Alumni and current students in the MGH Institute’s Doctor of Nursing Practice program have led the transformation of Spaulding Hospital Cambridge into a COVID-19-positive post-acute long-term acute care facility to support the Mass General Brigham health care system's acute care hospitals manage their surge plan.

Maureen Banks, a 2019 DNP graduate, president of Spaulding Cambridge and the Spaulding system’s chief nursing officer, initiated discussions in early March with Joanne Fucille, DNP ’12, vice president of hospital operations/director of nursing, on the need to convert two inpatient units to handle coronavirus patients. Fucile worked closely with current DNP students Tamera Corsaro, director of professional development, and Pauline Clarke, nurse manager, to research best practices in managing the environment and patient’s clinical needs. 

As one of the first post-acute hospitals in Massachusetts to develop this capability, they needed to develop new policies and procedures to assure both staff and patient safety. “We’ve used what we learned at the IHP to transform our operations so we could accept COVID patients,” said Dr. Banks. “It was a huge undertaking and we had to implement a number of changes very quickly, but it’s worked out quite well.”

As director of professional development, Corsaro worked with educators to train 500 staff members on such things as developing procedures on how to be fitted for and use personal protective equipment (PPE), creating educational videos, and implementing new documentation processes. Her team, including staff RNs, also provided training for multiple skilled nursing facilities as they developed their own COVID units. Corsaro also was responsible for training the deployed outpatient therapists and support staff to assist nurses in caring for patients. 

Clarke was responsible for creating the facility’s first two COVID-19 units, where she worked with between 175 and 200 nurses while creating a workflow process. She worked with her team to develop efficient workflows to minimize the utilization of PPE. 

While much of the work involves nursing care, there’s also the rehabilitation side of recovery. Because of social distancing regulations, patients can’t use any of the hospital’s three gyms nor could they walk the halls to get in their treatment. So, they went old school. “If a patient needed to walk a flight of stairs, we had them use plastic elevated steps that we used to use in exercise classes to simulate walking up a flight of stairs,” said Dr. Fucile. “We had to be innovative.”

The facility, which already has accepted over 155 patients – many of whom will have just come off ventilators – is about to have its own surge as more recovering COVID-19 patients arrive from Massachusetts General, Brigham and Women’s, and other acute-care hospitals in the system. And, even though it’s been just two months, Fucile spoke for the three nurses when she talked about how things have permanently changed in the post-acute care system. “It’s hard to even remember what it was like before this,” she said. “We’ll be treating COVID patients until a vaccine is developed.”

To help the cause, many MGH Institute BSN students were designated early this past spring as graduate nurses during their last semester so they could treat patients at the Boston Hope field hospital. They were the only nursing students who treated patients there. In addition, another 53 BSN students received a 1:1 preceptorship over the summer at Spaulding after working with patients at Boston Hope.