Handling the pressure: Team members step up to convert patient rooms, meet demand

April 15, 2020  //  FOUND IN: Our Employees,

Across the university, employees have stepped up to meet every challenge that COVID-19 has thrown their way.

That is certainly the case when it comes to managing hospital capacity. As the pandemic hit the state of Michigan, it was clear that the academic medical center was likely going to need more hospital rooms designed to treat patients with contagious diseases.

In response, team members from a wide range of departments came together to find a solution — using innovation and collaboration to prepare the organization for the forecasted surge of patients.

The need for negative pressure

A patient room before (top) and after (bottom) being converted to negative pressure.

To keep them and their caregivers safe, it is desirable to place patients with contagious diseases in negative pressure rooms. That means more air is removed from the room than comes into it at any time.

“By creating what is deemed ‘negative pressure,’ germs and other airborne contaminants are constantly being filtered out or dispersed outdoors to minimize the potential for exposure to staff and others in the hospital,” said Michael Hoeflein, business manager for Hospital Maintenance.

Normal patient rooms are not set at negative pressure, so Hoeflein is leading a multidisciplinary team that is working to convert them. To date, nearly 100 rooms have been changed over at University Hospital, C&W and the Frankel Cardiovascular Center. The capacity exists to increase that number in the weeks ahead should the need arise.

Coordinating across campus

The conversion process is complicated, though it can be carried out fairly quickly thanks to “an impressive amount of coordination and teamwork,” Hoeflein said.

Sheet metal is cut at the university’s metal shop.

First, windows in each room are measured and workers in the metal shop on the main U-M campus cut sheet metal and clear acrylic coverings to fit over the window frame. (The acrylic portion of the material allows natural light to still enter a room.) Each contraption is then brought over and installed by maintenance and facilities staff in the hospital.

Next, a HEPA (high-efficiency particulate air) filter is added, which removes the contaminated air from the room and discharges it outside.

“The HEPA filtration units we are using have come from our own internal stock, rental units, newly purchased units, and units provided by colleagues in the university’s Architecture, Engineering and Construction Department,” Hoeflein said. 

Once the room pressure is tested by HVAC professionals and meets rigorous guidelines, Environmental Services cleans the room and nurses, clinicians and those in the Admissions and Bed Coordination Center (ABCC) work to bring patients in. In all, a total room conversion can be completed in less than four hours.

The work doesn’t even end there: after patients are moved into a room, HVAC staff weekly measure airflow to ensure filters are working properly at all times.

“The whole process is a testament to the teamwork and resources we have at U-M,” Hoeflein said. “Not every health system has a sheet metal shop and architecture team down the street that they can lean on at any time.”

Planning ahead

While the curve of COVID-19 seems to be flattening, Michigan Medicine is still preparing for a potential influx of patients. Should that come to fruition, even more patient rooms will be converted to negative pressure rooms.

“The great thing about this effort is that everyone is stepping up whenever and wherever we need it,” Hoeflein said, adding that rooms can be worked on 24/7, with up to 10 conversions being performed in a single day. “We’re able to change on the fly as clinical needs change.”

Indeed, the team is working long hours in a challenging environment.

“But everyone is working so hard to meet that challenge head on,” he said. “It makes me proud to be part of this organization.”