective gear -- like N95 masks -- into the hands of healthcare workers. However, it is unclear how quickly that will happen.

Healthcare leaders in Wisconsin are looking to hopefully get a shipment of stockpiled medical equipment -- all while healthcare workers are being forced to stretch their current supplies.

Hospital policies, procedures impacted by coronavirus demands

Doctors in virtually every field are scrambling to alter care as the new coronavirus spreads.  Some cancer surgeries are being delayed, many stent procedures for clogged arteries have been pushed back and infertility specialists have been asked to postpone helping patients get pregnant until the outbreak eases.

Medical groups issued advice on how hospitals and doctors should adapt as beds and supplies are pinched and worries rise about exposing patients to possible infection. That includes canceling elective surgeries, including many for slow-growing or early-stage cancers.

For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

The vast majority of people recover from the virus. According to the World Health Organization, people with mild cases recover in about two weeks, while those with more severe ones can take three to six weeks to recover.

Nationwide, public frustrations over the difficulties of getting tested for the new virus have been building since the first U.S. case was confirmed Jan. 20. Early missteps with test kits developed by the Centers for Disease Control and Prevention, coupled with strict government criteria about who qualified for screening, have led to widespread reports of people struggling to get tested.

FOX6 News put together a running list of policies and procedures amid the pandemic:

Drive-thru testing at Froedtert South in Pleasant Prairie

Drive-thru testing at Froedtert South in Pleasant Prairie

Froedtert South in Pleasant Prairie established a drive-thru testing site for coronavirus. Hours of operation at the drive-thru testing site will be BY APPOINTMENT ONLY. The results come back in one to three days from swab samples taken -- one from the mouth and one from the nose.

Physicians and Advanced Practice Providers may determine that testing for COVID-19 is warranted based on the following:

  • Risk of exposure to the virus – whether the patient had close contact with someone with COVID-19.
  • Symptoms such as fever, cough, or shortness of breath.
  • Medical complications – whether the patient has chronic medical conditions such as heart or lung disease or diabetes.

Clinic hours

  • Monday – Friday, 6:30 a.m. to 6:30 p.m.
  • Saturday, 8 a.m. to 4:30 p.m.
  • Sunday, closed

Drive-thru testing at  Aurora St. Luke's

Aurora officials were planning to offer drive-up coronavirus testing sites in phases -- but you can't just show up. Patients will need to pre-register over the phone or through the Aurora app.

Only those who meet CDC criteria will be tested.

A patient at the drive-thru who has serious symptoms could be admitted immediately. Others will be sent home with instructions on how to access their test results.

Froedtert Hospital/Medical College of Wisconsin

Surgeries

Froedtert & MCW health network, effective March 17, made the decision that elective surgeries and procedures will be deferred provided that a delay does not put a patient at risk. Patients impacted by a deferred procedure will be contacted directly. This decision will be revaluated at a later date and we will continue to make decisions based on the safety and well-being of our patients, staff, and community. We encourage patients to call their Froedtert & MCW health care provider with questions.  As the COVID-19 situation continues to evolve, we continue to work to respect the CDC guidance on social distancing and will be transitioning in-person clinical visits with video and telephonic options when possible. We will continue to use in-person visits as appropriate based on each patient’s individual needs.

Testing

COVID-19 testing capacity continues to be an unprecedented challenge both nationally and locally. Guidelines are changing rapidly and we are focusing on testing our most at-risk patients and where the results would impact the care we provide our patients.

For patients with a Froedtert & MCW provider’s approval who meet the definition of a Person Under Investigation (PUI) for COVID-19 testing, the Froedtert & MCW health network has dedicated specific health centers to allow limited testing for COVID-19. These health centers are not open to the general public for COVID-19 testing.

Along with other health care providers, we are carefully monitoring information and following guidelines from the Centers for Disease Prevention and Control (CDC) and the World Health Organization. We will continue to work and collaborate with national, regional and local health care organizations to help manage the health care needs of our patients, staff, and community.

