Recent polls show the majority of Americans support social distancing measures to contain the spread of COVID-19. But if and when people begin to grow less committed to living in isolation, hospital leaders around the country have a message to share with them.
Six hospital and health system leaders shared how they would persuade people to stick with social distancing, how social distancing has impacted their organizations, and how they are preparing for a second surge should the relaxation of social isolation measures result in greater transmission of COVID-19.
All respondents shared their insights with Becker's via email from April 20-22. Responses were lightly edited for clarity and length. They are presented alphabetically.
The need for peer-to-peer learning among healthcare leaders has never been greater. To participate in future crowdsourced articles or provide feedback, please contact Molly Gamble (mgamble@beckershealthcare.com).
How would you persuade someone who is growing less committed to social distancing to stick with it?
Brent Burkey, MD, MBA, President and CEO, Fisher Titus Medical Center (Norwalk, Ohio)
First, to those practicing physical distancing – thank you! While it may feel like a challenge at times, it has made a great difference, especially in Ohio, where appropriate and decisive action has significantly impacted initial surge predictions in a positive way. Second, to those who may find it harder to commit to physical distancing in the longer term, as healthcare workers, we urge you to reconsider. As history has shown, we are concerned with what can happen if appropriate physical distancing isn’t followed in a time like this. Education on public health and the science behind physical distancing by credible sources, like the CDC and your state and local health departments, is a great place to start for fact-based information.
John Carrigg, President and CEO, United Health Services (King of Prussia, Pa.)
Social distancing forces isolation and flies in the face of how freedom is defined for many of us. Culturally, we are not used to being told how we can and cannot gather. Without knowing who may be immune, how long someone may be immune or how asymptomatic people may spread this disease, we are vulnerable. As individuals we have tremendous power to influence the way this pandemic story will be told for generations. The freedom we exercise to social distance or not will determine its ending.
Harold Courtois, CEO, Memorial Hospital (Abilene, Kan.)
If you will be patient and continue to commit to social distancing, we can change the number of people exposed to the coronavirus and the sooner we can get back to work. Social distancing was established to limit exposure to the virus, not overwhelm our medical facilities with positive patients, and give us time to get vaccines in trials and eventually develop a vaccine. The economy depends on each of us to be diligent and practice good distancing techniques so we can all get back to normal.
Jonathan Gottlieb, Executive Vice President and Chief Medical Executive, Indiana University Health (Indianapolis)
A professor of mine once said that every double-blind, placebo controlled, prospective randomized trial must be confirmed with personal anecdotal experience. If the devastating statistics about COVID-19 deaths and misery are not enough to maintain commitment to social distancing, I would appeal to that person’s values — their sense of regret and guilt should their most loved one succumb to the illness because of their lack of commitment. At the same time, I would emphasize that as difficult and painful as social distancing is, it will not last a lifetime, and our journey out of it will be much less painful if we maintain social distancing.
Alison Page, CEO, Western Wisconsin Health (Baldwin, Wis.)
Provide the facts. Have them watch the video showing how the virus disperses in the air. Everyone should mask and keep their distance. Read the National Institute of Health research on how long the virus lives in the air and on surfaces.
Jim Tavary, President, CEO and Member of Board of Directors, Wickenburg (Ariz.) Community Hospital
The community in Arizona our hospital is located in has, thankfully, reported no COVID-positive cases. Reinforcing the net effect of social distancing is the most effective means of encouragement.
Do you have firsthand accounts of how social distancing practices have impacted your health system?
Brent Burkey, MD, MBA, President and CEO, Fisher Titus Medical Center (Norwalk, Ohio)
Distancing has impacted the way we treat our patients, and the way we conduct operations internally. In our rural setting, our providers and patients have relationships that span decades and generations. Providers and patients alike enjoy seeing one another and catching up during appointments. From a treatment standpoint, shifting from a very personal, hands on appointment to one via telehealth has required community education to understand how this type of care can work for their needs, and still provide safe, high-quality care. We offer scheduled virtual visits, on-demand visits, and drive-thru screenings with our providers. From an operational standpoint, a contingent of staff are working from home, meeting rooms have been reconfigured to ensure safe distances, and all meetings are scheduled with remote video capability to ensure efficiencies and engagement are maintained during physical staff distancing.
John Carrigg, President and CEO, United Health Services (King of Prussia, Pa.)
