Stories: The path forward

The path forward

A conversation about recovery and reopening with our CEO, R. Guy Hudson, M.D., MBA, and Chief Operations Officer Jeffrey Robert

With the moratorium on elective procedures set to lift on May 18, we spoke to our CEO, R. Guy Hudson, M.D., MBA, and Chief Operations Officer, Jeffery Robert, to discuss what we learned from the COVID-19 pandemic, how our approach to care will change and—most important—how it will not.

The moratorium on elective procedures is set to lift on Monday. What will that mean for us?

JR: Up to this point, we have had a committee review cases to determine whether the procedures or surgeries should happen, based on whether we had enough staff, PPE and beds to accommodate patients. As of Monday, we’ll be able to greatly broaden the number of cases we see. So think in terms of non-emergent surgeries for heart conditions, as well as elective surgeries. With that, we are going to test all of these patients 48 hours prior to undergoing their procedure and surgery. Obviously if they test positive, we will defer the procedure or surgery.

Governor Inslee has announced a phased approach to reopening the state at large. What will our reopening process look like?

JR: Across our clinics and hospitals we will have a phased approach to getting patients back into the safest environments through the end of 2020.

GH: The other piece of that is the unknown. Can we anticipate the occasional spike in patients who are positive for COVID and need hospitalization? The answer is, yes, we are more than prepared for that. We have demonstrated that we were able to be flexible in meeting the community’s needs under the first surge, so we are quite confident that we can meet that need in the event of a second surge.

Speaking of meeting the community’s needs, we have been working with the state and other hospitals to coordinate our response. What is an example of how that relationship has guided our response?

GH: A perfect example of that is the Regional COVID Command Center, or what they call the RC3, where hospital leadership in the western part of the state coordinated a sophisticated response and worked to support one another.

JR: Let’s say a nursing home has a significant number of COVID-positive patients—maybe 20. Instead of all of those patients showing up at one hospital—as they did at Evergreen at the beginning of this outbreak—the RC3 will parcel those out to prevent any one hospital from getting maxed out.

GH: In other words, you are seeing a much more sophisticated response, similar to what might happen in a natural disaster, where all of the health care systems are acting as one—as opposed to being left to survive on their own.

Jeffrey Robert

What have we learned from this experience?

JR: We deal with infectious diseases all the time, but this was an infectious disease with unknown characteristics. We had no idea how contagious it was; it wasn’t until after we were already responding to it that we learned patients could shed the disease before becoming symptomatic.

So I was inordinately impressed by our ability to evolve our clinical capabilities in response. As we better understood the disease, we were able to quickly define our policies and procedures, as far as infection control and ensuring that our staff would be safe while caring for these patients.

GH: Given the limited access to testing and PPE early on, we relied heavily on local manufacturers and international contacts who were able to provide PPE. Were we ready for this? I would say that everyone stepped up to the plate and did an admirable job of caring for our patients.

JR: Not all enterprises in the state—or the nation, for that matter—had access to that robust supply chain that Dr. Hudson mentioned.

GH: We were very fortunate. In fact, we received a delivery of ventilators from FEMA in early April. But based on our circumstances, we were able to donate 118 of them to New York City.

In what ways will this experience change our overall approach to caring for the community in the months and years ahead?

GH: Swedish has been a leader in telehealth which began with TeleStroke years ago, but this pandemic has certainly driven it and virtual-based care to a new level, in regards to serving patients across various geographies. But along with that, you’re going to see a continuation of that collaboration that we just discussed. Situations like this require health care organizations to partner across geographies.

For example, right now we’re sharing a large amount of COVID-related data with other institutions so that we not only have apples-to-apples comparisons about how we care for and treat patients, but we also stay on the same page with state-of-the-art care.

What won’t change?

GH: We are still going to be here. And we are still going to treat every person, regardless of their ability to pay. We are going to serve our communities—it is what we do as a not-for-profit health care organization.

For up-to-date info on services available to you at Swedish as we continue to navigate the COVID-19 pandemic, visit our hub for coronavirus resources.