Utilising Red and Green Wards within the Community Hospital settings to facilitate safe transfer of patients from RCHT
The Royal Cornwall Hospital has divided its site into Red and Green Zones in an attempt to segregate patients with a suspicion or diagnosis of Covid-19 from those patients who are Covid-19 negative.
Logic would be to reflect this within the Community Hospital settings - accepting Green Zone transfers to Green Community Hospitals and Red Zone transfers to Red Community Hospitals. It is recognised that this may not be sustainable with the predicted exponential increase in Covid-19 cases within the coming weeks; but it would allow the transfer of patients in as safe a manner as possible within the current challenging scenario of the Covid-19 pandemic.
All RCHT patients will be reviewed twice daily against the reason to reside checklist and if none of the criteria are met the questions ‘why not home, why not today’ will be asked.
Based on current Covid-19 activity across the Community Hospitals, it is anticipated that currently 2 of the Community Hospital Wards could become green wards.
The frailty step down pathway established for Helston Hospital can be stepped down currently as the anticipated demand has not been experienced at this time, therefore Helston hospital can be designated a Red site. It has the benefit of single occupancy side rooms which will minimise the risk of infection spreading. The remaining wards with side rooms have been dedicated Green wards.
It is anticipated that as time progresses and more cases are seen, cohorting in community hospital wards will need to be undertaken.
Currently the wards that could become Green wards with minimal activity in priority order are:
Additional wards could potentially become green as follows:
At some point it may be possible to convert either Harold White or Heligan to green; if all the Covid-19 positive cases are transferred to one ward. This will then require a period of observation and preferably be used last for admissions to see if any of the exposed patients subsequently become positive. Alternatively and at the current time these wards will allocate each bay as being Red or Green
The remaining wards would become Red Wards:
Heligan or Harold White (see above)
Community Assessment and Treatment Units – Harbour, Hayman and WCH Med 1
Due to the operational aspects of these units, declaring these red or green will not be feasible. Where possible patients will be assessed initially in the side rooms prior to placement.
Initially it was suggested that it may be possible to allocate one Stroke Ward green and one ward red. Currently due to the number of confirmed and suspected cases across both wards, and in order to maintain the Stroke Pathway, red and green zones will now be allocated within each ward area (this includes Anchor ward due to its location with Woodfield)
As the positive cases increase and in order to protect those patients with a non-Covid diagnosis consideration may need to be given to mixing the genders within the hospital wards/bays/units.