three clinicians walking down hospital hallway

Getting Ready for Flu Season Surge: How Hospitals Can Prep

Just like the New Year’s Eve countdown clock, flu season is coming. To effectively meet that inevitable surge in sick patients, hospitals have to keep an eye on both short-term and long-term strategies. Not only do medical centers have to prepare their workforce and patient care centers to meet an increase in demand, but department managers – including cath lab leaders – also have to be ready for operational changes.

Based on historical averages, 5-20% of the American public could become infected by influenza this winter. The most severe cases could lead to the hospitalization of 200,000 people (or more). That’s an incredible strain on a medical center’s resources and anything that can be done to lessen the pressure on healthcare services should be done well in advance.

How Shift Scheduling Might Look Different During Flu Season

Annual influenza surges can affect the number of patients in waiting rooms at emergency departments and pediatrician offices – but it doesn’t stop there. More patients seeking emergency treatment for their acute symptoms means fewer patients on elective surgery schedules.

According to recommendations from the CDC, hospitals should not only promote flexible sick leave policies for healthcare staff but also encourage those who are feeling unwell to take time off and recover away from the medical center.

If implemented, this could mean that instead of just soldiering on, healthcare personnel who are sick should take real sick leave at home, requiring additional staff as temporary assignments or rotational support.

Why Hospitals Require Flu Vaccination for Staff

If a medical center workforce begins to fall victim to the flu, nurses and other support staff could get pulled into triage areas and away from their regular departments to make up for the staffing shortage. Often this is a critical reason why many hospitals and long-term care facilities require or strongly encourage their employees – no matter their role – to be vaccinated against the annual flu strain. Even if exposed to the flu, most vaccinated adults will have a lower chance of catching the flu virus, or if infected, they will have a less severe bout of illness. This means less downtime and an overall better result than a full-blown bout of the flu.

“A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients,” notes the CDC on their website. “Another study in 2018 showed that a vaccinated adult who was hospitalized with flu was 59% less likely to be admitted to an intensive care unit (ICU) than someone who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.”

While many healthy patients might toss off the flu as a few days’ inconvenience and perhaps some bed rest, the complications to much of the public are very serious. “Complications of flu can include bacterial pneumonia, ear infections, sinus infections, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes,” notes the CDC.

Other Ways Hospitals Prepare for Flu Season

It’s important to note that any additional strain on one department can lead to shortages in others. Outside of staffing and physical beds, resources like specialty equipment and medical supplies could become strained – especially if medical supplies are already experiencing delays or shortages. Hospitals that currently rent equipment can ensure they have extended rental contracts through the standard peak influenza months (December-February) to avoid shortages. In addition, hospitals should ensure that all equipment is well-maintained and in good working order. The last thing you want is a breakdown of respiratory machinery during flu season.

When it comes to physical spaces, plans for an increase in patient numbers can include additional triage spaces, support staff to effectively move new patients from street to clinic, and additional, flexible spaces that can treat the most at-risk patients. Unlike summer months, temporary tent structures aren’t practical in areas that experience severe winter conditions.

How Hospitals Prepare to Increase Safety Protocols During Flu Season

Beyond masking, hospitals may prepare all healthcare personnel to adhere to prevention strategies to avoid spreading influenza throughout the medical center. This would include adherence to certain safety protocols by everyone from physicians and nurses down to the security and billing department staff. 

Since influenza typically is transmitted through large-particle respiratory droplet transmission (i.e., through coughs and sneezes) the CDC recommends the following protocols be in place

  • administration of influenza vaccine 
  • implementation of respiratory hygiene and cough etiquette
  • appropriate management of ill HCP
  • adherence to infection control precautions for all patient-care activities and aerosol-generating procedures
  • implementing environmental and engineering infection control measures.

What Are the Influenza Infection Control Guidelines for the Cath Lab?

The above measures will affect those treating influenza patients, like in the ER or the ICU, but even in the cath lab, it’s important to adhere to best practices to minimize the spread of the flu virus. Not only could an infection brought on by slack protocols mean additional ICU cases, if an otherwise healthy patient becomes ill, but for some high-risk cath lab patients, it could be a fatal mistake.

At the same time, cath labs may see an uptick in patients who already have become infected with seasonal influenza. A 2020 study by the National Institutes of Health (NIH) found that in a survey of almost 90,000 lab-confirmed influenza cases, nearly 12% of cases had an acute cardiovascular event. Most often events included acute heart failure (aHF) (6.2%) and acute ischemic heart disease (aIHD) (5.7%). The treatment for these events can take place in the cath lab, bringing patients with the flu into the lab.

The fact that both high-risk patients could be in the lab for treatment of cardiological diseases and could cross paths with those who already have the flu but also are seeking cardiology services just underscores the need for adherence to protocols and maintaining vigilance to keep everyone healthy and safe, during flu season, and beyond.