For one of the most violent years of the war in Iraq, U.S. Army Col. James Ficke, commanded a 298-bed combat support hospital in Mosul.
He has spent the last seven years as director of orthopaedic surgery at The Johns Hopkins Hospital. And today, as director of a newly formed field hospital near Baltimore’s Inner Harbor, Ficke is calling on much of what he learned in Iraq.
Preparations to Care for COVID-19 Patients
In the days before COVID-19 infections are expected to peak in Maryland and across the country, government and public health officials are working to prepare for a wave of patients. Part of their preparation is the establishment of a facility at the Baltimore Convention Center where patients can be transferred from area hospitals to finish their recovery from the illness caused by the new coronavirus.
To free up hospital beds and important equipment and supplies, patients who no longer require acute hospital care, but aren’t yet well enough to return home, will be moved to the convention center site.
Hiring Health Heroes
The 250-bed Baltimore Convention Center Field Hospital is managed by both Johns Hopkins Medicine and the University of Maryland Medical System. Ficke directs the facility and Chuck Callahan, vice president of population health at the University of Maryland Medical Center, serves as deputy director.
The field station will be staffed by physicians, nurses and other local health care professionals who are currently being recruited, says Ficke.
“We’re looking for general internal medicine and family medicine physicians,” he says. “This facility won’t take any providers away from the hospitals. This is for patients who still need acute care, but who have ‘turned a corner’ in their illness, so to speak. They’ll get moved from a hospital to here to finish recovery.”
The staff recruitment and hiring process has been unusual, says Sharon Smyth, senior director of emergency medicine nursing at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center. She is now serving as the deputy chief nursing officer at the field hospital.
“We’ve needed to get the facility staffed quickly,” she says. “Our leadership team is all pretty seasoned, and I think we’re all good at spotting talent. So once we have everyone in place, it will be our jobs to find the diamonds who we can put into important roles, like charge nurse.”
She adds that the medical professionals hired so far are “people who want to help out in this really unusual situation. Few of us have ever done this type of work, and these people have risen to a challenge.”
Smyth describes the collaboration between the University of Maryland and Johns Hopkins as “a bit like speed-dating — we’re getting to know a lot about one another very quickly. The group has knitted together quite closely in not much time.”
Trained Military Leaders
Like Ficke, the University of Maryland’s Callahan served in the Army. Before joining the University of Maryland, he was commander of the Fort Belvoir Community Hospital and deputy commander and chief of staff at the National Naval Medical Center and the Walter Reed National Military Medical Center.
“The members of the University of Maryland Medical System team are privileged to be working with the state of Maryland and our colleagues at Johns Hopkins Medicine to provide care at this site for the citizens of Baltimore who have been affected by COVID-19,” Callahan says. “I am personally grateful to be working with Dr. Jim Ficke, a friend I have known for many years from our time in the Army. This facility won’t take any providers away from the hospitals. This is for patients who still need acute care, but who have ‘turned a corner’ in their illness, so to speak. They’ll get moved from a hospital to here to finish recovery."
To oversee the Convention Center effort, Johns Hopkins Health System President Kevin W. Sowers tapped surgeon Jonathan Efron, senior vice president of the Office of Johns Hopkins Physicians, and Jennifer Nickoles, the Johns Hopkins Health System’s vice president for operations and system integration.
In turn, they appointed Eric Howell and Melinda Kantsiper as the chief and deputy chief medical officers for the field hospital. Howell directs Johns Hopkins Bayview’s hospital medicine division and Kantsiper is associate director of the clinical information management system at Howard County General Hospital.
Efron and Nickoles agree that Ficke fits the bill to direct the field hospital.
“When we were thinking of who should be the director, Dr. Ficke’s name came to mind immediately,” says Efron. “Having run hospitals like this in the past, he seemed like a natural fit.”
After three weeks of planning and setup, Efron says the facility is prepared to care for patients if there is a surge. He anticipates the work will be challenging.
“Obviously, all the patients will be infected with the coronavirus,” he says. “That means the staff will wear full personal protective equipment at all times. Face shields, N95 masks, gowns, gloves — I think we can safely say that it will be physically demanding.”
The beds and supplies are part of a Federal Emergency Management Agency aid package sent to Maryland in response to a request from Gov. Larry Hogan. Ficke says troops from the Maryland National Guard unloaded three semitrucks full of supplies into the Convention Center on Saturday, March 28. Setting up beds, partitions, a command center and other elements of the field station came next. Smyth says each patient bed area is a 10-foot-by-10-foot cubicle with a cot, a chair, a bedside table and small footlocker for patients to secure their valuables. “Each one has a little reading light,” she adds. “We’ll have a schedule of lights-on and lights-off, just so we can try to keep normal sleep rhythms.”
Each cubicle also has four electrical outlets that patients can use to charge mobile phones or tablets, and that physicians and nurses can use to plug in equipment, such as concentrated oxygen machines, for treatment.
Ficke says the world hasn’t seen a crisis like this one for more than 100 years.
“The influenza pandemic of 1918 was far more deadly in that it took 50 million lives,” he explains. “But this virus is the worst we have seen since that time.”
Ficke also says he’s honored to have a role in Johns Hopkins’ response to the coronavirus.
“Really, I’m amazed at the breadth of important involvement [Johns Hopkins] has had,” he says, “from tracking the spread of the virus, to developing a test, to working on vaccines and, of course, to providing first-rate care for patients.”