Health care leaders reflect on innovating during, post COVID-19 crisis

October 29, 2021

Vaccines

Four health care leaders participated in "Healthcare Systems: Transforming and Thriving," a panel focused on evolving the clinical experience during the COVID-19 pandemic and beyond.

The presentation was part of The Denise J. Fiore ’78 ’91 Thought Leaders in Healthcare Speaker Series. Quinnipiac President Judy Olian introduced the topic at hand: How health care systems utilized and innovated protocols, procedures and processes to better serve patients during a period of contagion and death unprecedented in contemporary history.

“When trying to process the trauma and stresses of past year, it’s difficult think about it on global scale: The loss of more than 4 million lives. There has been an unfathomable amount of pain, and no one knows that better than the leaders of our health care system who served during this time,” said Olian.

Though silver linings of the pandemic aren’t immediately evident, Olian cited the way individuals came together to take care of those who couldn’t take care of themselves as a reminder of humanity and our global community. She also noted the rise of therapeutic development, which has been “nothing short of historic.”

President and Chief Operating Officer of The Mount Sinai Hospital and President of Mount Sinai Queens Dr. David Reich spoke about how his organization handled the pandemic.

“As New Yorkers like to say, we were the epicenter of the epicenter,” said Reich. He recalled the massive wave of patients Mount Sinai experienced and the outdoor tents used to house the overflow.

Before COVID-19, Mount Sinai began to invest in data collection and artificial intelligence machine learning.

Information input by doctors, nurses and other staff is processed through algorithms which in turn predict a wide variety of circumstances, said Reich. This includes discharge planning, respiratory insights, ventilator weaning and avoidable admissions.

Predictive technology became particularly useful during COVID-19, said Reich.

As more data from COVID patients was collected, providers referenced predictions for the number of available dialysis machines, ICU inclusion, and discharge scheduling, among other situations.

Mount Sinai staff also participated in data learning, as wearables such as the Apple Watch harvested information as they worked. The resulting analysis could predict the onset of COVID in workers, said Reich.

Overall, the integration of data learning and prediction into Mount Sinai’s culture has been a significant win. Clinicians are generally pleased with the technology, said Reich, and Mount Sinai’s research work inspired new philanthropic partnerships with companies such as Microsoft, Google and Goldman Sachs.

The next speaker was Kimberly Lumia, senior vice president and chief operating officer for the East Coast with Prospect Medical Holdings. Lumia reflected on the detrimental effect COVID-19 had on the medical staffing industry, as nurses and doctors quit, retired and relocated in droves.

A void of contract nurses is coupled with the increase of gig workers placed by tech companies, such as Nomad Health. This encourages a cycle of turnover within hospitals, and patients are suffering, said Lumia.

“We need to pay attention to recruitment, engagement and retention. We need to work on strategic partnerships and developing mechanisms that empower our nurses to stay. This also applies to those holding top leadership positions, as well as clinical and non-clinical workers,” said Lumia.

Geisinger Health System President and Chief Executive Officer Dr. Jaewon Ryu spoke about bringing better care to patients outside the hospital to treat individuals in their homes, schools and communities. When paired with telehealth options, the idea of mobile health care becomes more inclusive and effective, he said.

Holistically treating patients through preemptive care is another focus at Geisinger.

The Fresh Food Farmacy program provides free, healthy food and cooking guidance for diabetic patients. The results are clear: Hospital visits went down by 74 percent for Farmacy participants, as primary and preventive care visits increased, said Ryu.

Geisinger’s home care program also grew during the pandemic and continues to develop post-crisis. Visiting clinicians can administer nebulizers and other treatments in patients’ homes. This means that patients can often be discharged sooner as teams are able to sustain a high degree of care outside the hospital campus, said Ryu. It also equates to less exposure to disease for those with compromised immune systems.

CEO of Yale New Haven Health Marna Borgstrom closed the panel with a particularly poignant narrative. She reflected on the importance of agility during times of crisis and how independent hospital systems came together to share beds, supplies and insight through COVID-19.

Indelible lessons from COVID-19 will guide Yale leadership into the future, said Borgstrom.

Protecting health workers’ safety continues to be equally as important as protecting patients, and honest communication is intrinsic to this goal. “When we talked, we said what we knew as a fact, and what we didn’t know as fact. People wanted honest information and reassurance when possible. We based our system-wide communication on truth,” she said.

Looking forward, Borgstrom cites open communication as the foundation for operational innovation at Yale, and within the greater medical field.

“The best innovation is when we can take things off our plate because they aren’t helpful. It’s about encouraging staff to think openly and creatively,” said Borgstrom. “Stars don’t get work done in organizations; groups do.”

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