73 hospital leaders in 10 states hit hardest by COVID-19 offer advice to colleagues: If you do nothing else, at least do this 

Seventy-three hospital and health system leaders with organizations in the 10 states hardest hit by COVID-19 shared the most critical actions for their colleagues across the U.S. to take in the next week as the virus continues its geographic spread.

This compilation features guidance from leaders at organizations headquartered in New York, New Jersey, Massachusetts, Michigan, California, Pennsylvania, Illinois, Louisiana, Florida and Texas. Becker's asked them to complete the following statement: To my colleagues in hospital leadership: If you do nothing else in the next week, at least do this.

All respondents shared their insights with Becker's via email from April 13-16. Responses were lightly edited for clarity and length. They are organized by theme: 

  • Leadership, Communication and Strategy
  • Staffing and Surge Planning
  • Employee Wellbeing, Support and Health
  • Managing Resources (Beds, PPE, Equipment, Supplies)
  • Testing 
  • Collaboration with Healthcare, Community, Government Partners 
  • Technology

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). 

 

Leadership, Communication and Strategy

Michael Antoniades, Executive Vice President and COO, Maimonides Medical Center (New York City) 

Hold virtual town hall meetings with all staff at least weekly. You cannot communicate enough. Be open and transparent with your team.

Dawn Anuszkiewicz, COO, Reading (Pa.) Hospital

Implement a daily all-staff and medical staff communication vehicle. Everyone is struggling to stay connected and having a daily tether to the hospital is important. In the event you have a quiet day when nothing has changed, you can always share a story of support from your community.

Barry Arbuckle, President and CEO, MemorialCare Health System (Long Beach, Calif.)

Adopt principles to guide all decisions. Ours at MemorialCare start with safety first – for staff, physicians and patients. This has shaped our system-wide COVID-19 Response Team efforts since early March, not only for surge planning and all the key components, but also our recovery planning efforts as we look to the future. And, communicate continually with every constituent group.

Robert J. Corona, DO, MBA, FCAP, FASCP, Chief Executive Officer, SUNY Upstate Medical University and Community Hospitals (Syracuse, N.Y.)

Anticipate the unexpected. You are operating in an uncertain environment, and the cavalry is not coming. Reach out to collaborate with organizations promising to help you, but ultimately you're on your own. Low expectations will lead to less disappointment. You'll be disappointed by some you thought were good leaders and pleasantly surprised by others. A crisis reveals the essence of people's leadership skills and their true nature. At the same time, there are people on the bench waiting to get into the game. You will be surprised by the talent you have right under your nose. Delegate urgent issues to your team so you can focus on the critical. Keep vigilant to threats. You can't take the typical time to make decisions. As a neuropathologist, I compare it to making a frozen section diagnosis. Time is critical, and you have to make the call with the data you have. Also, start planning now for a rolling recovery and coming out of this crisis as a more resilient organization. Coming out of this crisis only to be the same organization you were before is a lost opportunity.

Myra Davis, Chief information and Innovation Officer, Texas Children’s Hospital (Houston)

Support your organization in any way you can. Stay positive, calm and anticipate opportunities to provide timely solutions to meet the organization’s needs (whether they know what they need or not). Stay close to your team. Be available and supportive – we’re all in this together.

Marie Duffy, DNP, MSN, RN, Chief Hospital Executive, CarePoint Health - Christ Hospital (Jersey City, N.J.)

It is said that the true test of leadership is how you function in a time of crisis. Your teams look to you on how you will respond. As a leader, times like these require leading, listening and a lot of consistent, accurate, constant and transparent communications with your employees at all levels. It is critical to provide support, tools and resources needed by your teams. You need to be there with your team in the trenches to provide encouragement and hope to all that you will get through this crisis together and much stronger.

Kerry Eaton, COO, Northern Dutchess Hospital (Rhinebeck, N.Y.)

We effectively managed the onset of the pandemic with an emergency preparedness mindset. Now we must adapt again and begin active planning for the "long-haul." While we are optimistic that our peak is approaching soon and we will begin to ride a downward curve in terms of volume, we should expect a standard inpatient volume of COVID-19 positive patients for many months. The end is not in sight. Now is the time to design long-term operational processes for delivering the required care over a sustained period of time across our system. 

Sandra Fenwick, CEO, Boston Children's Hospital

The challenge of containing the disease and the attention to personal protective equipment is as high here as it is across the street at our adult hospital campus neighbors. As we navigate these turbulent waters, I share these learnings: Look out for one another — these times are unlike anything we have experienced. Go the extra mile to reach out. Listen to your colleagues and the experts. Be a leader, but also be a "first follower." Communicate often, be transparent and deliver a consistent message from leadership. From daily updates and meetings to weekly virtual town halls, keep employees updated and answer their questions. At Boston Children's, our emergency management team and hospital incident command processes are key, as that is our daily north star to the entire organization. Take time for yourself — go for a walk, eat, check in with your family, friends and neighbors. Be flexible to change — things will get better, but they will be different. Say thank you … often. It is hospital leaders' job to support their work and share our gratitude to all those who selflessly and tirelessly sustain our mission in this challenging time.

Delvecchio Finley, CEO, Alameda Health System (Oakland, Calif.)

Revisit your mission statement, and incorporate it into your planning, conversations with your teams and decisions. COVID-19 is a perfect storm with enough force to wildly propel us thrashing in all directions at once. Now is the time to anchor your organization with the foundation of your core principles. In a crisis, knowing your organization at the start can serve as a guidepost to the other side. Reinforcing your mission, vision and values can provide the singular point of stability during a maelstrom of uncertainty, fear and crisis.

Laura Forese, MD, Executive Vice President and COO, NewYork-Presbyterian 

There is no such thing as overcommunicating. Communicate to your team members at all levels. Every person needs to know what is happening in your organization, how you are thinking about the evolving strategy and that you care about the team.

Derrick Frazier, CEO, Morehouse General Hospital (Bastrop, La.)

If you do nothing else in the next week, at least do this: Be prepared to make swift changes. Be adaptable to change because decisions are being changed or modified by the hour. Be an advocate for your staff and ensure they are able to financially and mentally survive this chaos. Communicate, communicate, communicate.

Barbara Griffith, MD, CEO, Woman’s Hospital (Baton Rouge, La.)

Stop and ask yourself, "What’s next?" It's been as important as ever, if not more important, to keep one's eyes on the horizon and avoid full immersion in operational crises. My role is needed to contemplate the next barrier or unexpected event. There has been a "next" challenge every week since this started, and it isn't going to end soon.

Stephanie Hall, CMO, Keck Hospital of USC (Glendale, Calif.)

