At Avista, effects of COVID will endure, even as CEO looks beyond pandemic
LOUISVILLE — Isaac Sendros sees a hospital and a health care industry in transition.
Sendros assumed the CEO position of Centura Health’s Avista Adventist Hospital in Louisville in November 2019, just months before COVID-19 pandemic swept across the globe, upending hospitals and their normal business practices.
Even as COVID cases spike again statewide — and as the COVID Omnicron variant emerges globally to unknown effect — Sendros sees a day when COVID will become a regular service line for hospitals in general.
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“Everyone is having to figure out, how do we manage [on an ongoing basis]?,” Sendros said in an interview with BizWest. “I think, COVID, long-term, it’s going to be just one of the things we treat, where I think for six months, it was the main thing we treated as an industry.”
Sendros said that, like cardiology and other fields, COVID will become an area of focus for hospitals.
“I think COVID would be just like that, another service line, another condition we treat,” he said.
Like other hospitals across the state, the 114-bed Avista has seen an increase in COVID cases over the past month or month and a half, with an increase in emergency-room visits, intensive-care-unit admissions and ICU days, Sendros said.
“They’re sicker patients, staying longer, which is requiring more resources in our ICU,” he said. “The same thing [is happening] in our emergency department. We’re seeing an increase in our ERs year over year, and the patients coming in are much sicker.”
The hospital also is feeling the effects of people having delayed health care, perhaps due to fear of contracting COVID, and then visiting the emergency room.
“We’re seeing more people coming in, and our admission rates are actually going up from what they were historically,” Sendros said.
But delayed patient care affects more than just the hospital, he added. Sendros recounted a recent conversation he had with a physician who has seen an uptick in patients going to his private practice after having delayed checkups, but actually needing surgery promptly because of the delay.
“It’s not just affecting the emergency rooms,” he said. “We’re actually seeing it at the physician practices as well, on what we would call the elective cases. They’re elective until they’re not.”
What comes next for telehealth
One trend to emerge from the COVID experience has been a rapid embrace of telehealth, or the ability of patients to access health care through technological means.
Telehealth usage increased 78 times in April 2020 compared with pre-pandemic levels, according to a study by McKinsey & Co. That number stabilized as the pandemic eased but was still up 38 times as of July 2021. Telehealth represented more than 32% of office and outpatient visits in April 2020 but stabilized to 13% to 17% across all specialities in July 2021, McKinsey & Co. reported.
Avista also saw that increase reflected in its patient volumes, especially during the early days of the pandemic.
“This is something that we saw across the industry,” Sendros said. “Whether it was here on the Front Range in Colorado or across the nation, we saw this pivot to telehealth. Patients still needed to be connected with their doctors, and that was the best way for them to be able to continue to do that, to see their physicians in that time where people weren’t sure whether they should be going to doctors’ offices or hospitals.”
Over the past six months to a year, Sendros said, Avista has seen a shift back to patients seeking face-to-face visits with their doctors.
He said that in the future, Avista and its 16 sister hospitals in the Centura Health system will weigh how to advance technological offerings to streamline the patient experience, whether in-person or online.
He said that being part of a hospital system means that new technology likely would be rolled out across all hospitals, not just one, although pilot projects might be launched. Learning lessons from the rapid rollout of COVID-driven telehealth will help the hospital going forward.
“I think leveraging some of the things we have learned from COVID about being nimble, being able to adapt … how we leveraged telehealth is an example,” he said. “I think there’s opportunity to also leverage telehealth across the hospital. To me, it’s how do we leverage technology to really make it easier for consumers or patients as they’re coming in?”
Worker shortages
One challenge facing Avista and other hospitals is a shortage of certain employees and specialists.
“Avista, just like anywhere else on the Front Range and across Colorado, we’re facing similar challenges,” he said. “Our team and every caregiver has been fighting on the front lines for the past 21 months. And people, whether they’re working and picking up extra shifts or not, and they’re just working their allotted times, they’re just tired. And I think part of it is work, and part of it is life in general.
“At Avista, we have talked of areas where we are seeing some, I wouldn’t say ‘gaps,’ but we’ve seen some nurses leaving certain areas or caregivers leaving certain departments,” he added. “We’re backfilling those, but we have not experienced it like I feel other hospitals have on the Front Range.”
Still, Sendros said, the hospital does have staffing shortages in “high-challenge” areas, such as the emergency room and ICU.
“All in all, we’re doing OK in that space but always could do better,” he said.
Hospital competition
Avista, which includes about 1,100 total employees, operates in an extremely competitive landscape, with SCL Health’s Good Samaritan Medical Center in Lafayette, UCHealth Broomfield Hospital and Boulder Community Health all operating nearby.
Sendros touted Avista’s achievement of an “A” safety grade from The Leapfrog Group for three years in a row, along with a five-star rating from the Centers for Medicare & Medicaid Services.
“I’m very proud of the work our teams are doing,” Sendros said.
And although Avista competes with other area hospitals, competition has increased during COVID, with at one time weekly calls with area hospitals and health-department officials.
“At this point, I would call us ‘competimates,’ where we’re competing, but at the same time, putting people first is the priority,” he said.
Sendros also is looking into the future at an aging of the population, and what effect that will have on Avista, its patients and what services are offered. An older population will necessitate increased emphasis on certain lines of care, he said.
“When the population ages, it’s going to enhance some services we have today,” he said. “I think cardiology care is going to continue to grow. Orthopedics will continue to grow … probably mostly from an outpatient setting. Oncology and, unfortunately, cancer care, we’re going to see those numbers continue to grow.”
125-year history
Although Avista itself dates back to 1990, “We’ve been in Boulder County for 125 years,” Sendros noted, with the hospital starting as the Boulder Sanitarium in 1895 and changing its name to Boulder Memorial Hospital in 1962. That name changed again in 1990, when the hospital reopened in Louisville as Avista.
“Back then [in 1895] the main mission was whole-person care, ‘mind, body and spirit,’” he said. “125 years later, we are still continuing that same legacy in Louisville…… We feel we are poised for growth. I think we’ve got a really good basis. The quality care that our teams are doing and some of the awards and recognitions we’ve received, I feel position us nicely for growth in the future to continue to meet the needs of our community.”
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