Dr. Amy Compton-Phillips found out by text Jan. 19 that a Providence hospital in Everett, Wash., was receiving a person who turned out to be the very first U.S. coronavirus patient. “We had been like everybody else, kind of monitoring from afar. But then we realized, ‘Oh, my gosh, this thing is real, and it’s coming to us,” said Compton-Phillips, chief clinical officer for the Renton, Wash.-based system during a webinar hosted by Modern Healthcare this month with more than 2,500 registrants.
In just a couple of months the situation has dramatically shifted. The virus is a full-blown pandemic that claimed Washington state as its first hot spot causing hospitals to activate their emergency plans.
While COVID-19 came quickly, years of extensive planning is helping some hospitals respond as best they can.
In Gig Harbor, Wash., CHI Franciscan was firing up the Mission Control Center it had launched last August that would very quickly prove its worth.
“It is allowing us to redeploy and refocus both our patient population and our resources to the right location. And then also to prioritize the placement of our patients as we need to appropriately,” said Mary Ragsdale, board chief for mission control and chief operating officer at St. Anthony Hospital who also was invited to present during the webinar.
As of April 2, CHI Franciscan’s intensive-care beds were at 90% capacity.
On that date, Dr. Paul Casey, chief medical officer at Rush University Medical Center, was preparing for an expected surge a week later. But the Chicago-based academic medical center was touting its preparedness in a campaign called “We were made for this.” That’s a nod to Rush’s new hospital building, opened in 2012 to be the region’s first specifically designed to handle patients during a pandemic. The building has 40 negative-pressure rooms. ED rooms and entry bays were designed to further isolate infected patients. This allowed Rush to pretty quickly enable high-volume screening, allowing throughput to grow an additional 100 patients a day.
Compton-Phillips said the key was to not let “bureaucracy and slow-moving and consensus-based management inhibit us from moving forward rapidly.”
“We’re just not going to be able to do that in this environment, and so we’re going to be incredibly innovative and move forward without fear,” Compton-Phillips said, adding that frequent communication was important for rapid-fire decisionmaking.
Facing challenges in testing enough people for the virus, Providence began gathering what data it could; the system built a syndromic surveillance tool that looked at rates of fever, cough, shortness of breath and other related symptoms being reported in the communities. Its model anticipates surges; manages flow through the system’s facilities and beds; and estimates average length of stay on ventilators and survival statistics.
All three leaned on telehealth to tend to patients who don’t have COVID-19. The industry overall has seen triple-digit increases in telehealth visits, according to several recent surveys.
Providence also built an app with a chatbot that feeds into a triage tool that tells patients they’re fine or gives them the option of speaking to a nurse or starting a video visit. Providence has increased video visits from 50 to well over 1,000 a week. Patients with manageable COVID-19 symptoms are sent home with a remote monitoring program.
CHI Franciscan considers the pandemic an opportunity to possibly reinvent itself. “We must consider not only what will the organization look like after COVID-19 but with everyone rescheduling services, how will we handle the volume of patients and resources after this, as well,” Ragsdale said.
“My prediction is that we’re going to come out of this pandemic with a very different looking healthcare system. That it’s not just simple things like telehealth, but it’s how do we ensure we have funds flowing into healthcare systems? Because the revenue stream from elective surgeries has dried up. The cash through the doors is going to be completely different,” Compton-Phillips said.