Communication among your leadership team and clinical staff is critical. Uncertainty and the feeling of not knowing what's going on is a huge source of anxiety and confusion. It is the nemesis of a safe, smooth response to a crisis. Strengthen your communication infrastructure to ensure consistent, clear and regular messages go out daily. Things change rapidly from day to day, so make sure you date all communications. Listen to your front-line staff — they have to deliver on the policies, procedures and protocols issued.

Jeff Hammel, CFO, OakBend Medical Center (Richmond, Texas)

We should not overcomplicate matters, as there are too many people involved. I work to focus on five things:

  1. Communicate frequently, making sure that the right people have the right information.
  2. Prioritize time and resources, including people, PPE, equipment and money.
  3. Plan ahead by thinking about what next week, next month and next year look like and work to plan for resource needs.
  4. Remain agile, as things will change quickly and we must adapt our communication, resources and planning to take that into account.
  5. Stay calm.

Greg Haralson, CEO, Memorial Hermann - Texas Medical Center; Senior Vice President, Memorial Hermann (Houston) 

Don't stop doing the most basic elements of leadership. Don't stop rounding. Keep yourself safe, but don’t become distant from your employees. Be intentional in your efforts to connect in meaningful ways other than email. The ability to calm employees down in the moment, actively listen and simply the practice of presence has proven invaluable. 

Robert Haynes, CEO, Guadalupe Regional Medical Center (Seguin, Texas) 

There are no maps to guide us. We follow our true north with our internal compasses that place our staff and our purpose — patient care — at the center of decision processes.

George B. Hernández, Jr., President and CEO, University Health System (San Antonio) 

Be transparent and communicate with all your key audiences, internal and external. Let staff know that they are your most important resource and their safety is your top priority. Remember to say "thank you," and say it a lot.

Paul Hiltz, President and CEO, NCH Healthcare (Naples, Fla.)

Focus, pull together your department leaders and strategize. Establish daily communications. Conserve your supplies. Support your team emotionally and let them know they are appreciated and supported. Leverage your supply chain relationships and other healthcare partners. Work closely with your local and state leaders and stay in constant communication. Host town halls, write op-eds, place ads and conduct TV interviews. Overcommunication is key in a crisis. The power of the human spirit is incredible, so leverage the power of your local community. We’ve seen tremendous support from our community, and it’s inspiring.

Melissa Howard, CNO and Clinical Executive, Emanate Health Foothill Presbyterian Hospital and Inter-Community Hospital (Covina, Calif.)

With so much uncertainty and information overload from various sources, Emanate Health provided clear and concise facts that staff and our communities could use to respond to the COVID-19 outbreak, as changes happen rapidly overnight. Senior leadership conducts daily command center conference calls, our president and CEO of our healthcare system issues a daily brief update about COVID-19, our company has hosted a series of virtual town hall meetings via digital platforms that include Zoom or GoToWebinar to respond to staff questions. We have also communicated updated to policies in the form of memos via email as needed. While practicing social distancing, our supervisors and leaders have provided up-to-date information to our frontline staff during daily unit huddles and 1:1 meetings.

Alan Iftiniuk, CEO, French Hospital Medical Center (San Luis Obispo, Calif.) 

Ignore all the superfluous and overly sensationalized media "noise." It's way too unproductive. Alternatively, stay the course by driving evidenced-based, science-centric decisions. And if the noise gets too loud — turn up the music.

Steve Johnson, President and CEO, Health First (Rockledge, Fla.)

Communicate, communicate, communicate; internally and externally. There is no such thing as too much communication in the face of a national crisis, especially one that can be so personal. Flood the airwaves. We require leaders to do listening rounds every shift of every day using a standard small set of questions, the answers to which they must document. We constantly communicate with our associates and providers in the form of detailed emails several times a week, videos and all major forms of social media. Our responsiveness and attention to associate questions has been critically important to morale and operational effectiveness. Similarly, we communicate with the community daily, including elected officials, patients and the general public using all tools available to us. 

Ruth Kain, MSN, RN, Chief Nursing Officer, Tulane Health System (New Orleans) 

It was important that senior leadership was present and visible in the hospitals. We were intentional about rounding on the COVID-19 units, modeling PPE use and further reducing staff anxieties about working in those areas. It also gave us the opportunity to have crucial conversations — like those around PPE conservation efforts — in person.

Mark Laret, President and CEO, UCSF Helen Diller Medical Center at Parnassus Heights (San Francisco) 

Establish the most frequent, robust bi-directional communication tools you’ve ever built to stay close to your physicians, staff, patients and community. They all need to hear what's happening in real time, have a chance to raise questions and express concerns, and to understand what's coming next.

Mark Lisa, CEO, Twin Cities Community Hospital (Templeton, Calif.)

Lead from the front. Lead with confidence — in yourself (without being arrogant) and in your team. Stay off of social media, including LinkedIn. If you are working hard, everyone who is important will know it already. You don't need to stroke your own ego by posting selfies and bragging about how proud you are. If you are proud of your team, tell them yourself, in person. 

Bill Lynch, Executive Vice President and COO, Jamaica Hospital Medical Center (New York City) 

Communicate, communicate and communicate. It's that critical! Good luck.

Richard Majzun, COO, Stanford Children's Health (Palo Alto, Calif.)

Our biggest problem is managing the fear and anxiety that has taken hold of our community, staff and physicians. Closing schools, social distancing, learning to work from home and empty grocery stores are creating an incredible amount of stress. Many of our staff and faculty are young parents, and they are literally terrified of contracting the virus, endangering their patients, and spreading it to their children and families. If the average American stress level is 50, I’m guessing the stress level is now coming in right around 500. 

Stress plus fear plus anxiety equals an even greater need for leadership. The most important thing we bring isn’t good judgment and effective decision-making. It’s creating calm. Like a virus, calm is also contagious. Our No. 1 job right now is keeping our team safe so they can provide great care for our patients. Our No. 2 job is making them feel safe. The first one is hard; the second is 10x as hard. This fear and anxiety was something I think I underestimated. Leader rounding, constant communication, and virtual town halls help. Making sure our communications — which are many — have a tone that engenders calm and gratitude is essential. Fear is having a good game, but if we stay vigilant, we will keep winning.

Nanette Mickiewicz, MD, President and CEO, Dignity Health Dominican Hospital

Be sure to take moments where you can — for yourself to restore and refresh, and for your staff to answer questions and share your gratitude for their hard work.

Matt Morgan, Vice President and CFO, Community Hospital of the Monterey (Calif.) Peninsula

Plan for recovery. 

Randy Oostra, President and CEO, ProMedica (Toledo, Ohio)

Provide your frontline caregivers with strong support and thoughtful leadership. Activating a robust, multi-disciplinary incident management team with the authority to act is essential to ensure an efficient and effective response to the COVID-19 outbreak. The incident management team should establish protocols and provide guidance about how the system organizes its resources. 

