Chief Executive COVID-19 Update: 8 September – Inpatient COVID-19 Model of Care

Inpatient COVID-19 Model of Care

As of today, we have:

• Two COVID-19 positive inpatients
• No employees with COVID-19
• 135 employees in precautionary quarantine

This will be the first of a series of single-topic Chief Executive Updates covering the key issues we need to address as we prepare for increased COVID-19 presentations. Today we begin with our Inpatient COVID-19 Model of Care.

Over the last two weeks, we have seen case numbers rise in the community. The infectious nature of the Delta variant means the virus is progressing much faster than in last year’s outbreaks. This means we need to prepare for an increase in COVID-19 hospitalisation.

Monash Medical Centre is currently a preferred site for providing maternity services to COVID-19 positive patients as part of the metropolitan health service response. As community case numbers increase, we will today expand our role to include adult and paediatric COVID-19 positive patients at MMC and MCH. If demand continues to rise, we will progressively expand capacity at Casey Hospital to manage non-tertiary COVID-19 positive adult patients.

We have drawn on our expertise and the lessons learned from last year to refine our Model of Care – ensuring our workforce is best placed to care for these patients without compromising safety or patient outcomes. As always, maintaining the safety of our employees, patients, and community remains at the core of every decision.

Employee and union consultation on the Inpatient COVID-19 Model of Care outlined below is underway. We appreciate the willingness, co-operation and understanding as we work through this process quickly, and I will continue to provide further updates on this vitally important work.

The proposed Inpatient COVID-19 Model of Care is guided by the following principles:

• The safety and wellbeing of our employees are paramount.
• We will protect our non-COVID-19 inpatients from transmission, especially our most vulnerable patient cohorts (immunocompromised and elderly).
• We will equip our employees with the resources they need (PPE, IT systems, equipment, training, psychosocial support) to provide care.

Ward configuration and order of activation
In considering the wards in which care for COVID-19 positive cases will be provided, we have considered numerous factors, including airflow in rooms/wards, clinical service implications, predicted patient demand (COVID and S-COVID) and a 1:5 (ICU bed to General/Ward bed) ratio.

As of today, Ward 32, MMC ICU and Forest 3A will receive COVID-19 positive patients.

COVID-19 Surveillance Program
To help protect the wellbeing of Monash Health employees and patients and reflect the current risk of COVID-19 transmission in the community, we have introduced COVID-19 surveillance testing.

Surveillance testing is routine testing for COVID-19, designed to serve as an early warning system and identify any transmission of COVID-19. Employees undergoing surveillance testing do not need to isolate.

Compulsory surveillance testing is now in place for:

• All employees, after caring for a COVID-19 positive patient.
• All employees in streaming areas and high-risk areas across other health services.
• All clinical staff in ED as caring for public / SCOVID.
• All employees who have worked in an exposure area.

Voluntary surveillance testing is available for:

• All employees in ICUs who are showing no COVID-19 symptoms and not caring for a COVID-19 positive patient.
• All employees working in community settings where increased transmission is present.

Guidance for employees/contractors working in streaming areas and high-risk areas within and outside Monash Health is available here.

Personal Protective Equipment (PPE)
Correct PPE usage is a cornerstone of our safety measures, and we have seen through exposures in our health service how effective it can be in containing the spread of COVID-19 when it is used properly.

The levels of PPE required in different working situations are outlined in our PPE Compulsory Standards.

I will focus on PPE usage in a future update. In the meantime, detailed information is available on our COVID-19 employee website.

I want to thank all those involved in the development of this Model of Care. Building on what we have learned through our pandemic response to date, it is a sensible, practical and, most importantly, safe way to manage increased hospitalisations due to COVID-19.

Thank you all, as always, for your ongoing dedication and support. I look forward to providing you with further information as it is available.

Andrew Stripp
Chief Executive