23 March 2020 – COVID-19 (coronavirus)
Message 2 of 3
Dear Colleagues,
As you’re aware, we have activated our pandemic plan in response to COVID-19.
I want you to have the confidence that we can and will flex up to meet this challenge. As part of our pandemic plan we have a three-tiered response after the initial containment phase.
Since the end of January, we have been in the Contain phase which has included our incoming traveller screening at the Brisbane International Airport and establishing our Fever Clinics and Community Assessment Centres. With the increase in confirmed cases over the weekend, we are now moving into Sustain Tier 1.
The tiers are:
Triggers are determined for each phase and may vary for each of our facilities, depending on its baseline capacity and capability. As the situation is changing rapidly the triggers will be used as a guide for transition between tiers rather than having a definitive hard number trigger.
Each tier has specific actions to be undertaken which may change if there is new scientific knowledge of COVID-19 or new information about the effectiveness of containment in Queensland and Australia.
| Contain | Sustain Tier 1 | Sustain Tier 2 | Sustain Tier 3 | |
| Definition | Travellers, no local transmission | Limited community transmission | Moderate community transmission | Significant community transmission |
| Trigger
Trigger metrics may vary hospital to hospital |
Presentations with influenza like illness (ILI) | Presentations to ED
Admissions to hospital Admitted patients with COVID-19 Medical beds with COVID-19 patients ICU beds and acuity |
Presentations to ED
Admissions to hospital Admitted patients with COVID-19 Medical beds with COVID-19 patients ICU beds and acuity |
Presentations to ED
Admissions to hospital Admitted patients with COVID-19 ICU beds and acuity |
| Response | Contain | Sustain Tier 1 | Sustain Tier 2 | Sustain Tier 3 |
| Fever clinic – asymptomatic or mild/moderate ILI symptoms,
Drive-through and home-based assessment capacity additional to physical spaces |
In or adjacent to ED, community-based – increase based on demand
Increase and/or redeploy staff Capacity RBWH – 20 (6+16) TPCH – 7 Redcliffe – 20 (8+12) Caboolture – 16 (2+8+6) Brighton – 13 Pine Rivers – 22 (2+20 drive through) Total 98 |
Adjacent to ED, external to ED, community-based, home – increase based on demand
Increase and/or redeploy staff Capacity RBWH – 22 TPCH – 25 Redcliffe – 26 Caboolture – 16 Brighton – 13 Pine Rivers – 22 (2+20 drive through) Total 154 |
External to ED, community-based, home – increase based on demand
Increase and/or redeploy staff
Capacity RBWH – 29 TPCH – 35 Redcliffe – 26 Caboolture – 16 Brighton – 13 Pine Rivers – 42 (2+40 drive through) Home based – 17 Total 178 |
External to ED, community-based clinic, home – increase based on demand
Increase and/or redeploy staff
Capacity RBWH – 29 TPCH – 35 Redcliffe – 26 Caboolture – 16 Brighton – 13 Pine Rivers – 60 (2+ 58 drive through) Home based – 19 Total 198 |
| ED – ILI patient requiring ED treatment or non-ILI patients requiring ED assessment
Fever clinic and ED capacity = 465+ spaces (+310)
In addition GP respiratory clinics |
Repurpose locations in ED for patients with ILI symptoms e.g. fast track
Capacity RBWH – 47 TPCH – 56 Redcliffe – 27 Caboolture – 25 Total – 155 |
Relocate ED patient cohorts to alternate location outside ED e.g. fast track to OPD, to allow space for ILI patients
Increase and/or redeploy staff Capacity RBWH – 60 TPCH – 56 Redcliffe – 27 Caboolture – 25 Total 168 |
Expansion of ED spaces to other locations e.g. into SSU and relocate SSU to accommodate all patients
Increase and/or redeploy staff
Capacity RBWH – 74 TPCH – 66 Redcliffe – 51 Caboolture – 37 Total 228 |
Expand ED spaces into adjacent or nearby areas to accommodate all patients
Increase and/or redeploy staff
Capacity RBWH – 108 TPCH – 66 Redcliffe – 56 Caboolture – 37 Total 267 |
|
Inpatient – COVID-19 Potential bed capacity 1700 (+130) |
Single rooms, isolate suspected/ confirmed COVID-19 patients | Single rooms, isolate suspected/ confirmed COVID-19 patients. Assess need for Designate 1 COVID-19 ward | Designate second COVID-19 ward. Assess need for third COVID-19 ward | Multiple designated wards and or floors or designated COVID-19 hospital |
| Virtual ward – for COVID-19 | Virtual ward – for COVID-19 including RACF
Increase and/or redeploy staff |
Virtual ward – for COVID-19 including RACF
Increase and/or redeploy staff |
Virtual ward – for COVID-19 including RACF
Increase and or redeploy staff |
|
| Inpatient – non COVID-19 | Elective procedures (surgery, medical and dental procedures and outpatients) – continue as is
Outsource elective surgery and endoscopy |
Reduce or suspend Category 3 and 6 surgery, medical and dental procedural activity
Outsource elective surgery and endoscopy Reduce, suspend or deliver virtual outpatient Category 3 and 6 activity Increase and/or redeploy staff Review category 2 and 5 in line with workforce availability Repurpose outpatient areas Repurpose surgical wards to medical wards |
As per Tier 1 plus reduce or suspend Category 2 and 5 surgery, medical and dental procedural activity
Outsource elective surgery and endoscopy Reduce, suspend or deliver virtual outpatient Category 2 and 5 activity Increase and/or redeploy staff Repurpose outpatient areas Repurpose surgical wards to medical wards |
As per Tier 2 plus suspend Category 2 and 5 activity
Outsource elective surgery and endoscopy Increase and/or redeploy staff Repurpose outpatient areas Repurpose surgical wards to medical wards. |
| Critical services – dialysis, cancer care, maternity and neonatal care, mental health, transplant services, burns service, trauma services, emergency surgery, Category 1 and 4 surgery/ procedural work – maintain | Maintain activity and critical referrals in from other HHSs.
HITH – 25% increase in capacity including virtual capability Increase and/or redeploy staff |
Maintain activity and critical referrals in from other HHSs.
HITH – 50% increase in capacity including virtual capability Increase and/or redeploy staff |
Maintain activity and critical referrals in from other HHSs.
HITH – 100% or more increase in capacity including virtual capability Increase and/or redeploy staff |
|
| ICU
ICU capacity 149 (+81) |
Maintain as is.
Capacity RBWH – 36 TPCH – 18 Redcliffe – 7 Caboolture – 7 Total – 68 |
Expand in ICU footprint.
Increase and/or redeploy staff
Capacity RBWH – 44 TPCH – 27 Redcliffe – 10 Caboolture – 8 Total – 89 |
Expand in ICU footprint and into adjacent areas (RBWH only).
Increase and/or redeploy staff Review need to expand into PACU and operating theatres. Capacity RBWH – 54 TPCH – 27 Redcliffe – 10 Caboolture – 8 Total – 99 |
Expand into PACU and operating theatres.
Increase and/or redeploy staff
Capacity RBWH – 82 TPCH – 37 Redcliffe – 16 Caboolture – 14 Total – 149 |
It’s important to note that because our facilities are different, we may have facilities and services on different tiers and there will be movement up and down tiers as needed.
Shaun Drummond
Chief Executive