Patrick Petre, CEO, Garfield Medical Center (Monterey Park, Calif.)

The lessons learned from COVID-19 come fast and are unforgiving. Of particular priority to me as CEO was — and still is — to keep very close to the heroic employees on the front lines. Recognition, encouragement, education, resource allocation, clinical and statistical updates, regulatory advisories, etc., all mean so much to them now. My job is their welfare.

Michael Restuccia, CIO, Penn Presbyterian Medical Center (Philadelphia)

Recognize that each day is a blessing and no matter how uncomfortable or awkward things may feel in this environment of social distancing, there are those on the front lines providing clinical care in an environment fraught with many unknown risks. So do your best, be a good teammate/parent/spouse and realize just how good you have it.

William Rhoades, CMO, Advocate Good Samaritan Hospital (Downers Grove, Ill.) 

My advice is to communicate. The biggest problem with early COVID-19 preparation and later, when patients started to arrive, was a lack of information. I started with information to the entire staff, including physician leadership and the medical staff, regarding our preparations for COVID-19. Once the patients started to be admitted, I was communicating with physician leadership, but not the entire medical staff. I listened to the physicians, and they wanted information. How many COVID-19 patients? How many ICU patients? Do we have enough PPE, ICU beds, ventilators, etc.? So, I started a daily email to the medical staff with our hospital's data noting that it is always changing hour to hour. But it's nice to have a daily snapshot.

Bill Santulli, COO, Advocate Aurora Health (Downers Grove, Ill.) 

Adopt a resilient mindset. When an organism faces a major change to its environment, it must rapidly adapt or risk survival. This also applies to an organization. Traditional approaches and solutions to normal challenges are often ineffective. You must have the courage to explore unconventional solutions to new problems; learn, adapt and repeat.

An organization must quickly implement a "command-and-control" operating environment — as such, it is critically important to empower Incident commanders to lead the preparation and execution. It is important to communicate this broadly to the organization’s leadership team and accept the fact that decisions need to be made quickly. When doing so, not all decisions will be perfect and the organization needs to be agile enough to adjust quickly.

Another key ingredient in leading through this complex crisis is to ensure that the organization is communicating in a multi-channel way, both internally and externally. Communications need to be built into the organization's daily rhythm and key messages need to be repeated. As COVID-19 races to adapt to its new environment, so must we. Through courage, cooperation, creativity and most importantly resilience, we will persevere.

Louis Shapiro, President and CEO, Hospital for Special Surgery (New York City) 

Set up a robust organizational structure as if you were starting a new company at scale. Be forward-looking and think about what you need to do before you need to do it. If you wait, it will be too late. Don't underestimate the importance of communicating with your workforce. HSS did so in many ways: web-app, daily videos, daily emails, live stream. Visibility, transparency, inspiration and timeliness are all critical. Remember your hidden heroes: environmental services, engineering, supply chain, microbiology. Figure out a way to capture what you learned and make sure you pull it through to the other side. Develop your "return to new normal" plan well before you need it.

Terry Shaw, President and CEO, AdventHealth (Altamonte Springs, Fla)

Focus first on the well-being of team members (including your leaders) to ensure they can take care of your patients and the community. We have cut through the red tape and are creating new policies, systems and apps at speeds never seen before to respond to major issues on a timely basis. As a result, our leadership team is doing amazing work to take care of our people. It has been the biggest difference-maker in our ability to confront the demands that this crisis has placed on our system.

Nathan Tudor, CEO, El Campo (Texas) Memorial Hospital

I would encourage all of my colleagues to pray for our healthcare heros and for the healing of our patients and this virus. I think it is also important to let our teams know how truly special they are and recognize the sacrifices they make on a daily basis. It's important to listen to their ideas as they are truly the innovators. Educating the community, providing timely information that help spread calm over panic, and hope over despair. Finally, take time to let your family and loved ones know that you love them.

Scott Wester, President and CEO, Our Lady of the Lake Regional Medical Center (Baton Rouge, La.)

With 200 COVID-19-positive hospital patients in our facilities as I write this, we're very much still in active response. However, we will emerge from this current state requiring a fresh look at how we return to operations. Can we make any operational improvements permanent? Can we use new collaborations and relationships to accelerate progress? Can we stop doing things that don't add value for the clinical care or patient experience? The discipline of strategic thinking between the stark contrast of today vs. what we need to be ready for tomorrow is absolutely essential. Healthcare will forever be changed, and my organization and my community are depending on us to be ready.

Patrick Wilson, CIO, Contra Costa Regional Medical Center (Martinez, Calif.)

Don’t forget the five Fs: Faith, Family, Friends, Finances, Fitness. Self-care is crucial, and staying grounded and connected with family and friends is important. Model this behavior to staff. Also, align with the business immediately. Their priorities are yours. Do not waste energy or create rework. Do not create multiple channels for setting priorities. Remember there will always be a thousand good ideas. Implement three that really matter. The situation changes so fast that there will be three critical needs tomorrow

Claire Zangerle, DNP, MSN, RN, Chief Nurse Executive, Allegheny Health Network (Pittsburgh) 

Model safety behaviors at all times. Whether rounding in the hospital or in an office setting, make sure you are practicing physical distancing, demonstrating proper sneeze and cough etiquette, frequent hand washing or using hand sanitizer, and, if appropriate, wearing a mask. The staff are looking at what you are doing all the time. If you are telling them to do something you are not doing, you lose all credibility. And that puts your staff, patients and families at risk. Also, overcommunicate. Make sure communication is timely, transparent, and clearly stated. As the messages are delivered, praise the work for the staff for being flexible, as policies and processes are changing daily. Invite feedback, give them a vehicle with which to respond. Let staff know that you are listening to them because they likely have the answers and you want to know what they are thinking. At no other time have we had the opportunity to connect closer to our frontline staff than now. And it is our responsibility to do so.

 

Staffing and Surge Planning 

Michael Antoniades, Executive Vice President and COO, Maimonides Medical Center (New York City) 

The demand in the night shift is just as busy as the day shift; the demand on weekends is no different than any other day. These are sick patients. Plan accordingly in terms of staffing and support staffing. Secure agency staffing for nurses (particularly critical care nurses), intensivists, respiratory therapists, pharmacists, security and support staff. Sick calls increase; staff will contract the virus. Don't wait, because it happens quickly. Also, stand up a family communication center. Once visitation is suspended, be prepared to have a plan for how each family will be kept updated. As the number of patients grows, this becomes challenging, so stand it up early. The medical teams will be stretched and will have a hard time keeping up. Each call takes about 15-30 minutes; do the math. Medical students, NPs, PAs, residents and retired medical staff can be very helpful.

