COVID-19  June 15, 2020

Hospitals say they’ll be ready for next wave

The region is in the process of returning to normal — or whatever the new normal will be — as the deadly COVID-19 pandemic appears to be waning thanks to a virtual shutdown of public gatherings.
But with nearly 1,400 coronavirus-related deaths statewide and more than 100,000 across the nation, the question looms: What if there’s a spike in cases this fall?
Health-care executives in the Boulder Valley and Northern Colorado believe they’re ready to face it, thanks to the lessons they’ve le arned this spring — some challenging but many surprising and gratifying. Most wondrous, agreed the hospital leaders who spoke May 13 at a BizWest “Front Lines” webinar, was the cooperation between otherwise fierce competitors.
“We’ve been on the phone with each other daily. This has really brought us all together,” said Dr. Robert Vissers, president and chief executive of Boulder Community Health. “You’re going to see a global health system that is better for it.
“I know there are a lot of people concerned about secondary surges,” he said, but added that “we all believe that our monitoring is in place to see it coming a lot more quickly. We have the ability now to increase our capacity dramatically. So we’re in a much better place than we were a couple of months ago, from equipment to capacity preparedness and to meet any future surge.
“At the end of it, we’ll look back, despite the devastation, and see this as a success story.”
“The collaboration between the hospitals, the cities and counties, and the communication has been great to see,” added Kevin Unger, president and chief executive of UCHealth in Northern Colorado.
Dr. Andrew French, chief medical officer for Centura Health, offered examples: To meet the demand for personal protective equipment, Centura began producing its own gowns, and ended up making so many of them that it was able to supply them to other health-care systems. Team members also built their own equipment for mask reprocessing and sterilization using ultraviolet light.
At SCL Health’s Good Samaritan Medical Center in Lafayette, president Jennifer Alderfer said staffers have sewed together more than 9,000 face masks using sterile wraps, have built their own face shields, and have converted traditional anesthesia machines to use as ventilators.
Margo Karsten, western division president for Banner Health, said her teams had developed cost-efficient employee screening processes that Banner can offer to universities and larger employers. “Reach out to any of us,” she said. “We want to be a safe community.”
Social-distancing requirements also fueled technological advances, the executives agreed, especially the use of “telehealth” and other forms of virtual connection between doctors, patients and families. French cited the case of a husband and wife who both were hospitalized for COVID-19 infection. They had to be housed in separate rooms, but could communicate with each other using iPads normally used for telehealth visits.
“Emotionally, socially and mentally,” French said, “there’s been some bright spots that will be helpful as we determine what the new normal is.”
Increasing the number of virtual visits has helped hospitals alleviate the strain of crowding in emergency rooms and intensive-care units — and, French noted, a side benefit has been less need for doctors and nurses to change their personal protective gear between visits.
“We were able to double and triple our capacity in intensive care,” Unger said. Before the onset of the pandemic, he added, UCHealth hospitals and clinics in the region recorded 110 to 120 virtual visits a week — but now it averages 4,000 virtual visits a day.
Alderfer said Good Sam held 70 telehealth visits in February but 6,500 in March. Instead of sit-down staff meetings, she added, they’re now done virtually using Google Hangouts.
“Within UCHealth, we’re doing things in weeks or days that used to take months and weeks,” Unger said. “So everything has been very speeded up. I’m pleasantly surprised at the pace at which health systems can adapt and make things happen.”
He also hailed the cooperation and generous aid his facilities have gotten from their surrounding communities.
“Businesses that I know are suffering have gone above and beyond to support our health system,” he said. “Restaurants that I know are challenged just to make ends meet have been feeding our staff, which I know is much appreciated.”
And internally, he added, “I have never heard during this pandemic anybody say ‘That’s not my job.’ Everybody has stepped up in incredible ways.”
Dealing with the pandemic also has led to some worrisome issues, the executives agreed, especially the fact that many non-COVID patients seem reluctant to come to the hospital for normal or acute care for fear of contracting the virus. “We’re all starting to see the consequences of delayed care,” Vissers said.
“ER volumes are down, and we’re concerned about that,” Karsten said. “People are delaying their care.”
She said Banner Health has assembled on its website a list of precautionary steps it’s taking at its facilities, adding that “If you come in, you’re going to be safe.”
Unger also noted an uptick in length of stay for patients admitted to the hospital. “COVID patients are more challenging to take care of and they are in the hospital quite a bit longer,” he said. “It’s very resource intensive.”
Vissers also acknowledged the financial hit health-care facilities and their staffs have taken.
COVID has “highlighted some of the failures in our reimbursement model,” he said. “Every one of us is going to have a really, really hard year economically. It’s hard to think of a year where we’ve really stepped up to serve the community in a more meaningful way, but if this isn’t a call for action and change, I don’t know what is.”
What worries Karsten most about the possibility of a surge in COVID-19 cases this fall, she said, is that “we don’t know when they’re going to happen. And what I’m curious about is a combination of flu and COVID and what that would look like for our community.”
So before autumn, she said, “the best thing we can do as health partners is to educate the community. Let’s get you super healthy this summer. Walk. Run. We don’t want to see you tucked in our beds. And I think if we can do a full-court press on health providers, it’ll help.”
The biggest key to preparation, Vissers said, is to remember “all that work and preparation that we did beforehand, we all anticipate it doesn’t go away and it will pay off.”
Part of that success came from the spirit of cooperation among the region’s health-care entities, Karsten said.
“We’re going to have to keep these partnerships together,” she said. “Our job, collectively, is to keep the community healthy and keep us safe. We can only do that working together, not competing around COVID — and then we can face the fall together in that manner.”

The region is in the process of returning to normal — or whatever the new normal will be — as the deadly COVID-19 pandemic appears to be waning thanks to a virtual shutdown of public gatherings.
But with nearly 1,400 coronavirus-related deaths statewide and more than 100,000 across the nation, the question looms: What if there’s a spike in cases this fall?
Health-care executives in the Boulder Valley and Northern Colorado believe they’re ready to face it, thanks to the lessons they’ve le arned this spring — some challenging but many surprising and gratifying. Most wondrous, agreed the hospital leaders…

Dallas Heltzell
With BizWest since 2012 and in Colorado since 1979, Dallas worked at the Longmont Times-Call, Colorado Springs Gazette, Denver Post and Public News Service. A Missouri native and Mizzou School of Journalism grad, Dallas started as a sports writer and outdoor columnist at the St. Charles (Mo.) Banner-News, then went to the St. Louis Post-Dispatch before fleeing the heat and humidity for the Rockies. He especially loves covering our mountain communities.
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