A year of dealing with the deadliest pandemic to hit the United States in a century has tested and toughened Region hospitals, health care systems, clinics, and medical professionals. COVID-19 has prepared them to deal with the worst in the future, led them to innovate and caused them to rethink how they provide care.
"As an industry, during the COVID-19 pandemic we have gained critical expertise in how to innovate to meet a crisis," Methodist Hospitals President and CEO Matt Doyle said. "But maybe most important has been the insight that, when we come together as a community to do what is necessary to keep each other safe, we see the results."
Coronavirus infections and deaths have been trending downward because of a team effort that included new treatments, better tests, effective vaccines and people following recommended precautions, Doyle said. Methodist Northlake Hospital in Gary and Southlake Hospital in Merrillville were forced to adjust the way they did business during COVID-19, Doyle said. Some of the adjustments, like more telehealth appointments, may prove to have staying power.
"At Methodist Hospitals we converted rooms to expand our ability to care for COVID patients, and opened outpatient monoclonal antibody clinics, drive-thru testing facilities and vaccine clinics. We introduced telemedicine to better serve our patients and established new cleaning and safety protocols," he said.
"Many of these innovations will have impact beyond the duration of the pandemic. We have learned that the need for innovation and change are constant, that our commitment to our patients can never waver, and that when we persevere we can meet the greatest challenges."
Patrick Maloney, president and CEO of Franciscan Health in Dyer, Hammond and Munster, said the public health crisis that killed 2.5 million people worldwide tested the health care system.
"I feel the biggest lesson is how important a secure and dependable supply chain is to our organization," Maloney said. "Whether it is personal protective equipment or pharmaceutical distribution, we need to ensure that our supply lines will be available when we need them the most. When the supplies are not available, it puts an immense amount of stress on our front-line workers."
The pandemic showed how essential it was to protect the health and safety of front-line workers, Maloney said.
"When a pandemic hits, we need to be able to ensure that we have the ability to protect our staff and make them feel safe working in our industry," he said.
The COVID-19 pandemic that infected more than 112 million people worldwide also forced health care providers to get creative.
"'Necessity is the mother of invention' could not be any truer in today's world of limited resources and high-stakes care delivery where we need to treat our patients and protect our staff from the pandemic threat. Franciscan flexed its innovative muscle in the communities we serve," said Dr. Daniel McCormick, president and CEO of Franciscan Health Crown Point.
"We saw the creation of temporary patient care areas, negative pressure rooms, 3D-printed goggles, face shields made in our onsite shop, new uses for technology to keep families in touch with their loved ones, remote patient monitoring and new workflows that allowed us to continue our mission while protecting our employees and community."
Moving Forward
The pandemic could cause healthcare providers to rethink how they utilize space in the future."Structurally, we have learned that flexible space planning is necessary when it comes to healthcare facilities and consolidation of space is helpful in efficiently staffing facilities to maximize safety," McCormick said.
COVID-19 resulted in high-tech innovations in health care that likely will be expanded to other applications, such as remote patient monitoring that allowed health care providers to keep tabs on patients who had been hospitalized for coronavirus.
"Most importantly, we saw the absolute power of everyone coming together and helping endure very difficult times. Our employees have shown phenomenal perseverance and rigor despite having the stress of the pandemic at home as well," McCormick said.
"So, I think the most lasting effect of this pandemic is that it has rightly brought a sense of pride, confidence and strength to all of us who have sustained the high quality of care during this time. Performing at this level will help us as we move into the future, understanding that we have the power to endure and the creativity to bring the best to Northwest Indiana health care."
After the success of remote patient monitoring at slowing the spread of COVID-19 while administering vital health care services, Franciscan Health Michigan City is exploring a hospital-at-home model of care, president and CEO Dean Mazzoni said. Home monitoring could keep patients out of the hospital while still being monitored by clinicians in some circumstances in the future.
"From our viewpoint in Indiana, this pandemic was a lot like watching a tsunami approach the shores," Mazzoni said. "I have colleagues in the Northeast who were relaying their experiences with COVID while we were still relatively untouched by the virus, and their stories were very concerning. However, it gave us time to prepare and to learn from their experiences.
"We quickly implemented several initiatives to meet the increasing demands of the pandemic. For example, we stood up drive-thru testing sites, dramatically increased our use of physician telemedicine visits both at the offices and in the hospital, began offering cutting-edge monoclonal antibody therapies in our infusion centers, and implemented vaccination clinics as soon as the vaccines were released in early December. In Michigan City, we recently started a phase II trial for a novel treatment for COVID-19, one of only three sites in the United States."