Dawn Anuszkiewicz, COO, Reading (Pa.) Hospital

Share your surge plan early! Each stakeholder will have a different perspective on what is needed and will need to develop their corresponding plan to provide doctors, APPs, nurses, RT, ancillary, support staff and supplies for those areas. 

Wael Barsoum, MD, President and CEO, Cleveland Clinic Florida (Weston, Fla.)

Surge planning is a critical element of COVID-19 preparation. If the worst-case scenario hits and there is a surge of COVID-positive patients coming to your hospitals, where will you put them all? Can you repurpose your outpatient areas, conference rooms, ambulatory surgery centers? Do you need tents for external care areas? 

Mark Bell, President, Pipeline Health (Los Angeles) 

Establish an ethics committee and hire an ethicist. Make sure to follow and have established allocations of scarce resources policies that your local hospital teams can use to guide disaster care. Don't leave it to chance, as it demoralizes local physician and nursing leadership. Establish a clinical subcommittee/team that helps decide what non approved therapies will be used at each facility, and when. Do mock drills for every emerging viral disaster scenario you can think of. You'd be surprised at what you find you are missing or weren't prepared for. Prepare for your nurses and doctors over 65 to be scared. Have contingency plans for use of consultants and internists. Telemedicine is key. The viral cycle in each region has been short term, and if you aren't prepared, you may find that by the time you are, you're already at the peak or beyond. 

Vicki Briggs, CEO, UT Health Tyler (Texas) 

Do all that is necessary to ensure the best care for the COVID 19 patients with a focus on patient, visitor and caregiver safety. But, do not forget about all of the other patients in hospital and how this situation has changed their experience. We have a team of employees whose departments have been closed that are serving as patient advocates, visiting patients and facilitating FaceTime calls with family members throughout the hospital. On our COVID 19 isolation unit, the nurses have become family to the patients not only providing excellent healthcare, but also emotional support throughout their stay. Families are responding by providing meals in appreciation for what the nurses are doing.

Moody Chisholm, President and CEO, UT Health East Texas (Tyler, Texas)

We're a 10-hospital, 70-clinic system across a multi-county geographic range. We didn't want patients showing up just anywhere, so we identified three locations as our primary COVID-19 symptom testing sites and moved triage out of the high-traffic areas to an outside covered location. We used our website and were able to get help from the local authorities in broadcasting the message to patients to use these locations if showing key symptoms. This helps keep other patients and caregivers safe from patients shedding virus. 

Joan Coffman, President and CEO, St. Tammany Parish Hospital (Covington, La.)

It will be absolutely crucial to enforce and reinforce compliance with social distancing, cough etiquette and hand-washing for your entire service area. Your clinical team probably already thinks it has great handwashing compliance, as we were proud of our 90 percent compliance rate, but the new normal is a level of compliance inside and outside your facility, by your own staff and everyone in town and around your area. 

William Cors, CMO, Lehigh Valley Hospital - Pocono (Pa.) 

Have a definite surge plan, and challenge it every which way beforehand to make sure it is real planning when the time comes. It's important to have a plan but it is more important to have planning. This should include capacities in strategic areas, including the emergency department and critical care, but also planning where to house non-critical COVID-19 patients. 

Derek L. Curtis Sr., DNP, RN, Associate Administrator/Chief Nurse Officer, Lyndon B. Johnson General Hospital (Houston) 

You must strengthen your readiness plan. We constantly review our response plan to ensure we are keeping our employees and patients safe. We will fight COVID-19 in phases via an agile response plan that allows us to care for respiratory and non-respiratory patients as we grow in patient volume, acuity and staffing. Our response plan is influenced by our existing partnerships with hospitals in Houston, New York City and across the nation. We are collaborating with some of the best minds in medicine to improve our patient experience and work toward improved outcomes.

Joseph Duffy, MD, Vice President and CMO, St. Joseph’s Health (Wayne, N.J.)

Plan on staff call-outs to climb through the roof. Gather your staffing organizations, physician recruiters and various headhunters now and shore up nursing staff, especially critical care, intensivists, cross-train techs and respiratory therapists. Have a plan for anesthesia around the clock to intubate. Plan on a hotel where staff may stay to avoid family transmission, or even a "clean place" to change clothes and shower before departing for home. Consider working with a state university to secure a dorm. 

Melissa Howard, CNO and Clinical Executive, Emanate Health Foothill Presbyterian Hospital and Inter-Community Hospital (Covina, Calif.)

Preparation: We anticipated that the COVID-19 outbreak could have a significant impact on operations, staffing, equipment and supplies, so we focused our preparations in these key areas early on:
1. Operations: We postponed elective procedures and community education programs, updated our hospital visitor policy and built tent systems outside of our three hospital emergency rooms to prevent any potential spread of the virus.
2. Staffing: By postponing elective surgeries, we were able to train and redeploy medical specialists and nurses to support the designated COVID-19 units for treatment. We redirected and trained support staff to clinical areas, and quickly assigned graduating nursing students to the frontlines. In addition, we also augmented our hospital security teams across our health care system.
3. Equipment and supplies: Almost daily, our procurement team has reached out to sources, in and outside of our regular supply chain, as well as government entities to secure as much PPE as possible. In addition, our foundation generated a public appeal to seek community donations of PPE, which has been very fruitful to date.

Elisabeth Kunkel, MD, CMO, Pennsylvania Psychiatric Institute (Harrisburg)  

Arrange furloughs for healthcare workers to preserve the health of your providers (i.e., time off site and on site).

Joshua Lenchus, Regional Medical Officer, Broward Health Medical Center (Fort Lauderdale, Fla.).

Plan and prepare. If you think this will be business as usual, you’re in for a surprise. Think about the unexpected, then begin to gather the supplies and craft a staffing plan. Map out rooms, areas and units in which overflow patients will be admitted. Walk the patient flow through the Emergency Department. And finally, encourage, empower and thank your frontline staff every chance you get. 

Bill Lynch, Executive Vice President and COO, Jamaica Hospital Medical Center (New York City)

These COVID-19 patients are very fragile — some go from shortness of breath to respiratory arrest in a short time. I would obtain all the critical care RNs, Intensivists and respiratory therapists you can find. I would also prepare additional ICU capacity.

Steve Marzolf, RN, Chief Nursing Officer, Spectrum Health Pennock (Hastings, Mich.)

Prepare by creating a detailed plan, while there is time, and know how and when to implement the plan. Also, to be honest with what you can staff considering a 30 percent attrition rate of staff.

