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N.J. hospitals adapt to surge of flu patients

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Flu season comes and goes every winter, some worse than others. This year's flu, considered by many to be the worst in a decade, is forcing hospitals around the state to adapt to an unexpected influx of patients.

Hackensack University Medical Center has been averaging about 120 flu patients every day for a few weeks.

"Any time you are over 100, that's at capacity," said Bob Garrett, president and CEO of Hackensack University Health Network. "People are very sick with this flu."

Garrett said Hackensack has set up a discharge lounge for patients who are ready to go home but need to wait for a ride or discharge instructions. He also said observation units are being used for patients who may not need to be admitted as inpatients but need to be monitored for 24 to 48 hours.

"If it really gets to be packed, with no more treatment space, we do go on divert with the ambulance squad, but we are the trauma center for the county, so sometimes these patients continue to come in even when we are on divert," Garrett added.

Garrett also said the system is looking forward to when HackensackUMC at Pascack Valley opens later this year to help with overflow patients.

At Virtua, a "surge" plan was instituted at the system's four South Jersey hospitals in conjunction with several Virtua Express urgent care centers and affiliated physician practices.

"We've developed the capability of managing patients outside of the hospital," said Dr. James Dwyer, chief clinical officer of Virtua. "All of these access points have become very, very challenged from the volumes with the flu activity, but the good news is, because of the size of the system and because of the multiple access points we've developed, we've been able to figure out ways to spread this surge across a larger base than managing it just through the emergency department."

Dr. John Matsinger, chief medical officer of Virtua, said each of the locations set up their flu-response areas based on the size and shape of the facility, but common measures like a segregated waiting room were established.

Matsinger said the areas usually reserved for "fast track" patients – those who enter the emergency department with minor injuries or sicknesses – have been converted to holding areas for flu patients. General hospitalists have also extended their hours at Virtua in order to move patients out of waiting areas and the emergency department and make space for new patients.

Both Matsinger and Dwyer said they've never seen volumes at the hospitals like they have this winter, but had previously implemented the system's surge plan proactively in response to H1N1 virus concerns and in preparation of possibly receiving 9/11 patients.

At Robert Wood Johnson University Hospital – Hamilton, staff had an early idea of how harsh flu season would be this year. The hospital uses software called MedMined, which analyzes infection to predict future patterns.

"Being able to see the threat of infection before it blossoms allows us to adjust procedures proactively and protect patients and employees from illnesses like the flu," said Anne Dikon, director of infection prevention. "Comparing the last two years of data, I was able to identify an increase in flu activity in early December."

A spokesman said in December alone RWJ-Hamilton saw 84 flu cases, compared with 13 in all of 2011. RWJ-Hamilton has been using MedMined since 2006, and Dikon monitors the data analysis daily for the entire hospital, the spokesman said.

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