Tampa General CEO John Couris: The key to effectively mobilizing for COVID-19 and how to plan for the 'new normal'

When the COVID-19 pandemic began, Tampa General Hospital CEO John Couris mobilized his team quickly to ensure the hospital would be able to safely deliver care to patients.

Now, he is looking ahead to what the hospital will need post-pandemic, and be better equipped to combat infectious disease in the future.

Q: How have you been able to mobilize your team and rapidly change priorities in response to the COVID-19 pandemic?

John Couris: Tampa General Hospital has done several things very quickly to mobilize a planning and operations team to mitigate the impending impact of the pandemic.

Our teams immediately mobilized our incident command center with various team members focused on clinical operations, facilities, testing, communications, finance, supply chain, ER, lab, pharmacy, IT, ambulatory, HR, ancillary services, patient access and visitor management, security, team member health, clinical pathways, research, and other various key clinical departments. We also worked very closely with our OR governance team to plan and implement any changes to the surgical schedule.

The incident command center was comprised of leaders of task forces that were immediately developed; each taskforce leader provided a daily update during the incident command center meeting.

We used a portion of our daily morning safety huddle to give the teams a state of the house update on readiness and patient status update.

Q: How did you care for team members on the front lines and make sure they were in the best position possible to care for patients?

JC: We focused a great deal on our team members and ensuring their wellbeing was being considered. Because of the change in census, and various department closures, our CEO executive council worked hard to develop plans to minimize any financial hardship our team members would experience due to this crisis, including plans for ATO usage, partial pay, staffing pool to redeploy team members whose departments were closed, and a COVID-specific team member emergency fund to assist our team members in paying bills such as mortgage/rent, utilities, car payment, etc. Our entire senior leadership team contributed to the fund financially and through ATO donations. Additionally, the entire CEO executive council, including me, took a pay cut to support the team member emergency fund.

Aside from the financial implications, we also developed a resiliency committee to care for our team members' mind, body and spirit. For example, the resiliency committee offers access to online counseling, exercise classes and is helping to coordinate delivery of donated food and services from community businesses to nourish our team members and lift their spirits.

Q: What did Tampa General do to stem the spread of the virus?

JC: An important process we put into place quickly was developing in-house COVID testing. We recognized early that broad and rapid testing capability was a vital weapon in the fight against COVID-19. Thanks to our state-of-the art laboratory, Tampa General also has been able to develop its own test – a key reason why our testing started so early, and our capability is so high. We have ramped up our testing capacity since the beginning of the outbreak, and we’re now able to process 850 tests per day. We have been fortunate to be able to help other Tampa Bay health systems who have more limited capabilities by performing hundreds of tests for other local hospitals. Our most rapid test has results available in one hour. We have two other tests which give results in two to four hours.

Q: What are one or two of the most difficult decisions you have had to make as your team responds to COVID-19?

JC: We believe in the healing power of a family member at the bedside so our decision to limit visitors to our hospitals has been very hard, but essential for the safety of everyone.

Right now, our teams are using iPads for Skype calls with family members. We're letting family members have a face-to-face conversation, even if they can't actually be in the room.

Following CDC guidelines and the governor's executive order, we canceled all elective surgeries. Although it is hard to tell a patient they are unable to get a procedure they had scheduled, it was what was best for the health and safety of our team and our community.

Q: How do you anticipate the hospital will change as a result of the coronavirus and what are you doing today to ensure a strong organization going forward?

JC: Pandemics such as COVID-19, as well as other infectious diseases, can be catastrophic to healthcare systems, public health and the economy. Our new normal is to begin shifting our thinking of infectious disease from a one-time event and more toward a 'service line' model that we plan for as part of our normal operations, along with our other services and service lines.

To shift toward this model, we are working on long-term strategies to deal with infectious diseases such as COVID and working quickly to create a contained COVID hospital. We are early in the planning phase and don't have all of the details as to if that will be a full hospital, or if it will just be a wing or unit. But we must plan for this and other infectious diseases and bifurcate those services from regular hospital operations. This means thinking about how we can quickly diagnose and treat infectious disease patients in a contained, cohort area with trained medical professionals with proper PPE and equipment. This special infectious disease hospital will care for all COVID patients regardless of acuity so those who have mild symptoms, to those who are extremely ill and are placed on a ventilator.

We have a version of this now where we have isolated areas within the ER and an isolated negative pressure unit in the hospital specific for COVID patients. But from what the experts say, this disease is not going away and will become one of many infectious diseases we diagnose and treat. So, we must plan for this now, and determine how we can care for this distinct group of patients with unique needs in our community, and also at the same time how we can keep our regular hospital operations running and care for our community as a whole.


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