For as long as he can remember, Kerwin Barden has put the needs of others ahead of his own. That’s how he explains his decision to enlist, at 19 years old, in the New Jersey Air National Guard as a medic 24 years ago. He later went on to earn a bachelor’s degree in biology and become a registered nurse.
In December 2008, Barden joined the cardiovascular step-down unit at the Hospital of the University of Pennsylvania (HUP), which cares for patients who are able to leave critical care but still require a high level of monitoring in their recovery. There he filled a variety of roles over the next four years, including charge nurse. From there, he moved to the cardiac electrophysiology department at HUP. Then, in 2019, Barden joined the electrophysiology team at Chester County Hospital, which treats abnormal heart rhythms.
Still a member of the Air National Guard, Barden is now a captain and chief nurse for the 177th Fighter Wing in Atlantic City, NJ, where he oversees a staff of 18 medics. He’s also in charge of several health, wellness, and safety programs on the base, an immense undertaking, though Barden says his “number one responsibility” is immunizations, even well before the COVID-19 pandemic. At any given moment, every soldier stationed at the base must be prepared to deploy, and that means, in part, being up to date with their vaccinations.
Asked if his job has been made more difficult by the pandemic and the subsequent vaccine rollout, Barden says, “Yes and no. Once COVID-19 hit, I knew everyone was going to be deployed, myself included.” Sure enough, the call came the night of March 31, 2020. He was to report the next morning at 8 a.m.
Soon, Barden’s combination of clinical knowledge and deft skill at improving operations was put to the test — and he has since taken many of the lessons learned in his deployment back to his focus on excellent, efficient care at CCH.
An unprecedented scenario
Barden and the 177th were charged with helping to run a 250-bed field medical station at the Meadowlands Exposition Center, in Secaucus, N.J. The medical station was one of three that were erected in northern New Jersey last spring in response to the public health emergency declared in New Jersey.
The large empty space was transformed into a medical facility using FEMA materials packed a decade earlier. The stated goal was to “provide some immediate relief for hospitals in northern New Jersey that were at war with a deadly disease.” With COVID-19 intensive care units across the region at or beyond capacity, these three field medical stations were designed to provide “hospital care for low-acuity patients.”
But when Barden arrived onsite on April 3, it was immediately apparent that the Meadowlands medical station was a long way from caring for anyone. In the wake of hurricanes Katrina and Rita, he was deployed to fully operational field medical stations in New Orleans. In contrast, the Meadowlands was a cavernous space with rows of beds. Everything would need to be figured out, from how to transport patients to and from the bathrooms to how to follow up with their physicians should there be any questions about their care.
It was an intense and unprecedented scenario for which there was not a single operating procedure in place.
“I was selected, along with another captain and a physician in my unit, to come up with all the necessary protocols with the medical station’s chief medical and nursing officers,” Barden says. “We did that in two days. And then we spent the next two days setting up the medical station and training the staff.”
The first patients were admitted on April 7, Barden’s fifth morning at the medical station. Much of his time was devoted to the medical station’s logistics. While the New Jersey Army and Air National Guard operated the medical station together, many of the vendors and healthcare providers were civilian. And the turnover among the providers was high. Barden estimates that during his roughly two months at the medical station, there were more than 300 different healthcare providers, each of which needed to be trained in the medical station’s specific protocols.
Just as the operation finally began to find a rhythm, the medical station was moved to another building.
“We had to revise all of the policies and procedures, but at least we weren’t starting from square one,” Barden says.
Collaboration saves the day
The medical station cared for hundreds of patients during Barden’s tour. In a letter to Chester County Hospital CEO Michael Duncan, David J. Adinaro, MD, M.Eng, FACEP, and Patti Drabik, DNP, RN, NEA-BC, the chief medical and nursing officers of the Secaucus medical station, respectively, described Barden as “the link between the care in the ‘hot zone’ and our command center in the ‘cold zone.’ His maturity, dedication, and clinical knowledge were vital to our success.”
Barden defers to those he served alongside. “Our team did a great job of recognizing issues and quickly coming up with solutions,” he says. “I relayed those ideas to the CMO and CNO, and we agreed on a solution together.”
One of the most valuable lessons he left the medical station with is that there’s always room for improvement, especially during a pandemic. Constantly addressing inefficiencies translates to minimizing exposure risks to patients, he says.
When Barden transferred to Chester County Hospital in 2019, he says he was tasked with helping the electrophysiology lab become more efficient, an endeavor that he now considers a success. For example, the turnover time between cases involving anesthesia has been reduced to less than a third of what it was previously.
“That not only had a positive impact on our ability to do our jobs, but it also really helped with patient satisfaction,” says Monica Pammer, PA-C, the lead physician assistant in the electrophysiology lab at Chester County Hospital.
Since he returned to the lab at Chester County Hospital in June, Barden, with the lessons from the medical station still fresh in his mind, has been working toward streamlining the protocols for ablations, a procedure done to treat irregular heart beat conditions. He has also examined the lab’s emergency preparedness, “which he’s showed us, isn’t only about having what we need when the time comes, but also making sure that it’s organized in an intuitive manner,” Pammer says.
The electrophysiology lab was relocated over the last year to a new larger, state-of-the-art facility as part of a $300-million expansion at the hospital. Barden, was integrally involved in configuring the new layout, which made “the adjustment easier for all of us,” Pammer says.
The move brought not only a wealth of new technology, including an advanced electroanatomic mapping ablation system, but a number of new staff members to help meet the increased capacity. Leaning on the experience he gained his deployment last spring, Barden created a digital onboarding program to ensure that new hires were thoroughly briefed on procedures and expectations.
Pammer says his prowess with technology has been a tremendous asset to the electrophysiology lab. Upon his arrival in 2019, he helped implement a new online patient management system after he was involved in getting the same system up and running at HUP. He continues to handle most troubleshooting with the system for the lab, Pammer says.
What resonates with Barden most about his deployment is the power of collaboration. Pammer, who worked with Barden at HUP five years ago, says he has always been team-oriented. “He gets everyone involved, and everyone feels like they’re contributing,” she says.
Barden saw the power of collaboration in action again on the first day at the medical station’s second location last summer, when a major flaw was discovered in the design. The administrative office was located on the first floor, right next to the building’s two elevators. Bringing patients in and out and donning and doffing personal protective equipment there would risk spread.
“We came together and figured out there was an elevator that ran down to the basement. With that new access point, we were able to come up with an alternative plan pretty quickly,” Barden says. “Time and again, we hit a roadblock. But we always regrouped and found a new route.”
Barden’s military training has taught him to always prepare for the unknown. It’s how he was able to remain undaunted last spring in the face of a torrent of obstacles. And while the electrophysiology lab at Chester County Hospital may never reach the feverish pitch of a field medical station at the onset of a pandemic, Barden knows, with his daily work, there’s still enormous value in preparing and collaborating.