Nanette Mickiewicz, MD, President and CEO, Dignity Health Dominican Hospital

Though the circumstances remain uncertain, continue to do everything you can to prepare for a potential surge. Solidify your PPE policy for the weeks to come, and communicate that policy clearly to your staff. Identify exactly who can be trained up for a surge and initiate a training program. Make sure you understand the capabilities and limitations of skilled nursing facilities in your area. 

Debi Pasley, Senior Vice President and CNO, Christus Health (Irving, Texas) 

Create the plan for how to utilize staff, especially RNs, in areas of greatest need should your organization face a capacity-exceeding spike. If you have the luxury of hospitals in multiple geographic locations, expand that plan to movement of staff from low-census hospitals to high-census hospitals. This should include rates of pay and housing plans. The planning should also cover how documentation would be reduced and policy for what volumes would trigger activation of the reduction. Most importantly — communicate that plan to your staff! Staff need to trust that you have a plan to support them should volumes threaten to overwhelm resources. Showing them a plan for how nurses from an ambulatory site can provide support to their critical care colleagues, for example, shows that you value the breadth of their clinical talent. They need to hear, "We got this!"

Susan Sandberg, President and CEO, MelroseWakefield Healthcare (Medford, Mass.); Executive Vice President, Wellforce (Burlington, Mass.) 

Be prepared to maintain a sustained incident command over a prolonged duration of time beyond what any of us have experienced in our careers. In Boston, we had an advantage of anticipating the impact of COVID-19 on the healthcare system by watching news reports and hearing from colleagues as it advanced its path across the world to us. We began strengthening supply chains immediately. We cancelled elective surgeries early, knowing we would need to ensure bed capacity and PPE and to lead locally in helping to stop the spread. We rapidly began training staff to roles outside of their norm. The importance of anticipating actions needed to help with cash flow was also important early on, as normal revenue streams were disrupted while supply and treatment of COVID-19 was known to be resource intensive.  

Terry Shaw, President and CEO, AdventHealth (Altamonte Springs, Fla)

Keep as many of your team members employed as possible. Set up a system to redeploy your team into different roles. This won’t last forever, but it will demonstrate that people are your most important asset.

Lina Shihabuddin, MD, CMO-Primary Care Services, RWJBarnabas Health (West Orange, N.J.)

To my colleagues in hospital leadership: If you do nothing else in the next week, at least set up telehealth from all your ambulatory space practices to continue to care for the patients. Stock up on oximeters and home oxygen supplies to be able to set up hospital-at-home quickly. Organize your transitions care team to care for these patients at home. Good luck, it takes 4-6 weeks to get out of the "war zone."

Scott Wester, President and CEO, Our Lady of the Lake Regional Medical Center

With the intensity of preparation and response to COVID-19, we have been appropriately consumed by every detail to manage our operations. We were on the early wave because we’re near New Orleans, and we’ve had to move quickly. We’ve tapped our colleagues across the country for their experiences and practices and we’ve added a few of our own. For example, from the beginning we have cohorted patients to accelerate the education and experience of our care teams, conserve PPE and reduce risk of spread. 

Michael Young, President and CEO, Temple University Hospital (Philadelphia) 

Have a plan. A pandemic plan. A disaster plan. Emergency preparedness. Have tabletop exercises and drills regularly. We did a tabletop on what to do when a novel virus strikes about 2 years ago. From that, we fixed the plans, recognized the need for rapid adaptation and mitigated some vulnerabilities, like workforce management. Having a plan and practicing it is a Joint Commission regulation, and it formed the backbone of our response. What we did with consolidating the patients in one building and using alternate treatment areas is important. Proactively discontinue elective surgeries to open capacity as well. Also: Predictive modeling. Data is your friend. It's also what will help you convince the community to engage (social distancing to flatten the curve) and let you know when it's time to resume normal operations. 

 

Employee Wellbeing, Support and Health

Vicki Briggs, CEO, UT Health Tyler (Texas) 

Be kind to one another. This is a very stressful time for everyone, whether you are working overtime in the isolated COVID-19 unit, quarantined due to suspected exposure, furloughed due to significant drops in volume, asked to work fewer hours, concerned about childcare, have a family member or friend that you cannot visit in the hospital, have had enough "family time," have financial challenges — the list goes on and on.

Moody Chisholm, President and CEO, UT Health East Texas (Tyler, Texas)

Don't forget to think about how you will pay your employed caregivers who are exposed and need to be quarantined. We added a special COVID-19 PTO bank.

Joan Coffman, President and CEO, St Tammany Parish Hospital (Covington, La.)

As your team dives further into your COVID-19 response, the stress, fear, work and tension will bear down. Hold them up, give them love and food and respite from the clash.

Robert J. Corona DO, MBA, FCAP, FASCP, Chief Executive Officer, SUNY Upstate Medical University and Community Hospitals (Syracuse, N.Y.)

People want to know you are focused on keeping them safe. This is their biggest concern. Have compassion for your people and yourself. It is OK to ask for help if you are having trouble processing your anxiety and grief. Communicate continually. People want to hear from you. Be mindful of every word you use. Encourage and inspire. Be real; the people you work with want to know you are strong and courageous, but want to know you are human and also have moments of weakness. Show up. People want to see you at the front line and not home operating remotely. Be visible and available. Listen to everyone, including the naysayers. It is important for all people to feel they are being heard. You need to listen to things you don't want to hear. And maintain important rituals; they restore and are powerful in managing extreme emotions.

Joseph Duffy, MD, Vice President and CMO, St. Joseph's Health (Wayne, N.J.)

Get a psychiatric support staff on board to counsel those who will see death in numbers no one has seen from disease in their lifetime, and hope to never again.

Sean Fadale, President and CEO, Community Memorial Hospital (Hamilton, N.Y.)

Be present for your staff; it makes a huge difference. You can not overcommunicate to your staff, board or community. 

Stephanie Hall, CMO, Keck Hospital of USC (Glendale, Calif.)

Respect and care for your healthcare workers. They are the essential engine. Do not take them for granted. We are asking them to risk their lives and the lives of their loved ones to care for patients. Do a minimum of two things: First, provide your workers with necessary PPE and do everything within your power to keep up the supplies necessary for them to do their work. Second, It is a singularly offensive thing to not offer testing to your healthcare workforce. If they become symptomatic or have a high risk exposure, offer testing and close follow-up care.

Barbara Griffith, MD, CEO, Woman’s Hospital (Baton Rouge, La.)

Think about your people. They won't be looking out for themselves when they are so focused on organizational needs. Encourage them to take time off and share the load with others, which is not typical of leaders who are deep in the middle of a crisis. This is a marathon, not a sprint.

Brent Jackson, MD, CMO, Mercy General Hospital (Sacramento, Calif.)

