Dr. David Curley, an emergency medicine physician, was named medical director of the emergency department at The Miriam Hospital in September. He was promoted after serving as the emergency department’s associate director since 2018.
Curley has been in a leadership position within the department throughout the COVID-19 pandemic, playing an integral role in adjusting and updating hospital protocols in response to the health crisis.
PBN: You’ve been associate director of The Miriam’s emergency department since 2018. What new responsibilities are you taking on?
CURLEY: As director, I now have primary responsibility for patient flow through our department. My role is to ensure we provide patients with safe, high-quality emergency medical care. I spend a great deal of time working on efficiency and interacting with individuals across all departments in the hospital, including our supportive executive leadership.
In addition, I will continue to be involved with emergency preparedness. Having served as co-chair of the Emergency Preparedness Committee, I helped plan and execute readiness drills for mass casualty incidents, chemical exposures, fires, blizzards and even pandemics like the current one.
PBN: What are some of the changes to operations and protocols that you were instrumental in making in the emergency department in response to the COVID-19 pandemic?
CURLEY: Several weeks before Rhode Island had its first case of COVID, we worked with our colleagues from Infection Control, Facilities, Environmental Services, Laboratory Medicine and others to design the process by which the first COVID patients would arrive, come back to a room, be tested and receive care – all while avoiding exposures to other patients and staff. Every detail from which door would be used to the route taken back to the room was mapped out, along with where and how staff would put on their protective equipment.
As the volume of COVID patients increased, we designed specialized areas of the department to care for these patients. In these “warm units,” maximum PPE [personal protective equipment] is worn at all times. Our partners in facilities ensured the best possible airflow and Environmental Services crews have worked tirelessly to turn over and sanitize rooms. The entire operation of the department was changed to minimize transmission amongst our patients and staff.
PBN: Are you still able to see patients in your new role?
CURLEY: Absolutely! I went into emergency medicine because I love caring for people in their time of need and on what is likely one of the worst days of their lives. This is a privilege and the trust they place in us is enormous. I plan to always provide patient care regardless of where my path takes me.
PBN: How many patients typically come through the emergency department each year? Did those numbers change at all in 2020 when COVID-19 popped up in Rhode Island?
CURLEY: In 2019, we saw approximately 80,000 patients. This is truly remarkable for a hospital the size of The Miriam. As we saw the number of patients with COVID climb, the number of patients with other presentations certainly fell. This was very worrisome to us, as we grew increasingly concerned that patients with severe illness may have been putting off needed care.
Now that things have progressed, we are seeing increased volumes again as people return, many of whom are now seeking care for those issues that had been put off for many months.
PBN: Did the virus have any impact on emergency department staffing at The Miriam, and if so, have things returned to a pre-pandemic state?
CURLEY: The pandemic has been incredibly stressful and people have moved on to other opportunities or made career changes for a variety of reasons. Nurse staffing is challenging across all health care institutions right now.
Fortunately, at The Miriam, one thing that has been consistent is how incredible the group of nurses, physicians, nurse practitioners, physician assistants, techs, certified nurse assistants, secretaries and all other staff have been stepping up to help one another. Our clinical managers and assistant managers are filling in nursing assignments.
Emergency Medicine has always been a field of doing what is needed during challenging times. We will do what is needed. The best thing the public can do to help is to get vaccinated, wear masks around others and keep your distance whenever possible. With everyone’s help, we will emerge stronger than ever.
Elizabeth Graham is a PBN contributing writer.