UCI Health CEO on expanding during pandemic: 'Access was even more important'

Chad Lefteris is the CEO of UC Irvine (Calif.) Health, a role he assumed in April 2020 after serving as COO since December 2018. He spoke with Becker's in August about continuing with the health system's planned expansion during the pandemic and workforce burnout in the wake of post-vaccine COVID-19 surges.

Editor's note: This interview has been lightly edited for length and clarity. 

Question: What are some of the trends you're noticing in Orange County as far as the delta variant is concerned?

Chad Lefteris: So, fortunately Orange County has been leading the way as it relates to vaccination in many ways, and even with this latest surge we're seeing an uptick, absolutely, but we're not seeing it quite at the level maybe some colleagues and health systems have seen elsewhere across the country because I think we started with a pretty high vaccination rate.

And I think it's proven that the higher the rate, of course, the lesser severe illness that then will be contracted. Meanwhile, we continue to prove here in Orange County, just like we do elsewhere, that just being vaccinated alone is not going to perhaps prevent you from testing positive. And so we're in that boat just like our colleagues elsewhere, but I think maybe we're starting from a little bit better standpoint than some of these locations that may have just not been able to get their vaccination numbers up high enough. But we've definitely seen a surge — I would say nowhere near where we were at in our last surge pre-vaccination — but definitely an increase in cases, 100 percent.

I would also say that compared to our last surge, it's a slightly younger demographic. And we continue to feel the effects of people who delayed care for a year.

Q: What are you doing to manage the uptick in patients who have deferred care?

CL: We are working very closely with, what we would formerly call, our competitors, in our entire county, the major health systems. We convened with them many months ago in a collaborative way. And I think we call it a coalition, actually, to help get the word out. And we started this months and months ago to remind folks to get back to taking care of themselves and their healthcare needs for themselves and their families. And so we did this across the Orange County and even in the [Los Angeles] metro area with our colleagues at UCLA as well. And it's been a neat way to bring communitywide competitors together with a unified mission and message. And we continue to do that. Meanwhile, we continue to put out our own information, whether it's an email blast from some of our providers to our patients or on social media, just to remind folks to get the care they need.

One of the things that we have done that I'm very proud of is that, in spite of a pandemic, we've continued to move forward with opening two more additional sites of care. It could have been very easy to shelve those and wait, but access was even more important. Of course we flooded the marketplace with our virtual care offerings, and those are not going away, but at the same time, we also opened, as planned, two more additional sites in the county in the last 12 months. And more are also under planning right now. So we reminded people, here are all the options available to you to get back to taking care of yourselves and getting your healthcare needs for you and your family taken care of. If you want to go virtual, we've got virtual. If you want to come to one of these sites because it's closer to your home, check this out, we just opened this new one last month.

Q: Besides the new locations, what would you say have been your biggest accomplishments over the last year?

CL: We got out on the right foot getting vaccines in arms quickly here in Orange County. We were doing 5,000 vaccinations a day. We delivered hundreds of thousands of vaccine doses in a short amount of time, as did many of our other community partners, which of course we are now reaping the benefits of collectively.

Q: What do you anticipate your biggest challenges being over the next year?

CL: One that keeps me up at night is our caregivers, our co-workers, our faculty physicians — they are worn out and tired. I think they love a challenge. Many of them love the adrenaline rush of the previous surges that we've gone through. And we could see those spikes and we could see them falling — a light was at the end of the tunnel. Vaccinations came and that was literally the shot in all of our arms that we needed to get over the next hump. And now this hits, and it hits in various ways.

Again, I feel very fortunate that we're being hit with a surge, but not to the level of what others may be experiencing. But if you look in the eyes of our amazing caregivers, and I don't care if you're an environmental services worker or you're a physician — it doesn't matter. They are tired.

And so the challenge for us, and for every health system, is how do we continue to support them, encourage them, focus them on their health and well-being? Which is certainly something we've been doing a lot of — giving them every resource we can possibly provide because we need them desperately. So that's a really big foundational concern. And I'm sure it's not just mine, but it's something that I spend a lot of time working on.

Q: Looking ahead, what are your top goals for UCI Health?

CL: I think one of the things [the pandemic] has taught us is that, as the only academic health system in Orange County, we have a unique mission. And I think collaborating with our competitors has been a fun way of learning together about our needs for the community. And so we spend a lot of time right now thinking about how we can continue to improve the health of our community. And that's different than healing you when you're sick. And that continues to be our focus as we plan the next program, whatever it may be. And that's a challenge because we also know that in every community, there are so many pockets and sub-pockets of underserved populations. And the pandemic has really highlighted some of the disparities in care. And so we knew some of this probably nationally, but now we're all living it. And so this has given us probably the greatest challenge and opportunity to think about how we can impact that. If we're going to improve the health of our community, we have to attack that, and how do we leverage our partners across our community to do that as well? So I see that as a really unique opportunity and challenge for Orange County. We're 3.5 million people. That's a lot of people. And so I think we have a real challenge given our scale there. 

I think the other for us is we are full every day, regardless of the pandemic. And so as a regional referral center, we receive the highest level of complex cases. And that's what we thrive on. We are constantly working to be able to say "yes" to every one of those transfers. They're calling us because they know that we have an expert in that very specific thing, and they want to send us that patient from near and far. And so we're working on our ability to say yes every single time, by expanding with renovations to add more patient beds. We have started construction of a $1.2 billion campus in Irvine that will expand our capacities dramatically in that location. A challenge going forward is how we manage until we get that open. 

Q: Given your capacity situation for the time being, are you at all worried about this new variant and how it might affect your situation?

CL: We're tracking it very closely. Our infectious disease experts were tracking this long before it arrived in the U.S. So I feel really good about how far out we're looking, and that's the beauty maybe of being a private academic health system. We have a depth of experts like our infectious disease team that are plugged in internationally. I feel really good about where we are and what we've already been through, and how we have care processes in place, including the process we set up to get patients discharged sooner so that we could monitor them at home. And so I think we are very well prepared, thanks to our amazing co-workers, for whatever comes at us next.

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