Johns Hopkins University: Johns Hopkins Bayview Medical Center Activates Crisis Standards of Care

While communities across the country grapple with the recent surge in COVID-19 cases, the pandemic continues to critically stress staffing and resources at hospitals and health care facilities, including the six hospitals within the Johns Hopkins Health System (JHHS). As a result, today, JHHS and Johns Hopkins Bayview Medical Center (JHBMC) leaders announced that JHBMC will implement Crisis Standards of Care (CSC) protocols.

“This decision was not taken lightly,” said Kevin Sowers, president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine. “Unfortunately, we’ve seen Johns Hopkins Bayview’s census of patients with COVID-19 and non-COVID-19 clinical needs spike dramatically in recent days. Working closely with the Johns Hopkins Medicine Unified Command Center staff, we have agreed that moving to CSC is the right decision.”

During the month of December, JHBMC saw a 360% increase in patients hospitalized with COVID-19. This is the highest increase the hospital has experienced since the start of the pandemic.

Several other Maryland hospitals are already operating under crisis standards of care. The CSC concept was developed by the Institute of Medicine (IOM) at the request of the Department of Health and Human Services (HHS), following Hurricane Katrina, to provide a standard of care framework that would apply during disaster situations. Johns Hopkins Medicine has worked with the University of Maryland Medical System (UMMS) to standardize the process for activating Crisis Standards of Care.

To meet the growing demand for the care and safety of patients with COVID-19, while caring for patients with other medical needs, Johns Hopkins Health System hospitals have already opened additional treatment spaces for patients with COVID-19, rescheduled elective surgical procedures and redeployed staff to ensure that patients with COVID-19 and those dealing with other medical conditions are receiving safe, high-quality care.

Changes under CSC protocols will allow additional flexibility in how we:

Advance different clinical care models
Further modify elective surgical schedules
Simplify documentation requirements
Redeploy clinical and nonclinical staff
Improve patient flow through measures such as early discharges, when safe and appropriate
“Implementing CSC protocols at Johns Hopkins Bayview Medical Center allows us the flexibility to increase access to care for those who need it most and enables the hospital to care for as many patients as possible with the staffing we have,” said Richard Bennett, president of Johns Hopkins Bayview Medical Center. “Our commitment to providing safe, high-quality care for all our patients will remain at the forefront of everything we do.”

The CSC protocols for JHBMC are effective as of Dec. 29. JHHS will continue to monitor patient census and staffing levels at JHBMC closely —on a daily basis — and will reevaluate crisis level protocols accordingly.

JHHS notified the Maryland Health Secretary and the Office of Health Care Quality (OHCQ) in the Maryland Department of Health (MDH) about this situation, and submitted supporting documentation, as required under Governor Hogan’s directive. The Centers for Medicare and Medicaid Services (CMS) will be contacted through the appropriate channels.

Johns Hopkins Medicine leadership remains in close contact with federal, state and community leaders and continues to collaborate with health care partners and peers, including the University of Maryland Medical System, to ensure consistency and alignment in care protocols.

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