Health system executives reflect on ‘Leading and Learning Through Crisis’

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Top of Mind Online virtual summit features leaders from Dartmouth-Hitchcock, Indiana University Health, and UPMC discussing an unprecedented year in health care

Health systems had prepared to respond to public health emergencies but there was nothing in their crisis plans to ready them for a pandemic like what the United States has experienced with COVID-19.

Leaders from three prominent health systems came together during Top of Mind Online — a virtual summit from the Center for Connected Medicine (CCM) — to discuss their trials, tribulations, and lessons learned from an unprecedented year in health care. Their panel discussion, “Leading and Learning Through Crisis,” was one of six sessions from Top of Mind Online.

“As we came into the pandemic, we knew we had these plans we created for Ebola. But the reality was, they were not helpful,” said Matt Cook, Chief Strategy Officer at Indiana University Health and President of Riley Hospital for Children at IU Health. “We had to go back and completely rethink our surge plans for the volumes we were expecting.”

Joanne M. Conroy, MD, President and CEO of Dartmouth-Hitchcock and Dartmouth-Hitchcock Health, agreed that earlier pandemic plans were not transferrable to the COVID-19 response.
But the leaders who spoke during “Leading and Learning,” which also included Mark Sevco, President of UPMC Children’s Hospital of Pittsburgh, credited the quick formation of incident command teams for leading their responses.

Focus of response shifts from PPE to staffing

Despite their success in quickly responding to the demands of COVID-19 in spring of 2020, health systems have had to remain nimble as new challenges surfaced.

Health systems have faced several different waves of challenges over the course of pandemic. Early on the response was focused on preparing for an onslaught of sick patients and making sure hospitals had enough supplies and ICU capacity. By the summer, the response involved bringing in-person services back and resuming routine medical care. And by fall, it has become a balance of keeping medical services running while keeping staff and patients safe amid resurgent infections.

“We talk about these different waves,” Sevco said. “In the spring it was very different. Wave two in the summer we were relaunching, and now it’s wave three where we’re open and ready.”

At IU Health, Cook said the early focus was on preserving personal protective equipment (PPE) and stockpiling other supplies to ensure systems were prepared for a potential rise in severely sick patients. But this fall, the focus has shifted to managing staffing as infection rates have surged across the country.

“In the spring, it was really about preserving PPE and making sure that we had an adequate stock,” Cook said. “As we’ve moved into the fall, it’s really much more about staffing and making sure we have enough staff to take care of our patients.”

Yet after months of planning, Cook said IU Health has been better prepared to handle the situation. “Now, even though our volumes are higher, and we had these issues with enormous numbers of team members being quarantined, it doesn’t feel as devastating as the spring did.”

“Now, even though our volumes are higher, and we had these issues with enormous numbers of team members being quarantined, it doesn't feel as devastating as the spring did.” - Matt Cook, IU Health

Harnessing the lessons of incident command

Dr. Conroy agreed that Dartmouth-Hitchcock has experienced a similar shift: “The first wave was all about stuff versus the second wave, which is really all about staff.”

She credited her organization’s incident command and its quick decision-making for the New Hampshire medical center’s ability to handle everything COVID-19 has thrown at them. Her biggest lesson from this fast-paced response is to carry that mindset forward to other challenges facing health care.

“I want to bottle incident command — meaning, they got a lot of stuff done fast. We set up incident commands to get around the bureaucracy when we needed to move quickly,” Dr. Conroy said. “I’m not saying that everything we do should move that quickly. But I’d like to bottle a little of that and use it in our normal operations because sometimes we do just get stuck in our bureaucracy.”

UPMC experienced a similar acceleration in operations in its response, which was no easy task considering the health system has 40 hospital and more than 90,000 employees, Sevco said. “We’ve seen that here, too, and it’s really been quite amazing,” he said.

“I love the challenge that you put to all of us, which is how can we bottle that up?” Sevco said. “How can we move quicker and be stronger and provide access quicker for patients?”

Learn more about the CCM’s Top of Mind program

The CCM’s Top of Mind program focuses on telehealth, artificial intelligence and revenue cycle management through a research report, webinar, virtual roundtables, and a virtual summit. Read about all the components of the program that seeks to examine innovation and digital health priorities in the year ahead.

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