Clinical Redeployment of an Academic Family Medicine Department in an Early, Severe COVID-19 Pandemic in the Bronx, NY.

ABSTRACT

INTRODUCTION: A severe surge of the COVID-19 pandemic in spring 2020 infected 33% of the population and caused more than 7000 deaths in the Bronx, NY. The Department of Family and Social Medicine at Montefiore Medical Center rapidly and strategically reconfigured clinical services to meet the needs of patients, communities, and the health system. CLINICAL RECONFIGURATION Family medicine hospitalist services tripled in size within 2 weeks to cover 71 beds and cared for 447 patients between March 24 and June 10, 2020, of whom 279 (62.4%) had COVID-19. Community health centers reorganized to maintain primary care services, shifting abruptly to telemedicine while maintaining 95% of the previous year's visit volume, and address intensified patient needs related to viral infection and mental health impacts. Core principles for redeployment included role flexibility, communication, responsiveness, and safety and wellness. DISCUSSION: During a pandemic surge, academic family medicine departments have an important role in expanding hospitalist services and redesigning primary care services. The ability to reconfigure work to meet unprecedented demands on health care was facilitated by family medicine's broad scope of practice including training in hospital medicine, interpersonal communication, behavioral health, care across settings, collaborative partnerships with specialists, and adaptability to communities' needs.