Brookings Health Releases Bed Management Plan in Case of COVID-19 Surge

  • April 24, 2020

Brookings Health System’s bed management plan, pictured above, outlines how the health system will handle a medical surge capacity of COVID-19 patients. The plan is a collaborative effort of physician, nurse, pharmacy, anesthesia, infection control and case management representatives from Brookings Health System and Avera Medical Group. If Brookings sees a surge of COVID-19 patients, medical professionals from those entities as well as Sanford Clinic Brookings have agreed to pool together to care for the community.

Today Brookings Health System released its bed management plan for handling a medical surge capacity of patients in the event the community’s health needs exceeds Brookings Hospital’s normal medical infrastructure due to COVID-19. The plan will be used for the current wave of COVID-19 infections as well as any subsequent waves that may be experienced in the future.

“The bed management plan expands upon our current COVID-19 precautions we already have in place, including keeping patients under investigation of COVID-19 separated from patients who have no symptoms of, or no possible exposure to, the virus,” said Chief Nursing Officer Tammy Hillestad, RN.

The plan is a collaborative effort of the C19 Response Team, a multidisciplinary group led by Hillestad that includes physician, nurse, pharmacy, anesthesia, infection control and case management representatives from Avera Medical Group Brookings and Brookings Health System. The response team’s plan details how Brookings Health will use its 49-bed capacity in different stages based upon the number of COVID-19 positive patients it must care for.

“The surge plan really starts in the ER,” said Medical, Surgical and Emergency Department Director Karen Weber, RN, who has been working on logistics of physical space, supplies and staffing to carry out the plan. “When confirmed or suspected COVID-19 patients present to the ER, we ask them to enter through our ambulance garage rather than through our main entrance and waiting room. This process would continue during a surge situation. In addition, we’ve created zones within the ER to care for COVID-19 patients in one area and non-infectious patients in another. Even in a surge situation, we still need to care for any emergent issues, including heart attack or stroke, emergency surgery or other needs.”

Because patients with emergent issues may also need hospitalization, the plan also includes keeping five to 10 beds free at all times for non-infectious patients. In addition, New Beginnings Birth Center will never house infectious patients. Instead, one room will remain available in the inpatient care rooms to deliver any mother who is positive for COVID-19.

The plan also notates at what point the hospital must exceed its 49-bed licensure in accordance with the Centers for Medicare & Medicaid Services’ emergency declaration. The plan then climbs gradually to 80 beds, the hospital’s top medical surge capacity to safely evaluate and care for a markedly increased volume of patients.

“Our case management team will continually work to identify which patients can be safely discharged to free up beds,” said Hillestad. “Our goal is to care for all patients here at the hospital.”

The C19 Response Team has examined creative ways to use existing hospital space to make room for COVID-19 beds. Some patients with similar cases will be roomed together. Same-day surgery rooms will be repurposed for inpatient care. A barrier will also be added in same-day surgery to keep infected patients separated from non-infectious patients who still need hospitalization. The barrier will also maintain a sterile pathway to surgical suites.

In addition, beds will be added to the old OB unit, cardiopulmonary rehab, and the outreach clinic. Some of those beds will be cots from Emergency County Management. Other beds will come back to the health system from the donation made after the hospital expansion and renovation project.

“Craig Severtson from Helping Kids Round First still has a fair number of the hospital beds we donated to their organization,” said Weber. “The beds are in storage, waiting to be cleared to ship to Nicaragua. Craig is holding them as well as some other key supplies for us as we weather the pandemic.”

In addition to beds, extra staff will be needed to care for the increased patient load. To complement the bed management plan, the C19 Response Team has setup a points system based on patient acuity to determine the number of physicians, nurses and other medical team members needed to safely deliver care.

“Staffing will need to be flexible depending on how sick any COVID-19 patients are,” said Weber. “COVID-19 patients have a greater weight in our points system, meaning we will need to increase our staffing levels in order to better care for them.”

Another element the C19 Response Team created to complement the bed management plan are guidelines for medical management of patients.

“Our hospitalist Dr. Cathy Leadabrand, our ER physician Dr. Chris Wangsness, plus two Avera Medical Group physicians, Dr. Rachel Sunne and Dr. Kelly Evans-Hullinger, took the lead on creating the medical management guidelines,” said Hillestad. “They educated themselves on best practices and lessons learned from other regions, like Seattle and New York, which have experienced a COVID-19 surge. They’ve also begun educating their colleagues as well on the medical management guidelines so all of the physicians have the same knowledge regarding COVID-19 patient care in the hospital setting.”

If there is a surge of patients, medical professionals at Brookings Health System, Avera Medical Group Brookings and Sanford Clinic Brookings have agreed to pool together to carry out the plan and provide high-quality care to the community.

A PDF download of the plan plus more information about Brookings Health System’s local efforts to fight COVID-19 can be found at

About Brookings Health System

Brookings Health System, located in Brookings, South Dakota, includes a 49-bed hospital, the 79-bed The Neighborhoods at Brookview nursing home, Brookhaven Estates senior living apartments, Yorkshire Eye Clinic & Optical, and medical clinics in Arlington, White and Volga, South Dakota. It is a non-profit, city-owned facility that offers the community a full range of inpatient, outpatient, emergency and extended care services. Brookings Hospital provides local access to doctors in Brookings and offers robotic da Vinci surgery and Mako robotic-arm assisted procedures, making it one of the premier rural community hospitals in South Dakota. For more information about the services offered at Brookings Health System, please call (605) 696-9000 or visit us on the Web at