Visitors

Effective March 19, we will no longer allow visitors in the inpatient setting. Exceptions may be made for end of life care and other limited situations. at Froedtert Hospital, Froedtert Menomonee Falls Hospital, and Froedtert West Bend Hospital.

Along with other health care providers, we are carefully monitoring information and following guidelines from the Centers for Disease Prevention and Control and the World Health Organization. We will continue to work and collaborate with national, regional, and local health care organizations to help manage the health care needs of our patients, staff, and community.

What patients should do

  • If you are showing any sign of COVID-19 symptoms (new/worsening cough or new/worsening shortness of breath), contact your local health care provider. Your provider or a nurse will direct you to our dedicated COVID-19 team.
  • If you do not have a primary care doctor, call 414-805-2000 if you think you’ve been exposed to COVID-19, are experiencing symptoms or need to learn more about testing.
  • Visit froedtert.com for up-to-date information and to access our virtual care options 

What patients should no do

  • Do not come to a clinic or hospital to be tested. Walk-in COVID-19 testing is not available.
  • Please call your local provider first to find out how to be evaluated. This will help us minimize potential exposure to other people.

Hotline for patients or the public:

If you think you've been exposed to COVID-19, are experiencing symptoms or need to learn more about testing, call our hotline at 414-805-2000.

Children's Wisconsin

Children's Wisconsin

Surgeries

Appointment, surgery, and procedure cancellations:  Beginning March 17 until further notice and in accordance with guidance from the CDC, Children’s Wisconsin suspended all non-time-sensitive surgeries and canceled all clinic appointments that can be safely put on hold. If your upcoming appointment or surgery has been canceled, you will be called directly.   What does that mean for you and anything you have scheduled or planned?

  • Well-child appointments for children under 18 months will remain in order to keep those children on their critical immunization schedules. If your child is sick, please call your child’s doctor for medical guidance or to schedule an appointment.
  • All Children’s Wisconsin urgent care locations will remain open. We will continue to provide robust guidance via phone, Online Urgent Care video visits or MyChart message.
  • In our specialty clinics, all non-essential appointments, including lab and imaging, are cancelled at all locations. Your child’s appointment and medical record will be reviewed by their provider to determine if it’s medically necessary at this time and you will be called with the status of their appointment. If you are unsure of the status of an appointment or have a concern, please call the clinic or use MyChart for assistance.
  • If your child has a surgery scheduled or planned in the next two weeks, unless it is a medical emergency, it will be rescheduled for a later date. You will be called with the status of your child’s appointment.

Testing

If your child has COVID-19 symptoms (fever, cough or shortness of breath), confirmed exposure or both, please call your child's doctor for guidance. You can also go to chw.org/OnlineUrgentCare for an Online Urgent Care video visit with a pediatric provider.

A doctor at Children’s Wisconsin has tested positive for COVID-19 on March 16 after being exposed while traveling outside the state. The provider was quarantined at home with mild symptoms. The care provider was at Children's Wisconsin Milwaukee campus from March 9-15.

In total, 48 patient families, plus staff, have been identified and contacted. They were advised on next steps based on CDC guidelines, ranging from monitoring for symptoms, self-quarantine or testing.

As always, our number one priority is the health and well-being of our patients, our staff and providers, and our larger Wisconsin community. We have rigorous internal systems for infection prevention and have expanded them greatly in response to the COVID-19 outbreak. Every COVID-19 case underscores the need for all of us to stay vigilant in the face of the virus while offering support and care to all those who need it in our community.

Visitors

Please do not come to a Children's Wisconsin location without calling first.  For most kids, the symptoms of COVID-19 are mild and your child’s doctor will likely recommend they stay home, limit their contact with others (especially at-risk populations such as the sick or elderly) and treat the symptoms with over-the-counter medication.  Your child’s doctor knows them and their medical history best and they will determine if additional steps, including a COVID-19 test, are needed.  Please note: Children’s Wisconsin is not a public testing location for COVID-19.

DoctorProHealth Care

Surgeries

ProHealth Care has not yet postponed elective surgeries, but this step is under discussion.

