National Critical Care and Trauma Response Centre

Submission by the Australian Medical Assistance Team – National Critical Care and Trauma Response Centre

Terms of reference item Number 4. The timeliness and effectiveness of closing the North West Regional and the North West Private Hospital in Burnie, and the impact on other health and health related facilities.

Background

The AUSMAT initiative, involves multi-disciplinary health teams incorporating doctors, nurses, paramedics, fire fighters (logisticians) and allied health staff such as environmental health staff, radiographers and pharmacists, drawn from all states and territories. AUSMAT members are experienced Australian health professionals working in either public or private hospitals or health care facilities across Australia. The initiative is further enhanced by close collaborations forged with neighbours in the Asia Pacific region. In January 2020, the AUSMAT was deployed for the first time domestically in response to the New South Wales and Victorian catastrophic bushfires. AUSMAT was deployed in March to support the WA Health response to COVID-19 outbreak on the German cruise ship MS Artania.

In April the AUSMAT was requested for a joint deployment with Australian Defence Force to provide clinical leadership in response to the COVID-19 outbreak and the subsequent quarantine of >1,200 staff and contacts at two North West Tasmanian Hospitals. The North West Hospital and associated regional referral hub services closed due to an emerging cluster COVID-19.

Following a request on 11 April the AUSMAT/ADF supported deployment involved 7 AUSMAT members and 43 ADF personnel and was conducted 14 April 2020 through 1 May 2020.

The tasking was to provide essential emergency care services to North-West Tasmania catchment area including assistance in coordination of prehospital, retrieval & critical care regional referral services.

AUSMAT activation to North West Regional Hospital, Burnie.

The Northwest Hospital and associated regional referral hub services were closed 12 April 2020, due to an emerging COVID-19 cluster in health care workers (HCW) resulting in over 1200 staff subsequently quarantined in 14 days home isolation. This closure was unprecedented in the region.

TAS Health submitted a joint AUSMAT / ADF DACC request on 12 April 2020, as part of their ongoing state-wide COVID-19 pandemic response. This request sought direct support to Northwest Regional Health (NWRH) Service to maintain provision of essential emergency care services including assistance in coordination prehospital, retrieval and critical care Regional Referral services, WEF 0700hrs Wednesday 15 April 2020.

AUSMAT deployed on Tuesday 14 April 2020 and in collaboration with ADF commenced operations in Burnie on Wednesday 15 April 2020 for a period of 14 days. The Joint Commonwealth response included AUSMAT providing the overarching leadership and clinical coordination team; seven personnel, with ADF providing frontline clinical staff and allied health services support (35 personnel).

AUSMAT

• Mission Team Lead
• Medical Clinical Lead
• Nursing Clinical Lead
• Logistics Lead –
• IPC / Maternal services Lead –
• Prehospital Advisor –
• Health Information & Epi Advisor –

Overall, AUSMAT/ADF facilitated an expedited, comprehensive refurbishment and recommissioning of the Northwest Emergency Department with regional Emergency care services re-established WEF 1400hrs Friday 17 April 2020. However, there were multiple, complex arms to this bespoke deployment. They include:

• All Frontline clinical services to the ED
• Assisting with re- establishing a limited maternity service
• Midwife providing coverage of initial maternity services
• Mission Team Lead joined TAS Health statewide Regional EOC briefings (twice daily)
• Daily Coordination link with Regional COVID19 taskforce IMT
• Ongoing NW Health Operational coordination; ADF, AUSMAT, Ambulance, NW Clinical leadership & Hospital Executive teams
• Preliminary planning for staged, transition phases to reopen full NWRH services
• Involved with staged deep clean of the Emergency Department
• Initial daily COVID-19 screening of all visitors/ workers to the NWRH site
• Infection Prevention and Control planning and risk management in the ED
• Consolidating links with TAS Health Infectious Disease Physician in Hobart
• Transition of returning HCW to the ED
• Detailed stock control/management of PPE materials

LESSONS LEARNED

• Communication talking to your team, patients, and clients keeping them informed via Whats App, on the phone.
• Consistency  Systems and processes – ensuring all staff understand the processes and systems. How to use personal protective equipment, checks and audits.
• Compliance Donning and Doffing Personal Protection Critical. No PPE breaches across all missions.
• Compassion Social and mental health – important to make it more than a basic check in.  Actively talking to people, checking in about their social wellbeing while in quarantine.