As a CMO, my biggest challenge was managing anxieties amongst some members of the medical staff. Again, constant and consistent messaging was key to managing these anxieties. Changes in recommendations required transparent explanations of the "why" with references.

Ruth Kain, MSN, RN, Chief Nursing Officer, Tulane Health System (New Orleans) 

You can't overestimate the importance of caring for your team's mental and emotional health.

Rhonda Medows, President, Population Health Management and CEO, Ayin Health Solutions, Providence Health & Services - California 

First, communicate frequently and regularly with your front-line caregivers and your behind-the-scenes staff that support daily operations. You need them as much as they need to hear the truth from you about what they are facing. 

Amit Mohan, Phd, CEO, Barlow Respiratory Hospital Main (Los Angeles) 

Tell your team you trust them and you are there for them. Be open to all sorts of questions and hypothetical scenarios. Be sure the team knows that they will have appropriate PPE. Be sure the infectious disease physician leaders are engaged in all process designs and decisions. Be open and transparent. It is important to recognize the depth of fear COVID-19 instills in your team. Expect both courage and cowardice. Encourage your team to be at their best, seize the moment and stand proud in the face of their fears. Our training and professionalism allows us to predict our clinical response, and our preparations give us confidence that we have equipped our team with the knowledge, skills and protection they will need. But until those patients come through our doors, we cannot know how well we will fare in processing the COVID-19 pandemic crisis on an emotional level. Frequent encouragement and reassurance of faith in the team's readiness and capability can help. Tell your team as often as you can, in as many ways as you can think of, that you trust them and you are there for them.

Dennis Pullin, President and CEO, Virtua Health (Marlton, N.J.)

To my colleagues in hospital leadership: If you do nothing else in the next week, at least spend time personally checking in with your frontline teams. Ask them what's worrying them the most and how they are keeping their spirits high so they can show up with the right mind for others. The gift of listening is so powerful and it sends an important message to your workforce that you truly care about not only what they are doing, but how they are feeling. I also believe a message of encouragement and solidarity will help them to rally for the challenge ahead. An email is one approach, but I think a video message, which allows your team to see and hear you, resonates even more. 

Susan Sandberg, President and CEO, MelroseWakefield Healthcare (Medford, Mass.); Executive Vice President, Wellforce (Burlington, Mass.) 

Do not underestimate the emotional toll on caregivers and patients. Ensure there is constant support. 

Nicholas Testa, Chief Physician Executive, Dignity Health Southwest Division (Los Angeles) 

Pace yourself; this is a marathon not a sprint. During the early phases of the pandemic, all of our teams were dealing with fear and anxiety. But we've moved into a new phase. What was unfamiliar six weeks ago has become our "new normal" and with that, people are understandably getting tired. If we are truly going to 'flatten' the curve, we will need to be thoughtful about both how we take care of our patients, how we take care of ourselves and how we take care of one another.

Ronette Wiley, RN, MHA, CPPS, Executive Vice President and COO, Bassett Medical Center (Cooperstown, N.Y.)

Purposefully connect the dots of the heroic work that so many of your staff are doing during this challenging time back to your organizational mission. Too many times, a mission statement exists on a wall that people walk by daily or buried in an employee handbook that is never read. Seize this opportunity to galvanize your team’s sense of purpose, shared pride and teamwork. Show them that they are living the mission every day, no matter what their role is. Share stories of everyday heroism — no matter how small — that demonstrate an organization that is deeply committed to its mission no matter what.

Michael Young, President and CEO, Temple University Hospital (Philadelphia) 

Leaders, unions, physicians, other staff. Engage them early and often on the necessary effort. Rally them. Keep them informed. Stop rumors and crises early. Let the experts shine. Remind them in positive ways why we all came to healthcare. Identify staff who work in different areas and have had previous training to allow them to step in. 

 

Managing Resources (Beds, PPE, Equipment, Supplies) 

Michael Antoniades, Executive Vice President and COO, Maimonides Medical Center (New York City) 

1. Liquid oxygen systems are being pushed to their limits. Watch them closely, de-ice them multiple times a day as ventilator and high-flow utilization increases in your hospital; rent a "back-up" liquid oxygen system (on trailers) and connect it to your oxygen system. 

2. Get oxygen flow meters and oxygen concentrators.

3. IV pumps and modules: Make sure you get extra, because vented patients require a lot of modules.

4. With doors closed on medical floors and without central monitoring, it is critical to have a way to monitor pulse oximeters. Buy pulse/ox units (we bought Masimo, but there are others) that can be connected to the patient via bluetooth so that they can be monitored outside the room more frequently.

5. Secure PPE and set up a process to distribute it internally. 

6. Track your numbers multiple times a day (admissions, ICU utilization, sick calls, vented patients, high-flow patients, on-hand inventory for PPE, vents, other supplies and medications — particularly those used with vented patients).

7. As hospitals increase the number of inpatient units, the internal supply distribution operation will not keep up with demand. Increase staffing to ensure supplies and PPE are readily available. Consider standing up a logistics center just to get supplies up quickly to floors that run out during the course of the day and night.

Wael Barsoum, MD, President and CEO, Cleveland Clinic Florida (Weston, Fla.)

Your workforce is more critical than ever during a long-term pandemic such as this. Keeping them safe is a priority, which puts a focus on managing PPE. The Cleveland Clinic enterprise began preparing for COVID-19 in January, which gave us time to begin shoring up supplies such as PPE and ventilators. This has become more challenging as the virus began to explode across the country and internationally, but we have made supply chain management a priority. 

Mark Bell, President, Pipeline Health (Los Angeles) 

Have a supply/inventory needs assessment forecasted for your facility that ties out to a national COVID-19 tracker that shows viral growth rates in your region. The key is to follow the tracker daily, as the growth rate estimates change day to day, and therefore so will your supply/inventory needs.

Moody Chisholm, President and CEO, UT Health East Texas (Tyler, Texas)

Implement strategies to optimize PPE, utilizing CDC guidance, immediately. 

Joan Coffman, President and CEO, St. Tammany Parish Hospital (Covington, La.)

Necessity is the mother of invention, and the COVID-19 pandemic has absolutely inspired innovation at St. Tammany. We disinfected precious PPE to make it safe for longer use. Our foundation rearranged its planned purchase of UV cleaning robots for an expansion currently underway, to enable their germ-killing technology to go into use right now in our current COVID-care setting.

William Cors, CMO, Lehigh Valley Hospital - Pocono (Pa.) 

Do not assume you have adequate PPE. You don’t. Keep planning. My hospital president and I handpicked some level-headed and clear-thinking advisors as a trusted "cabinet" to guide our thinking and planning for worst-case scenarios. They were physicians, clinicians and operations folks who were not not necessarily at the top of an organizational chart, but rather the emotionally intelligent individuals who we could trust.

