How the fastest growing academic health center prepared for the COVID-19 surge

In greater Philadelphia, the COVID-19 surge was first felt at our suburban hospitals — not our large academic health center. 

Similar to other areas of the country, the novel coronavirus hit retirement communities especially hard, including those in north and northeast Philadelphia and southwestern New Jersey. It strained staffing as well as medical supplies and personal protective equipment for our smaller community-based acute-care hospitals. 

The incendiary progression of COVID-19 placed all of our healthcare and academic leaders into a position of facing an administrative crisis and clinical challenge that had proven nearly catastrophic in other countries. The reported morbidity and mortality rates painted a grim picture. 

It was clear early on that every one of our hospitals needed ICU capacity for a surge, access to life-saving medical equipment, PPE and supplies. 

But how does a geographically dispersed academic health system and university — still on its journey to full integration after a few short years of dramatic expansion and growth — strategically respond?

Answer: We operationalized our first ever Enterprise Incident Command Center (EICC) with one imperative — to care for our community while keeping our healthcare professionals who are critical to providing life-saving interventions to those suffering from the coronavirus as safe as possible. As we addressed the now familiar challenges of acquiring additional medical supplies, PPE and backfilling staff exposed and quarantined, we immediately recognized the value in enterprise planning and strategizing. This approach allows us to be nimble enough to strategically deploy ventilators, PPE or clinical staff to sites with the greatest need at any given moment.

In addition to enterprise-level planning for supplies, Jefferson’s EICC also leverages the collective expertise of many world-renowned leaders. Epidemiologists, with real-world experience battling Ebola and SARS, emergency medicine physicians with decades of insights from working in under-resourced environments such as Haiti, and engineers and designers thinking outside the box to address equipment supply issues have all come into play.

Hundreds of clinical leaders, experts, physicians and higher education executives are virtually connected every day and collaborate on nearly every aspect of care delivery and more. The enterprise command center structure enables us to plan globally while aligning and executing locally through site-based incident command centers. Collectively, we've built surge plans that go beyond local capability, giving every care site access to intelligence reports, predictive models, and real-time local and national updates on equipment levels, resources and funding. 

We have crafted and serially modified more than 200 guidelines, memos and videos so that thousands of front-line healthcare professionals and support staff have clarity on rapidly changing recommendations from our internal experts and the CDC. We regularly publish consumer-focused articles on our Jefferson-powered news site, The Health Nexus, to ensure the public has news they can use, and we share these stories across some quarter-million followers on our social media channels. 

As national leaders in telehealth, Jefferson has experienced its own surge on our JeffConnect telemedicine platform -- going from approximately 50 virtual visits per day to seeing an average of 2,500 visits per day through the month of March. After taking five years to hit the 100,000 telehealth-visit milestone, we expect to hit another 100,000 in this quarter alone. And we know that this is our "new normal."

Our whole is quite literally greater than the sum of our parts. Leveraging the resources and talents of Jefferson's 14-hospital health system and its university have maximized our overall response to the communities that we serve. 

As of the time of this writing, Jefferson has experienced episodic surges amidst a steady rise in case volume. But we feel as aligned and prepared as any healthcare and higher education system could possibly be due to our ability to check our egos at the door, recommit ourselves to our mission, truly embrace our values, stand up the EICC,  and work together to serve our patients and keep our employees — the real heroes of this pandemic — as safe as possible.

Bruce A. Meyer, MD, MBA, is President of Jefferson Health and Senior Vice President of Thomas Jefferson University. 

Stephanie Conners, MBA, BSN, RN, NEA-BC is Executive Vice President and Chief Operating Officer of Jefferson Health.

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