The pandemic proved to be a major strain on the health care system, both in Northwest Indiana and around the nation. Even as hospitalizations surged, healthcare systems suffered because of prohibitions on elective procedures and patients who became more reluctant to seek care while largely staying home.
The coronavirus show why it may be necessary to rethink some big-picture structural issues, Mazzoni said.
"COVID has forced all of us, as an industry, to be more innovative and more adaptive. Our business model is still based on volume rather than value — for the patient. COVID exposed the serious shortcomings with that model," Mazzoni said. "The industry needs to move away from treatment and more toward wellness — with a greater emphasis on keeping people healthy rather than simply treating them when they get sick. COVID has also forced us to give greater consideration to public health funding. Very early on, we all realized we simply did not have the infrastructure in place to conduct effective testing and tracking for a pandemic."
COVID-19 has shown health care systems they can never be too prepared for a crisis, said Alan Kumar, chief medical officer of Community Healthcare System.
"This crisis has lasted a full year now," he said. "How we handle a long-lived crisis is different than a short-term stressor."
Community Healthcare System's crisis plans worked as designed, but Kumar said there's always room for improvement.
"We had to increase our focus on supply chain, especially as it applies to personal protective equipment and diversify our vendor network to adapt for all levels of support," Kumar said. "We also had to be resolute in support for our staff, especially during the pandemic. This pandemic increased the staff level of stress exponentially, and the support they needed from the system was key toward keeping turnover low, morale high and patient care at exceptional levels."
Making Way for Changes
The pandemic likely will result in some changes even after it fades away, such as diversified supply chains and more PPE being kept in storage."Telehealth has become commonplace and accepted among patients. In addition, telehealth has increased the flexibility for patients and staff as noted by decreased cancellations during the heavy snows this winter because of the ability to switch to telemedicine appointments. Telehealth is here to stay," Kumar said. "Surgical schedule planning now includes new layers for enhanced cleaning between cases, COVID testing prior to each procedure, and a combination of process-driven planning and algorithms were used to maximize efficiency and safety."
The health care system likely will emerge much stronger after ramping up elective procedures safely after a two-month hiatus, taking an "all hands on deck" approach to patient care, and establishing clinics to effectively administer 1,000 vaccines a day, Kumar said.
"Communication between health care systems has improved significantly, sharing best practices during the depths of the crisis. The Indiana Department of Health also has been very helpful, especially with vaccine rollout in coordinating care and patient outreach," Kumar said. "Our understanding of viruses (not just COVID) and how to combat them will be light-years ahead of where we were at the beginning of 2020 with current efforts being put into research."
Ashley Dickinson, CEO of Northwest Health-LaPorte and Northwest Health-Starke, said the pandemic has shown the importance of adaptation.
"Our entire team, including physicians, showed a remarkable ability to respond quickly and adapt effectively as we made changes to processes and facilities in efforts to slow the spread of the virus," she said. "Their ability to adapt to change allowed us to keep our staff and patients safe. For example, some staff members were quickly deployed as screeners inside the entrances of all locations; engineers installed transparent shields to protect registration staff, and they also rapidly converted hospital wings to larger isolation areas; the nursing teams implemented drive-thru COVID testing; and physicians adapted to the use of telehealth for some patient visits."
Seeing the Positive
The stresses of the past year also demonstrated the power of gratitude, Dickinson said."We also learned the profound impact of gratitude. Within our organization, we see the incredible compassion, skill and dedication of our team members every day. The pandemic allowed our entire community to see how special they are," she said. "The community's generous outpouring of gratitude from thank you notes, to special treats, to first responder parades lifted the spirits throughout our organization. We continue to be in awe of our amazing caregivers and appreciate their valiant efforts. The community's gratitude is much appreciated."
COVID-19 also has resulted in even more stringent sanitization measures at local health care facilities, both to stop the spread of disease and ensure that patients feel safe.
"As I think about takeaways, I'd add that we discovered that too many people were, and still are, delaying care because they are afraid of exposure to the virus, and we know that delaying care may put lives, health and well-being at risk," she said. "At Northwest Health, our facilities continue to take extraordinary measures to keep all parts of our facilities safe and sanitized for patients and staff. We are always ready to care for all patients — those experiencing emergencies as well as those needing routine wellness care — and we are keeping them safe from the virus while in our hospitals, outpatient centers, and doctors' offices.
"Communication is key in relaying this important message, and we are continuing to remind community members not to put off necessary medical care."
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