Joseph Duffy, MD, Vice President and CMO, St. Joseph’s Health (Wayne, N.J.)

Anticipate a burn rate of PPE double of what you expect. Expect emergency responses, cardiac arrests and team responses that will tear through your supply. Secure refrigeration trucks for morgue expansion (a sad reality that capacity will reach overflow) and know which funeral directors will be ready to retrieve bodies as soon as possible. 

Harold Engle, CNO, First Texas Hospital / Adeptus Health (Houston) 

Do this: Stock up on PPE and provide constant communication, but have multiple contingency plans for how to increase the useful life of PPE should it run scarce. Think protection of the [healthcare professionals]. Protect the employees during this time. 

Sean Fadale, President and CEO, Community Memorial Hospital (Hamilton, N.Y.)

Over-invest in PPE. Begin a full masking policy and temp screening for staff and visitors as soon as possible. 

David Fleece, CMIO, Temple University Health System (Philadelphia)

First, secure your supply of PPE and develop and communicate the PPE plan to all staff, along with appropriate use and evidence supporting your plan. Staff can overuse and hoard PPE out of fear, wasting this resource. Second, establish a way to triage and segregate potential COVID-19 patients who present to your facility. Make a plan for cohorting patients and staff caring for COVID-19 patients, preserving beds and staff for non-COVID-19 patients. Finally, learn what's working from a treatment standpoint from other places, and look at your pharmacy supply of drugs commonly used.

Brent Jackson, MD, CMO, Mercy General Hospital (Sacramento, Calif.)

The takeaway for us here in Northern California has been triage. Except, instead of triaging casualties, we are triaging PPE. Uncertain and unreliable daily PPE deliveries drove a shortage of PPE. We had to balance what supply we had across individuals at the greatest risk.There were a number of individuals at community levels of risk who were still anxious that we did not have PPE for them. So, we had to manage a lot of anxieties. Constant and consistent messaging coupled with rounds by leaders not wearing PPE were key to managing this.  

Ruth Kain, MSN, RN, Chief Nursing Officer, Tulane Health System (New Orleans) 

It is vitally important that your team is educated and comfortable with proper PPE donning and doffing techniques.

Elisabeth Kunkel, MD, CMO, Pennsylvania Psychiatric Institute (Harrisburg)  

Make sure you have a PPE protocol in place for all types of patients, healthcare workers and other employees. This includes the ability to garner the supplies needed to offer PPE to all per the protocol.

Rhonda Medows, President, Population Health Management and CEO, Ayin Health Solutions, Providence Health & Services - California

Learn from history and prepare not just for today but also for the second wave of viral transmission that will impact people who were not infected this first time. Take what you just learned about resources needed, then prepare and retain the resources needed for the next wave. For reference, see the CDC reports about second waves during the 1918 Spanish Flu and 2009 H1N1 Swine Flu. A vaccine or effective antiviral medicine would help reduce this risk.

Randy Oostra, President and CEO, ProMedica (Toledo, Ohio)

There should be a group within the incident management team that is specifically tasked with acquiring and processing PPE, including community donations. That group should work to ensure that PPE is being deployed in a judicious manner that considers future needs while shortages continue.

Fernando Petry, DO, CMO, Cleveland Clinic Martin Health (Stuart, Fla.)

Monitor your PPE burn rate, looking at daily usage and how to reduce overutilization of PPE. Meet twice a day with your supply chain department to ensure you are aware of days on hand for each PPE component.

Bill Santulli, COO, Advocate Aurora Health

A shortage of resources has proven to be one of the biggest challenges. Labor, facilities, equipment and supplies are all in high demand. Creative solutions to these shortages abound. Team members from across the board are stepping into new roles. A significant reduction in elective procedures has freed up clinical team members for redeployment. A significantly expanded virtual health system and online symptom checker has provided patients with new ways to access care. New methods of procuring and conserving precious personal protective equipment and critical medical devices include: partnerships with non-traditional manufacturers, unconventional conservation and reuse, community donations and even 3D printing.

Joseph Scopelliti, MD, President and CEO, Guthrie (Sayre, Pa.)

PPE is the most critical factor you will deal with, and it influences every decision you make. The perception of inadequate PPE instills fear in your staff and the reality of it galvanizes that fear. Inadequate PPE will paralyze your management team's ability to make all kinds of necessary decisions. First, find all your inventory and pull it all into a central repository. Count and catalog it completely accurately (that took us multiple time-consuming tries). Then accurately measure your daily use of each critical PPE supply and project it forward at different levels of patient volumes. Lastly, put your very best person in absolute charge of this — someone very organized and disciplined with great execution skills. 

Terry Shaw, President and CEO, AdventHealth (Altamonte Springs, Fla)

The first step hospital leaders should take is to align resources and make the necessary financial investments to keep team members whole to the best of their ability. Find several reliable sources for PPE. Don’t negotiate. Buy to protect your team. If you don’t experience an overwhelming surge, it will be put to good use in the future. 

Eleanor Wilson, Vice President and COO, Doylestown (Pa.) Health 

Ensure your staff has the needed PPE.

Patrick Wilson, CIO, Contra Costa Regional Medical Center (Martinez, Calif.)

Work with procurement to identify the quickest but safest way to procure items. California has price-gouging laws. We have seen companies charge $200 for something one week and $600 the next. Create the shortcuts needed, but not so much you lose track of expenditures or double purchasing. 

Michael Young, President and CEO, Temple University Hospital (Philadelphia) 

For PPE, expect supply chain disruptions. Know your supply chain. Have someone who can work magic around your supply chain. 

 

Testing

Nishant Anand, MD, FACEP, Executive Vice President and CMO, BayCare Health System (Clearwater, Fla.)

Use yours and your institution’s influence and assets to support social distancing, both in the community but also in your institutions. Become an advocate for testing in your community. Support efforts to provide early testing, such as drive-thru testing, for symptomatic patients. Our efforts have raised awareness that COVID-19 positive individuals need to isolate and reduced disruption in our hospital facilities by providing testing for non-acute patients elsewhere. Offer to work with cities and counties to test vulnerable populations, including the elderly, the homeless and those with chronic diseases. For example, we worked closely with our county and state regarding nursing home populations.

Joan Coffman, President and CEO, St Tammany Parish Hospital (Covington, La.)