Visitors

ProHealth Care has put in place stricter rules for hospital visitation to protect patients and employees amid the coronavirus pandemic.  At ProHealth Waukesha Memorial Hospital and ProHealth Oconomowoc Memorial Hospital, only one visitor per patient at a time will be allowed. ProHealth staff also will strongly encourage that in any 24-hour period, a hospital patient should have the same visitor, rather than a succession of different visitors.  In the hospitals’ labor and delivery and neonatal intensive care units, the following restrictions are now in place:  Visitation in labor and delivery will be limited to one person at a time, and it is recommended this be the same person throughout labor and delivery. Visitation in the NICU will be limited to two people at a time.  Visitors are limited to parents, guardians or support partners.  Visitors must be 18 or older.  Visitors will be screened prior to entering patient areas. Any visitor with a fever or other signs of illness will not be allowed to enter and will be asked to leave the hospital.  There will be no restrictions on visitation in situations where a patient is near the end of life.  Especially now, anyone who is feeling unwell should not visit a hospital or other health care facility unless it is to seek care.  In addition to the visitation restrictions, ProHealth Care has suspended volunteer services at its hospitals and canceled student visits and patient support groups.

ProHealth Care is closely monitoring developments and adhering to guidelines established by the U.S. Centers for Disease Control and Prevention.  Our medical experts and leadership team have developed a thorough response plan designed to promote safety and meet the needs of our communities during this outbreak.  As we work to protect our patients, staff, and community, we have announced stricter hospital visitation guidelines, discounted virtual health visits to $20, and suspended all community and patient events, including classes, tours, and support groups.

Advocate Aurora Health

Surgeries

Elective surgeries and outpatient appointments In response to COVID-19, we’re limiting nonurgent outpatient appointments and certain elective surgeries/procedures for the health and safety of our patients and team members. If you have a nonurgent appointment or elective surgery/procedure scheduled in the next few weeks, your physician will determine the best approach.   Outpatient appointments may be done via video visit, over the phone or may be rescheduled. Elective surgeries/procedures are being assessed on a case-by-case basis and may be rescheduled. Your physician’s office will contact you if there is a change to your scheduled appointment, surgery or procedure. Thank you for your cooperation and understanding. Please contact your physician if you have any questions.

Visitors

To stem the spread of COVID-19 and help keep our patients, visitors, and team members safe, Advocate Aurora Health implemented new visitor restrictions beginning March 16: No visitors, with a few exceptions, will be allowed in any inpatient areas until further notice. All visitors who meet exclusion criteria must pass a health screening, which will be administered at a central hospital checkpoint. Exclusion criteria includes:

  • Pediatric caregivers (2)
  • Caregivers necessary for the emotional well-being of the patient (1)
  • Partner and midwife/doula of a laboring mother (2)
  • End of life situations (# of visitors determined on a case-by-case basis)
  • Emergency Department companion (1)
  • Outpatient area companion (1)
  • In-person discharge instructions (1)
  • Professionals assigned to assist with procedures (1)

Ascension Wisconsin Health Center -- Mount Pleasant

Ascension Wisconsin 

Surgeries

In order to protect against potential COVID-19 exposure, and to ensure the availability of resources to meet emergent health needs during this pandemic, Ascension Wisconsin is following guidance by the CDC, the U.S. Surgeon General, and American College of Surgeons and postponing elective services and
non-urgent medical appointments.

Our top priorities are the health and safety of our patients, associates and visitors. Ascension providers will continue to provide emergency surgeries and procedures and clinically evaluate time-sensitive care delivery needs. We recognize that each case is unique, so processes are in place to review requests for
procedures that might be considered elective to determine issues of optimal timing and resource support.

