USNH Sigonella - 2020 Year in Review

2020 has been quite a year for the hospital at Sigonella, with the most significant global pandemic since the Hong Kong flu killed up to four million people in the late 1960s. Some of the differences in the COVID-19 pandemic have been the increase in rapid communication, including social media and the ease of spreading inaccurate or incomplete information, and the use of newer medical technology, such as the equipment used to detect viral genetic material (beginning in the 1970s) and the advent of telemedicine in the 1950s with exponential growth beginning in the 1990s. Here, a few of our local subject matter experts share our responses to COVID-19.

Nurse and Head of the Emergency Department (ED) Lt. Christopher Parker: We implemented the screening, treatment and disposition of infectious patients in the ambulance bay on Feb. 23. Care was executed in the ambulance bay utilizing an out of service ambulance and socially distanced seating throughout the ambulance bay as an overflow. On March 26, NAS Sigonella Fire & Emergency Services provided a decontamination tent to the hospital, and since this time, we have met enterprise-level standards of care while separating possibly infectious patients from physical hospital interaction. On April 8, the NAS Sigonella emergency management team provided a larger tent which was outfitted with dividers and easier to clean structure surfaces. On April 9, we initiated the use of a closed circuit video teleconference (VTC) system to improve patient interactions while we continued to use alternate screening processes and environments of care during the pandemic. These tents and VTC not only minimize in-person interactions between staff and possibly infectious patients, they also mitigate non-essential foot traffic throughout the hospital since radiology can collect portable images within the bay and the pharmacy delivers prescription medicines directly to patients.

Nurse Anesthetist Cmdr. Jeremy Kilday and Anesthesiologist Lt. Cmdr. Brigid Maruszak: To maximize the care of our beneficiaries during the COVID-19 pandemic, we established a six-room intensive care unit (ICU), which, prior to the pandemic, was not a capability. While the ICU has not yet been needed, the planning and training of our staff has allowed us to prepare in the event our patients may require this advanced level of care. This was a command-wide initiative working across directorates to revamp our staffing model, tailor training towards COVID-19 specific healthcare, and practice utilizing personal protective equipment in both controlled and urgent/emergent situations. Working with the facilities department, we were able to reconfigure airflow to four additional patient rooms to expand the ICU and split the multiservice ward into COVID-19 and non-COVID-19 wards, ultimately ensuring the safety of all our patients and staff. While we hope that our beneficiaries will not need this asset, we are standing by. Please take care – wash your hands and wear a mask so that you will not need us!

Virtual Nurse Manager Lt. Kayla Peterson: Our virtual health (VH) program allows beneficiaries to take advantage of 52 specialties in additional military treatment facilities (MTFs) across Europe. Since its inception as a collateral in February 2019 thanks to the efforts of nurse Lt. Jacqueline Canfield, it has grown considerably. Once COVID-19 began distressing healthcare systems, local network specialty providers were unable to continue seeing non-urgent patients, creating obstructions in access to specialty care. Our resolution was to heighten the VH program and dedicated an active duty nurse to running it full-time. We have expanded the program from an average of 19 to 32 appointments per month and have ensured the program stands in compliance with Defense Health Agency guidelines. We established new services for our clinic in Bahrain, spearheaded a new pilot to open services to our clinic in Souda Bay, and enhanced the referral processes for three MTFs and 11 specialties. During the restrictions, we coordinated 51 initial VH appointments with Naples ENT (ear, nose and throat) clinicians in preparation for upcoming site visits. This allowed clinicians to assess and prioritize patients, successfully maximizing time in the operating room during the visit. The same approach was used in preparation for the four-day site visit of the developmental pediatrician from Landstuhl Regional Medical Center, Germany. This was critical for our beneficiaries, many of whom have needs that cannot be met in the local economy.

Laboratory Officer Lt. j.g. Lina MacPartland: At no time in recent history have laboratories around the globe been more in the spotlight than today with the COVID-19 pandemic. Well-trained and talented laboratory professionals are the backbone of medical services, supporting clinical testing and diagnoses on a daily basis in theater, in the fleet, and at home. Our laboratory team saw an increase in testing demand due to the pandemic and met the challenge head on. We quickly increased capability to support testing for our community and deploying units. The laboratory spearheaded the Swab-ex evolution, which is a way to quickly sample and test large amounts of people. These evolutions ensure that service members and their beneficiaries are screened and tested for the SARS-CoV-2 virus. We have done this by coordinating with NAS Sigonella and tenant commands in Bahrain and Souda Bay in conjunction with 5th and 6th fleet. The screening and testing performed support mandated Department of Defense sentinel surveillance testing and operational risk reduction measures in addition to emergent symptomatic testing.

U.S. Naval Hospital Executive Officer Capt. Walter W. Dalitsch III: And there you have it from our subject matter experts! On behalf of the hospital triad, I would like to say how proud we are of the flexibility, adaptability, resilience, passion and dedication of every single member of our staff to ensure the health and safety of both our own personnel and our precious patients. From E-1 to O-6, and all of our U.S. and local national civilians, the accomplishments of this team have been simply eye-watering to witness. In Sigonella…we’re always ready!