It comes down to testing, testing, testing! Fighting a pandemic in the parking lot of one of our diagnostic centers to take the influx away from our emergency departments has been a key factor in our success. [As of April 14,] we are at an 82 percent negative result rate. The drive-through testing we instituted early in the onset of COVID-19 in our community truly made a difference, even though we faced adversity due to shortages and blockages. We began drive-through swabs and sent them to our state department of health, but their lab quickly became overwhelmed. Then they had us contract with private vendors, such as LabCorp. They also became overwhelmed. Until we were able to secure the necessary equipment to perform our own test in our hospital lab, we devised a system of sending some tests to the state and others to private labs, based on severity and expectation for turnaround.

Stephanie Hall, CMO, Keck Hospital of USC (Glendale, Calif.)

Having timely testing is the core of being able to manage patients, flow and staffing. Get testing capability up and running, and be as liberal as possible within the confines of resources. Reach out to other health systems to help with testing if you don’t have it in-house. Many are willing to share resources.

Michael Young, President and CEO, Temple University Hospital (Philadelphia) 

Lab testing is key. Can your equipment handle novel viruses? Do you have the staff (and leadership) who can quickly adapt and overcome? 

 

Collaboration with Healthcare, Community, Government Partners

Wael Barsoum, MD, President and CEO, Cleveland Clinic Florida (Weston, Fla.)

It is imperative the community is educated about the virus and has correct information. We have collaborated with community partners to disseminate information and offer resources.

Vicki Briggs, CEO, UT Health Tyler (Texas) 

The thing that I am most worried about is patients who need urgent healthcare staying away from the hospital due to fear. Messaging to the community to seek healthcare when you need it is critical to address heart conditions, strokes, cancer diagnosis and other conditions that are very time sensitive. We do not want opportunities for full recovery to be impacted because patients are too concerned about COVID 19 to come to the hospital.

Moody Chisholm, President and CEO, UT Health East Texas (Tyler, Texas)

Before it hits nursing homes, encourage nursing homes and senior care facilities to get advanced directives from patients and families. 

Sean Fadale, President and CEO, Community Memorial Hospital (Hamilton, N.Y.)

Work with your local colleges and universities; they can be a goldmine for solutions or sources of PPE, volunteers, alternate care sites, PPE disinfecting options and other resources to support your operations. 

Sandra Fenwick, CEO, Boston Children's Hospital

Like our colleagues at adult hospitals, we are working hard to educate legislators and the general public that while children are not as negatively impacted as adults in terms of COVID-19-associated disease, the immediate and long-term impact on children and the financial implications on children's hospitals will be deep. The federal stimulus packages for children's hospitals must address this. I am not the first to say it, but it is worth repeating: Children are not the largest segment of our population, but they are 100 percent of our future. We owe them the opportunity to live the healthiest lives possible through this pandemic and into the future. That is our mission.

George B. Hernández, Jr., President and CEO, University Health System (San Antonio) 

Let the community know that the trusted health system it has come to know and rely on is here for them during this critical time. Provide the community access to you and your leadership team to address concerns and give feedback. Reach out to assure the needs of the most vulnerable are met. A community is only as strong as how it cares for its weakest members.

Melissa Howard, CNO and Clinical Executive, Emanate Health Foothill Presbyterian Hospital and Inter-Community Hospital (Covina, Calif.)

Since the beginning of the outbreak, we have provided educational information to staff and our communities on how avoid the spread of COVID-19 with new guidance from public health agencies.

Frank Hyland, Executive Director, Good Shepherd Rehabilitation Network (Allentown, Pa.)

Post-acute providers in areas not seeing significant COVID activity should establish an incident command team now who will meet daily and plan how you will protect your patients, residents, staff and community. Do not waste a minute in assessing your PPE inventory and considering how much you may need should a surge occur in your area. Post-acute providers have a unique role to play in this pandemic by safely providing services, reducing readmissions to already taxed acute care systems and working alongside acute partners to assist with surge planning. Above all you must innovate, think outside the box and move quickly.

Thomas Marchozzi, CFO, Lehigh Valley Hospital - Cedar Crest (Allentown, Pa.)

Mobilize your submission to your State Emergency Management Office to obtain FEMA funds.

Gregg Meyer, MD, Chief Clinical Officer and Interim President, Newton-Wellesley Hospital (Newton, Mass.)

Reach out to your area’s skilled nursing and assisted living facilities. Work to get them the testing, PPE and support to complete advanced directives as appropriate. In addition, work with them to identify a strategy to accept COVID-19 patients back into their facilities after they are ready for discharge from acute care.

Barry Ronan, President and CEO, UPMC Western Maryland (Cumberland)

Embrace the kindness of the communities you serve. At UPMC Western Maryland, we are receiving daily donations of food, supplies and many other examples of goodwill and generosity from people and groups in our region wanting to assist our front-line staff members. During challenging times, the best traits in people and in communities often show up in remarkable ways. My advice is for you to let people show they care.

Maria Scenna, COO, Cancer Treatment Centers of America (Philadelphia) 

Despite COVID-19, cancer patients still need us to do everything in our power to continue providing lifesaving cancer treatment. Each day, 1,600 Americans die from cancer, and we expect that number to increase in 2020 if more cancer appointments are canceled or if we put cancer care on hold during the current crisis. I recommend leaders work collaboratively as we have here in Philadelphia to ensure the safe and continued treatment for cancer patients. Specialty hospitals can help neighboring hospitals that are overwhelmed with COVID-19 patients by temporarily cross-credentialing doctors so non-COVID-19 patients may be relocated and treated at specialty hospitals until the crisis is under control.

Patrick Wilson, CIO, Contra Costa Regional Medical Center (Martinez, Calif.)

Connect with your critical vendors as soon as possible. Identify your needs so they can work on your behalf on procuring stuff. Microsoft, Apple and others all have healthcare-specific teams. They are awesome and advocate on our behalf.  

 

Technology 

Myra Davis, Chief information and Innovation Officer, Texas Children’s Hospital (Houston)

Make technology usage easy. While it may seem like a great time to leverage tech to transform your organization, be mindful of the amount of change your employees are enduring. Remember everything they are already going through personally and recognize that digital transformation can be perceived as disruptive. Stay true to your core pillars. In my world, this is to ensure our core infrastructure maintains an Available, Reliable and Secure technology platform. Some may also refer to this as “stay the course” or "run and maintain." Data, data, data. Transform your data into meaningful information, whether that is providing frequent updates regarding PPE days-on-hand, COVID-19 data (PUIs, positives, etc.), daily census updates or other outputs. It is essential to leverage your data platforms. Leverage telemedicine. Virtual visits are a fantastic (and safe) way we can all benefit from technology. Educate and encourage your patients and staff to take this route, if they can.

Fernando Petry, DO, CMO, Cleveland Clinic Martin Health (Stuart, Fla.) 

We have instituted video visits on the inpatient side for consultants to do follow-up visits so they don't have to don/doff PPE every day. The video visits have been used by our team to connect patients with families as well.

























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