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Hurry Up and Wait: Monument Transforms Shell Space in Record Time Ahead of Expected COVID-19 Surge

Jun 24, 2020 07:00AM ● By MED Magazine

With models pointing to a surge in hospitalized COVID-19 patients in the Midwest, health systems across the region had to scramble to make sure they had enough beds, personnel, and equipment for what was projected to be unprecedented patient numbers.

For Monument Health, the timing was good. The health system is in the final year of a $210 million expansion of the main Rapid City Hospital campus. The recently finished, 32-bed Heart & Vascular Unit was immediately converted to accommodate COVID-19 cases. 

And in just two weeks - record time by any standard - unfinished shell space on the campus that was earmarked for future growth, was also converted into bed space for possible COVID-19 patients.

"We had no idea how much time we had to get ready," says Dave Ellenbecker, Monument's VP of Facilities Management. "It was a race to get these built out." 

With the help of a local architect and input from user groups, Monument had a design concept in just three days. Contractors who were already working onsite hired local subcontractors and redirected their efforts to the conversion.  

"It reminded me of experiences I have had in the military when you have to mobilize quickly," says Ellenbecker. "We identified the needs, took a look at what we had to work with, and mapped out a simple plan."

Workers hung drywall and extended water, electricity, and other services to the spaces while Monument Health teams located beds, supplies, and staff. The project added 172 dormitory style beds and 17 ED beds, ready for the sickest patients.  

"Each area had its own limitations and possibilities," says Chief Nursing Officer Nicole Kerkenbush. "We knew that we would need high flow oxygen and ventilators in these spaces. And we tried to make sure we could maintain safety with things like bed rails and call lights."

Some corners did have to be cut for speed and practicality. The first area to open, called The Foothills, has half-walls, shower curtain doors, and no windows. The ceilings are unfinished and there are no private baths. The Prairie, which will one day be another inpatient unit for Monument, is more open with 8 to 20 beds in a section. 

"We had to look at what we could put in quickly that would be safe and functional but that we can also eventually take out," says Kerkenbush. 

"This was very unusual for us to be able to push aside the barriers and get this done so quickly," says Ellenbecker who worked closely with the Department of Health to make sure safety standards were met in the build-out. "Between our construction team and our local subcontractors, everyone felt so empowered to jump in and fill these spaces." 

 As of mid-June, there has been no surge of COVID-19 cases at Monument. As non-essential services ramp back up and coronavirus is still with us, Kerkenbush says the next challenge will be to figure out how to care for these patients while also meeting the ongoing community healthcare needs.