Elective procedures are those that have options in terms of timing/level of urgency to be completed or are determined non-essential at this time. Examples of postponed services include:

  • Nonurgent procedures that would require intensive care unit (ICU) care
  • Elective procedures that post-procedure would require occupancy in an inpatient hospital bed
  • Elective procedures on high-risk patients when post-procedure status may require occupancy in an inpatient hospital bed
  • Elective procedures on any patient
  • Annual Wellness Visits Well Child Visits (when immunization is not involved)

Non-medical services

  • United Way 2-1-1: Accepting calls for questions related to the Covid-19 crisis that are non-medical in nature. These calls might pertain to such needs as food delivery programs for home-bound seniors, transportation options, as some public transit services close down, nutrition programs for children who rely on free and reduced meals at school, information on emerging resources in the community.
  • Residents across the state of Wisconsin can access this service by calling 2-1-1 (or 1-800-924-5514). In addition, residents can text COVID19 to 211-211 to receive links to CDC information about the virus.

Testing

Ascension Medical Group Wisconsin is developing drive-through testing sites for COVID-19. When available, individuals who wish to be tested must first be pre-screened by an Ascension Medical Group provider, by phone, or virtually using Ascension Online Care. We are working diligently with local and state health officials to operationalize these sites as quickly as possible to keep the health and safety of the communities we're privileged to serve a top priority.

The screening involves answering a series of questions about symptoms, travel history and any potential contact with COVID-19 patients. Patients who meet the criteria, which is based on guidance from the Centers for Disease Control and Prevention, will be given an appointment for drive-through testing at
the appropriate site.

There also is an Ascension COVID-19 Hotline set up for those who have questions about COVID-19, are experiencing symptoms, or those who want to receive a text message to schedule an Ascension Online Care appointment with a provider. The toll-free number for Wisconsin is 1-833-981-0711.

Visitors

Ascension is further expanding temporary visitor restrictions, in both inpatient and outpatient settings.

Our goal is to protect our associates and those we are privileged to serve by limiting possible exposure to COVID-19 and directing people to the right level of care.

The following visitor restrictions are similar to the infection control precautions we put in place in our hospitals and care sites every year during flu season to protect our patients, visitors, and associates. The Ascension Wisconsin updated restricted visitation policy at Ascension Wisconsin includes the following:

  • All visitors, associates, clinicians, and vendors entering Ascension Wisconsin facilities will be screened for flu-like symptoms including fever, cough, runny nose/nasal congestion and or sore throat.
  • No visitors who screen positive for cough, fever or difficulty breathing will be permitted into the facility.
  • To implement this, Ascension Wisconsin facilities will be implementing minimized entrance points as needed.
  • Visitors will not be permitted for patients under investigation (PUIs) or with a confirmed case of COVID-19.
  • Virtual options will be discussed with patients and families.
  • It is highly recommended that children under age 18 do not visit during this time.
  • Only one visitor per patient is allowed at one time, with the exception of pediatrics, obstetrics (labor and delivery) and end-of-life care.
  • Per guidance from the CDC, we are restricting visitors who have returned from a country within the past 14 days that the CDC has designated as Level 3 Warning or Level 2 for COVID-19.
  • Those who do visit are encouraged to please wash their hands and use hand sanitizer before and after any visit. We appreciate the cooperation of our visitors, patients, associates, and providers to support our infection control efforts and help minimize the spread of respiratory infections and COVID-19.

Tips for Virtual Visitation During COVID-19:

We understand that during this time it is important to stay connected to your loved ones and remain aware of their status while hospitalized. We encourage communication through the use of personal devices. Consider one of the following apps to connect virtually with your loved ones: Facebook Messenger, Facetime, Google Hangouts, Google Duo, WhatsApp, Skype, Viber, or Signal. You can download them in either the App Store (iPhone) or the Play Store (Android). Both patients and visitors will need to download the same application. Access to guest Wi-Fi at Ascension facilities is available by connecting to AH-Guest.

Ascension Wisconsin has launched a toll-free information line:

Ascension Wisconsin has established a dedicated telephone resource for COVID-19 questions. This can be accessed 24/7 by calling 1-833-981-0711. The launch of this service is intended to provide useful information to people in the communities we are privileged to serve who have questions about COVID-19. The hotline is an effort to reduce the number of incoming calls to our hospitals and clinics.

We ask that this resource only be used for questions about COVID-19 and its symptoms. If you are experiencing a medical emergency, please dial 9-1-1.

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