UCLA CEO: Standing strong after 2 COVID-19 surges

Johnese Spisso, RN, is president of the University of California, Los Angeles' health system and CEO of the UCLA Hospital System. She spoke with Becker's about the Southern California organization's vested interest in the healthcare of migrant children, mental health awareness and what has kept her feeling inspired, even during the darkest days of the pandemic.

Interview has been edited lightly for clarity.

Question: UCLA Health just launched an intake clinic for migrant children. Not many health systems are doing this. What was the inspiration behind this?

Johnese Spisso: We wanted the opportunity to really bring our world-class UCLA healthcare to really serve these children. We knew that we had a lot of expertise through our UCLA Mattel Children's Hospital and the ability to bring not only pediatricians, but really our child-life specialists, our pediatric nurses, to really make sure that we could give these children the best chance of health.

Q: Do you know of any other health systems participating in similar initiatives? 

JS: We are working with the team at Rady Children's at UC San Diego. We're also in partnership with our colleagues at UC Irvine Health and Children's Hospital of Orange County. 

Q: UCLA has a virtual mental health awareness concert coming up. What else is UCLA doing to create more awareness when it comes to mental health issues?

JS: We've made a major investment in our community and mental health. We operate our Resnick Psychiatric Hospital, and through the work that we do at Resnick and through our community, we've been actively looking at how to really improve access to care for mental health. We also, through the University of California, Los Angeles, have the Depression Grand Challenge, which has been a multiyear initiative to really look at addressing depression early on when we can make the most difference. And that's a very large-scale communitywide effort that really has gained a lot of national recognition.

Q: Why do you think mental health issues are becoming such prominent topics of discussion?

JS: Well, we definitely think the pandemic has really exacerbated that. Mental health has always been a big issue in our healthcare community with not a lot of resources available nationally. And we began to see throughout the pandemic with people losing their jobs, with children not being able to go to school, with the uncertainty of what was happening, it really began to cause an increase in depression and anxiety. We began to see much younger children and adolescents even needing support. And so as we go forward and plan for our community, we continue to look at ways to make investments in mental health and access to care.

Q: What are your priorities for 2021 as we come out of the pandemic? 

JS: Well, as we emerge, we really continue to focus on making sure that all of our patients are coming in for the care that's needed. We know that during the pandemic, many people deferred care. So we've been really focusing on making sure that we have prompt access to primary care, making sure people are getting their preventive health in, and that we're continuing to really address some of the challenges with caring for patients long term who have had COVID. We started a COVID post-discharge clinic for people who are having a longer sequela of recovery. And we're continuing to learn from this pandemic. 

I think one of the silver linings we saw is the adaptability through telehealth. That's allowed us to serve many more patients. Throughout the pandemic, we've had almost 550,000 telehealth visits. So having a percentage of patients who can be safely cared for by telehealth opens up more capacity for patients who need to come in for actual physical exams. So we're continuing to leverage those capabilities. 

Q: What challenges has UCLA faced during this pandemic that perhaps were different from those of other health systems?

JS: I think our whole community in Los Angeles, one of the challenges we had is we really went through two surges. We had the initial surge of patients. Then we were able to kind of get the numbers down and things under control. And then after the holidays we saw what was our biggest surge that really led to a lot of fatigue and exhaustion of our healthcare workers. And we were continuing to look at ways to really support them and to build resilience. Fortunately, we're on the other side of that now. And we're able to really manage our entire health system with being open for everything. Our workers have shown incredible resilience, but I think that was one of the most challenging parts, really having two surges that really taxed people.

Q: What do you think is a personal attribute that helped you get your health system through this situation?

JS: First of all, I was inspired every day by seeing the work that our staff were performing in order to care for all patients and to do that safely and effectively. I think the resilience quality, I think, having the stamina to continue every day to look for ways to really be able to proceed through this pandemic and do the work that we need to do for the community, but it definitely took a team effort. And I will say, I felt, in Los Angeles, all of our hospitals worked together and we worked so closely with LA County Public Health, with LA County EMS, with our mayor's office, so that we could really craft a plan that really supported everyone in the community. So it was a great time where you saw health systems really coming together for the overall good of the public.

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