MGH’ers in the Time of Coronavirus

During the early stages of its COVID-19 response efforts, the Massachusetts General Hospital Incident Command System (HICS) activated its labor pool, redeploying clinical, non-clinical and administrative support to help meet the changing—and often challenging—dynamics raised by the coronavirus pandemic.

“Mass General employees across the hospital—at all levels, and from all departments—are fully committed to going the extra mile to do what is necessary to slow the spread of the coronavirus,” says Jovita Thomas-Williams, senior vice president for Mass General Human Resources. “Sometimes, this has meant working beyond their normal workday, on different teams or accepting modifications to their normal schedule. Some employees have been reassigned or redeployed to responsibilities outside of their typical role as needed to support hospital operations and patient care.”

View Mass General's redeployment key results from March 10-May 7 (PDF).

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Shelby Bell, DPT

Physical Therapist, Department of Physical Therapy

In late March, Shelby Bell, DPT, of Mass General's Outpatient Physical Therapy in Revere, was redeployed to act as a project manager in the Center for Disaster Medicine (CDM) within the COVID-19 Emergency Operations Center.

“Typically, working as a clinician, I am used to spending my days treating and advocating for individual patients,” says Bell. “This new position requires me to transition to a population-based mindset, which is different than anything I have done before within health care. It has also been very different working a desk job since I am used to moving all day with my patients.”

Bell’s daily tasks include documentation of critical events—including policy and operational changes—and of the Incident Action Plan, the hospital’s overarching response strategy. Bell also helps manage the detailed slide presentations for the daily HICS briefing.

“The CDM and HICS team have been welcoming, appreciative and a great group to spend the workday with,” says Bell.

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Amy Kendall, NP

Nurse Practitioner, Department of Radiology

In her role as a nurse practitioner in the Department of Radiology and the Martinos Center for Biomedical Imaging, Amy Kendall is responsible for a host of nursing duties, including performing physicals on study participants, providing medical coverage in case of a reaction for contrast and radiotracer injections and drawing samples from arterial line placements during PET-MR scans. PET-MR is an imaging technique that pairs the whole-body functional imaging of positron emission tomography (PET) with the local anatomic detail and morphological information of magnetic resonance (MR) imaging. Since early April, however, Kendall has been reassigned to work at The Ragon Institute of Mass General, MIT and Harvard, consenting patients for a biospecimen COVID-19 study and the Partners HealthCare Biobank. Each person she works with has had—or is at risk of contracting—COVID-19.

“This new role is both interesting and challenging, as operations change daily,” says Kendall. “One of my favorite parts of this new position is talking to potential study participants who are eager to contribute to COVID-19 research, as it offers them an opportunity to give some meaning to their suffering. Most of the people I've spoken to are thankful for the opportunity to contribute in this way.”

Kendall also has helped assemble the numerous biospecimen collection kits needed as part of the consenting project. “I am grateful to work with brilliant and dedicated people, and to be connecting with people in our community who are struggling,” she says. “I find myself chatting with folks I have called to consent, listening to their stories. Often they are lonely and scared and happy to talk to a nurse from Mass General.”

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Jarone Lee, MD

Medical Director, Blake 12 Intensive Care Unit (ICU)

“I continue to be amazed by the outpouring of support internally to help us in the ICUs,” says Jarone Lee, MD, medical director for the Blake 12 ICU. “This is especially true in our new surge ICUs here at Mass General. Everyone wants to help and as true team players, the people who have been redeployed to us have not only stepped into their assigned roles, but also have found many other ways to help.”

Lee says with the redeployment of staff across the institution, he’s had the opportunity to work with and meet employees he normally wouldn’t encounter. “For example, I’ve met many non-ICU nurses now working in our ICUs and researchers who are helping with anything needed on our units—from transporting blood work to watching alarms. Within our hospital community, I have no doubt there will be a lot of new friendships and bonds that were not there before this crisis.”

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Redeployment Numbers

The number of redeployments speaks to the unprecedented volume of manpower needed as Mass General scaled up its response to COVID-19. To date, 787 employees have filled 5,414 shifts through the Mass General General Labor Pool.

“There is a lot of talent within the hospital, and when disaster strikes it is immensely helpful to redeploy staff from departments with decreased operations for utilization in areas with increased need resulting from the disaster,” says Megan Brown, manager of Projects and Analytics for MGH Human Resources. “The professional resilience of our staff has proven we are all in this together to conquer this virus.”

Assignments in the General Labor Pool include:

• 18 employees per day for the N95 sticker program
  Staff distribute color-coded stickers to those staff who wear N95 respirators or powered air-purifying respirators, indicating what model and size should be used. This program was created as a proactive measure to help the hospital continue to monitor and conserve personal protective equipment.
• 35 employees on a rotating schedule for food donation program(s)
  A delivery team was formed from the labor pool to pick up and distribute more than 28,000 meals across every unit, department and shift multiple times. Thanks to several generous donors, large donations of up to 5,000 meals are scheduled to continue over the next few weeks.
• 20 employees a day for the ventilation and pump listener program
  At its peak, the ventilation listener program required 55 employees per day. With the increased number of patients requiring mechanical ventilation from COVID-19, Mass General deployed multiple types of new ventilators, many of which do not connect to the hospital’s central monitoring alarm system. To help nurses already providing general ICU care throughout each patient’s room, Mass General deployed additional staff to watch and listen to ventilator alarms to immediately help alert ICU teams. With more vents being brought into the central monitoring system, and also decreased patient dependence on vents across the hospital, the number of staff required has decreased.
• 75 employees daily for the mask distribution and attestation program
  Members of the labor pool are present at each of the four entrances to the hospital. Employees are guided through the entrance by labor pool staff who verify each employee’s symptom attestation via the daily COVID pass, provide Cal Stat (hand sanitizer) to perform required hand hygiene and then are given a mask to don prior to arriving at their work location.
• Facilitated deployment of 104 Mass General staff have been redeployed to Boston Hope including eight nurses, 39 providers and 57 other clinical and non-clinical employees
  Opened in early April, Boston Hope is a 1,000-bed medical center constructed inside the Boston Convention and Exhibition Center to serve post-acute COVID-19 patients and homeless patients with COVID-19 who do not require hospitalization in an acute care facility. The effort is a partnership between Partners HealthCare, Boston Health Care for the Homeless, the office of Massachusetts Gov. Charlie Baker and the office of Boston Mayor Martin J. Walsh.

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Nicolette Maggiolo, RD, LDN

Manager, Clinical and Culinary Nutrition, Home Base

Prior to her redeployment to Boston Hope on April 14, Nicolette Maggiolo, RD, LDN, managed the clinical and culinary nutrition program for Home Base, a partnership of the Red Sox Foundation and Mass General, providing individual nutrition consults, group nutrition classes and educational cooking demonstrations for veterans, service members and their families.

At Boston Hope, Maggiolo serves as manager of Nutrition and Food Services, overseeing a team of registered dietitians, diet technicians and food service employees.

“The amount of work that has gone into establishing and maintaining this operation is truly unbelievable,” says Maggiolo. “The task has certainly required a lot of hard work and many long days. Our team essentially built a clinical nutrition and food services operation from the ground up inside of the convention center. Without a doubt, there have been learning curves and we work hard every day to ensure patients and staff are well-nourished.”

Maggiolo notes her team must constantly evolve and adapt. “The dedicated and compassionate colleagues we work with make this place so special. The comradery and unity that come with serving such an important mission is remarkable. Every single person in this building, and every single person supporting us from afar, is integral to the mission. There really is nowhere else I would rather be.”

She says Boston Hope has given her a renewed sense of purpose. “I am a civilian ‘re-deployed’ and working side-by-side with many Army Reserve and National Guard personnel at Boston Hope. Together, we are connected by a central mission. While I have never served in the military, I have felt more connected to my Home Base veteran and service member patients than ever before.” 

Maggiolo has further taken joy in the many fun food-related posters shared at Boston Hope, created by children which have helped boost the morale with sayings such as, “You are a pineapple. You are tough on the outside but sweet on the inside. You wear a crown like a pineapple, and you stand tall like a pineapple.”

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Matt Larrabee, Research Technician

Research Technician, Martinos Center

As a research technician within the Laboratory for Computational Neuroimaging at the Martinos Center, Matt Larrabee usually collects ex vivo MRI and OCT scans of brain tissue, processes scan data, and helps users with the software the lab produces. Since the beginning of April, Larrabee has been deployed as a ventilator listener, a role in which he says the learning curve was “pretty quick.”

With the increased number of patients requiring mechanical ventilation from COVID-19, Mass General had to deploy multiple types of new ventilators, many of which do not connect the hospital’s central monitoring alarm system. The only way to not miss a ventilator alarm, which might be life-threatening, is to be very close to the room. To help nurses already providing general ICU care throughout each patient’s room within the unit, Mass General deployed additional staff to watch ventilator alarms to help to immediately alert ICU teams. 

In addition to signaling to nurses the moment a ventilator or pump alarm sounds, Larrabee also helps with other tasks, including getting supplies and setting up iPads for family and patient teleconferences. “I've enjoyed getting to know the staff and learning about their work and how they are coping with all the demands and changes they have faced with COVID-19,” he says. “I am in awe of skill and work ethic of the staff of Bigelow 6.”

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Mary O’Hara

Operations Manager, Martinos Center

Mary O’Hara, operations manager for the Martinos Center, had a short but meaningful week-long run managing the portable X-ray machine. “Prior to the pandemic, I had not taken a portable X-ray in more than 25 years, but the ER staff was excellent in training me to help with this important role,” says O’Hara. “It all came back to me.”

O’Hara says she enjoyed the feeling of being part of a team and trying to make a difference in patient care. “I was amazed at how hard everyone was working without complaint. It was all hands-on deck and everyone answered the call. A nice part about folks getting redeployed is that I have been able to see and catch up with old friends in non-clinical roles that I have not seen since the beginning of this crisis. For example, I recently saw one of my fellow researchers giving out stickers to help organize our N95 masks.”

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“We applaud and are humbled by our team of health care professionals for their tireless commitment to providing excellent care of patients and each other during this unprecedented time,” says Thomas-Williams. “The selfless way these folks execute their vital roles in this COVID battle is nothing short of remarkable. We are extremely proud of our Mass General community and their willingness to go to great lengths whenever necessary to stand shoulder-to-shoulder in this fight.”