Instituting our visitor restrictions has been one of the most challenging responses that we have had to make for the sake of patient and staff safety. Our nurses’ hearts break right along with their patients’. They see their patients emotionally suffering because their loved ones can’t be with them in-person as they fight through some of the hardest days of their lives. We are getting creative with the use of virtual tools, but the emotional toll on staff and patients cannot be overstated.
Harold Courtois, CEO, Memorial Hospital (Abilene, Kan.)
Memorial Health System has experienced an increasing number of patients for routine monitoring in our clinic, admissions for other health issues, and specialty clinics continuing to serve patients who would be worse off if we waited. At first we saw huge decreases of 50% or more but as time has provided the ability for social distancing to work we have begun to see more patients and physicians willing to either come in or as a physician, to ask a patient to seek treatment.
Jonathan Gottlieb, Executive Vice President and Chief Medical Executive, Indiana University Health (Indianapolis)
In-person meetings have all but vanished, and as a result there has been rapid and widespread acquisition of competence in virtual communication. Our telehealth capabilities have also advanced at a rate that would have been unthinkable prior to COVID-19. And we are re-examining our operating model in light of our success at standing up and maintaining a virtual incident command for our system.
Alison Page, CEO, Western Wisconsin Health (Baldwin, Wis.)
Yes – we have lightened the load in our facility. Only staff who need to be here are on site. People are working effectively from home.
Jim Tavary, President, CEO and Member of Board of Directors, Wickenburg (Ariz.) Community Hospital
Because our community has been incredibly responsive to social distancing guidelines, our CAH hospital has been motivated to support constituents by introducing a new telehealth program. Now, community residents have the option of remaining in their homes for annual wellness visits and routine office visits. The contact center that reaches out to our patient population, reports that – when telehealth clinic appointments are offered – over 50% of patients are scheduled. The community/hospital partnership that has developed is one that encourages stay-at-home compliance and the continuation of vital health care services.
Have you made tactical or operational adjustments to prepare for more COVID-19 cases if social distancing guidelines are lifted or resisted?
Brent Burkey, MD, MBA, President and CEO, Fisher Titus Medical Center (Norwalk, Ohio)
Yes, adjustments have been made in capacity, staffing, testing and PPE to address a potential surge anticipated with more lax distancing guidelines. From a patient care standpoint, a plan is in place to be able to double our medical/surgical capacity and triple our ICU capacity. This was accomplished by focused staff cross-training to be able to staff up in these areas, and identification of areas within our Medical Center that can be used for patient care. We have an overflow tent with patient care stations as well should it be needed. To ensure testing can be done quickly, we also invested in onsite COVID-19 testing capabilities. Regarding PPE, in addition to usual measures to secure adequate supply, we received over 1,000 3D printed face shields from local schools and businesses and are sterilizing in-house N95 masks.
John Carrigg, President and CEO, United Health Services (King of Prussia, Pa.)
Early on in our pandemic response, we were able to quickly ramp up our telehealth capability by training over 340 of our providers in our telehealth platform. We already had a strong infrastructure built but it was slow to catch on with our patients. Our providers enthusiastically accepted this change and our patients’ use of telehealth has grown exponentially over the last month. Our patients and providers are finding that they can have a meaningful experience through this platform. As we emerge from this pandemic, telehealth capability will be a critical element to effectively keeping our patients and staff safe in the event of more COVID-19 cases.
Harold Courtois, CEO, Memorial Hospital (Abilene, Kan.)
No, we have not changed our tactical approach to more COVID-19 cases. We planned for maximum cases initially.
Jonathan Gottlieb, Executive Vice President and Chief Medical Executive, Indiana University Health (Indianapolis)
Yes, and here are highlights:
- Redesigning a pre-admission testing center to incorporate COVID-19 testing.
- Maintaining a larger reserve of supplies (PPE, ventilators, space, personnel) to accommodate potential surges.
- Creating separate management lanes for COVID-19 positive and COVID-19 negative patients in our facilities.
- Implementing a revised priority system for elective surgery that incorporates IU Health’s capacity to serve the greater community in the presence of COVID-19.
Alison Page, CEO, Western Wisconsin Health (Baldwin, Wis.)
Yes – we are ready. More cases will erupt.
Jim Tavary, President, CEO and Member of Board of Directors, Wickenburg (Ariz.) Community Hospital
Yes. We have a system-wide COVID-19 Surge Plan in place. While we have plans in place to manage a surge, it’s clear that social distancing and compliance with infection control measures among community residents will help mitigate the size and/or the severity of a surge event.