If COVID has caused added stress for the average family this year, it has had exponential effects on the medical community. Valley hospitals say they are proud of how they have weathered this unprecedented storm, and reflect on some lessons learned and new innovations that they will carry with them well into the future.

“We’ve learned a lot throughout the COVID-19 pandemic,” said Dr. Rosemary Leeming, chief medical officer for Geisinger Medical Center. “While the pandemic did upend the American healthcare system, it also gave hospitals and health systems the unique opportunity to innovate.”

Innovative care

At Geisinger, a new focus on telehealth visits and their mail-order pharmacy helped them to continue providing necessary care for their patients.

“We already had some telemedicine programs built out before COVID hit our communities,” she said, “but the pandemic accelerated the adoption of the technology by our patients and we’ve expanded it to every specialty. Many patients, including seniors, enjoy telemedicine as it is quicky and easy.”

With social distancing and quarantine, Leeming said their mail-order pharmacy service “exploded”, and additional benefits were discovered.

“We have found that patients who receive prescriptions through this channel have nearly 40 percent higher rates of medication adherence,” she said.

Leeming said they plan to continue telemedicine and the mail-order pharmacy even after the pandemic subsides.

Kendra Aucker, president and chief executive officer of Evangelical Community Hospital, said they, too, have realized the value of telemedicine after seeing how it allowed them to continue helping people during the pandemic – particularly those who were hesitant to seek care so as not to expose themselves. Now, looking to the future, Aucker said they plan to continue utilizing telemedicine.

“It doesn’t matter whether there is a pandemic or not,” she said. “People have difficulty with mobility or transportation when it comes to access to care.” Seeing how well it can work, Aucker said they plan to continue evaluating where its use is most effective.

At Evangelical, they also saw a benefit in evaluating who needed to show up to the office, and who didn’t.

“We’ve learned there are so many jobs that can be done remotely and can actually save money and space by allowing people to work remotely,” Aucker said. Working where you live, versus living where you work, she said, “nationally is a big conversation.”

When the pandemic struck, Evangelical Community Hospital was also in a unique position of being in the middle of opening up a new addition. In response to the growing need for isolation rooms that the pandemic revealed, Aucker said they were able to adapt the plans to add more. They opened the addition in November, just as COVID numbers began to rise again.

Managing resources

Hospitals also learned to better address the managing of resources – in particular, personal protective equipment for staff.

In his job as medical director of Infectious Diseases at UPMC in the Susquehanna Region, Dr. Rutul Dalal said he and his staff were not overwhelmed by news of COVID-19. They were well aware of the previously existing strains of coronavirus, how it spreads, and how robust it could be, as well as how it can be killed. They also knew better than most the importance of hand washing, sanitizing, and mask wearing, to get it under control.

But one thing they did learn through the pandemic response was the need to ration supplies.

“Initially, we did not know the magnitude of the problem,” Dalal said, “so we started using our resources very quickly, rushing through too quickly.” They eventually began reusing equipment and recycling N-95 masks, and conserving masks and gloves.

Now, as they prepare to respond to a second wave, “We will definitely be better prepared,” he said. “It has been drilled into healthcare workers how to conserve – using sparingly and using for the right patients.”

Aucker said at Evangelical they also learned that they can’t fully rely on the strategic national stockpile of critical equipment and supplies.

“We learned very quickly as a small organization that we’re pretty much on our own. Yes, the state and federal government is there, but initially you don’t know how long it’s going to take for action to be taken.”

Aucker said they learned it’s better to stay connected with local government officials whose interest is much more focused on local needs. They have also become better prepared to manage what resources they do have and to build relationships with vendors and other suppliers whom they can deal with directly.

The pandemic also stretched the hospital to prepare for this unique kind of emergency.

“We practice all the time how to respond to mass casualty pileups on Route 80, and hospital evacuations,” Aucker said. “Preparedness for a pandemic is an entirely different thing.” She said they learned that at a moments’ notice staff may need to be reassigned, and they may need to create separate areas to deal with COVID, even spaces outside of the hospital – such as their alternative testing site that drew many, many people. Those numbers again have risen to about 350 a day over the last six to seven weeks.

“When you have to react and think out of the box and really expand your resources, we have a tremendous ability to do that,” Aucker said.

Healthcare workers praised

None of the local medical response could have been possible without the unified and tireless efforts of medical staff.

“I’m proud of our whole team at Geisinger for acting quickly, making adjustments, and always keeping the patients at the center of our care,” Leeming said.

She had always known about their commitment, but she said it was “on full display during the pandemic”.

“They have been stretched to the max over this past year, especially these past few weeks as our numbers locally have risen,” she said. “They are tired and stressed, but they are here each day for those who need them. I, and our community, cannot thank them enough for all they do.”

Dalal said he has also been encouraged to see how UPMC employees have also worked hard to help one another, and to keep pressing through the fatigue that this long pandemic has undoubtedly created. They have been uplifted by the outpouring of support from the community and their patients.

“This will not be the last virus we are ever going to see in our lifetime,” Dalal said, adding that while “things are changing” and the “world is getting smaller”, there is one thing that he is sure will remain steady: “the indomitable spirit of our healthcare workers”. Even when they sacrificed time with their own families, or struggled to find childcare, and the strong chance of contracting the virus on the frontlines.

Leeming said she and the rest of the Geisinger staff has learned to appreciate the important things, like family and friends, as well as “the kindness of people – like our staff caring for patients like family when their own families couldn’t be there.

“And we’ve learned that each day is a gift, not to be taken for granted.”

Aucker has been proud to watch the Evangelical workforce meet the challenges head-on.

“You enter healthcare to help take care of others,” she said. “There’s a culture of being a family and caring for everyone.” She said she saw that in action, especially in 2020.

In the meantime, Aucker said they are responding better to the mental and emotional health needs of their workers – something that COVID especially revealed the need for.

“They have an inordinate amount of stress at work, and we are taking care of them appropriately,” she said.

Looking to the future

Now, with better understanding of the virus, a new vaccine that’s being rolled out, and knowing the importance of people to continue social distancing and using proper hygiene practices, medical professionals see hope for the future – more so than they may have admittedly seen nine months ago.

Aucker said they have learned to treat patients with a ventilator as a last resort, rather than a first, and have been encouraged to see how many people do actually recover from the illness. Now, as they continue to learn more about the virus, they are also continuing to monitor the new vaccine and collect data, such as how long immunity lasts.

Dalal continues to stress the importance of a community effort to irradicate the disease. Much of his work is focused on educating the public about infectious disease, and so he has spent much time in the past months talking with local colleges, school districts, and the community as a whole. Going into the holidays, he continues to urge people to do all they can to prevent spikes in virus cases. Even with the vaccine, he said, “I don’t see anything will get better or normal until spring of next year.”

“Once life is lost, it is irreplaceable,” he said, encouraging people to just keep following protocols for a few more months. “There’s always going to be another Christmas, another New Year’s. There’s light at the end of the tunnel.”

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