Albany, Georgia was the fourth highest hotspot in the world for COVID-19 cases back in 2020, and Phoebe Putney was at the center of what was happening. How did they pivot for this crisis? What innovations can they share? Find out here.
Part 1: Navigating the disaster response challenges of COVID-19.
Part 2: Vaccination strategy.
With special guests CMIO Dr. William Sewell, and VP and CIO Jesse Diaz, from Phoebe Putney Health System
Title: Navigating The Disaster Response Challenges Of COVID-19
Guests:
Jesse Diaz, VP and CIO, Phoebe Putney Health System
Dr. William Sewell, CMIO, Phoebe Putney Health System
Host: Christine Parent, Associate Vice President, MEDITECH
Jesse: This is different in a hurricane. It's different in a tornado. This didn't just come and go. You know we had to kind of invent the wheel.
Christine: Hello and welcome. I'm Christine Parent, Associate Vice President at MEDITECH, the leader in healthcare technology. Empowering you to be a more informed healthcare consumer and provider and I'm excited to be your host for our new MEDITECH podcast series. Where you’ll hear the latest from our friends and colleagues in the U.S., Canada and abroad on topics we think you should know about. Be sure to subscribe to hear our latest podcast.
Recently, I sat down with Phoebe Putney Health System, a not-for-profit network in the state of Georgia. Back in 2020, Albany, Georgia was the fourth highest hot spot in the world for Covid 19 cases and Phoebe Putney was at the center of what was happening. How did they pivot from this crisis? What innovations can they share? That's what we're here to talk about today.
I'm joined by Jesse Diaz who has been the VP and CIO at Phoebe Putney for the past 14 years. Jesse is a certified professional in health information management systems with more than 34 years in healthcare experience. I'm also honored to introduce Dr. William Sewell. He has been the CMIO for Phoebe Putney since the end of 2014. He is also the Medical Director of Phoebe Putney's Women and Children Services and the Medical Director of Phoebe Health Partners, a physician hospital organization.
How do you even begin to prepare for something like that? Jesse, Why don't we start with you.
Jesse: We have had experience with natural disasters so in the last starting and I think 2017, we had cross-line winds. We had a tornado come through town, did a lot of damage, a lot of destruction. We had a hurricane, Hurricane Michael came through and all throughout every one of these we had some type of damage to our campus and we stood up our command center that deals with these types of disasters. We practice these things at least once or twice a year. And so when Covid hit, we were well prepared to stand up our command center and our incident command center and start planning, the planning process for what we had to do. So you know, things like PPE staffing, all these things that we had to get ready to have to do, inventories on, to figure out. Are we prepared enough?
We've just got our first patient, this could really turn bad and it did. Our senior leadership really met all day long, every day, 24 hours a day and they were in our main boardroom which became the command center. We took stock of the things we had, like PPE and we thought we had enough for months and months and months but that was at the rate we used it before. We didn't realize, as we got this big influx of patients, the amount of PPE, we would use how quickly we went through about five months worth I think in about two weeks, something to that effect. It was pretty bad.
So we did have the, I guess, the framework, the infrastructure in place as a leadership group, as a disaster response team to be able to handle these things. But you know, this is different in a hurricane. It's different in a tornado. There's a much different situation. This didn't just come and go. So we had to figure out how to kind of invent the wheel sort of speak. How do you respond to this ongoing situation that's going to last for months and months and months and we didn't know when we're going to see the light at the end of the tunnel.
Dr. Sewell: We had never faced anything like this before. Nobody had, nobody who's alive pretty much had, and so our regular playbook, let's call it, it didn't apply. This one just seemed to get worse and worse and worse day by day until, you know, we peaked out with 150, 160 Covid patients in our hospital at one point and that's pretty busy.
As everybody knows, these patients are pretty sick on the medical side, the clinical side, we didn't really know how to treat them very well. We knew they had adult respiratory stress syndrome but it didn't look like anything we'd ever seen. So the physicians were, you know, racking their brains working hard. The administration was doing the best they could to support them. What about the PPE? You know we did think we had five and a half months supply and at a normal burn rate, we would have. But with these very sick patients where you change your PPE very often, maybe every encounter, we burn through that five and a half months worth in about 10 days or so and never ran out of PPE but we got within a couple of days, we quickly learned how to inventory that and create a new burn rate, a new Covid burn rate.
You know, we figured it out and we stayed ahead but it got pretty close there sometimes and that starts to take an emotional toll on you, on everybody. Are we going to be able to protect ourselves? How do you even protect yourself from this? And when you're seeing, you know a large percent of the patients get hospitalized and then what is in normal terms a large percent of those dying you don't know that you're not going to contract this disease. We have no way to treat it. So it takes some real fortitude just to keep coming to work every day but our staff was amazing. You know they were, they voiced some of those concerns but not enough they weren't coming. Just we need to be protected. We need to be taken care of and you know we've seen that all over the nation. So we're no different down here. We were just hit and hit early by this pandemic.
Christine: Definitely something we did not anticipate and you know the fortitude that your staff had in dealing with the early Covid patients and symptoms is incredible. Let's talk a little bit. You talked about space and you talked about your volumes. So how were you able to provide space in bed so quickly to meet your needs? Like how were your staff affected with the surge of the patients? And did you get to bring in care providers from any other outside systems? How did you assimilate them to your processes and systems relatively overnight? I don't know if this is more of a question for Dr Sewell to start off with but you know how were you able to pivot so quickly?
Dr. Sewell: Just like everybody, you shut down all non-essential services. You know, there's no more elective surgeries and those kinds of things. You convert your normal medical med surge units over to Covid units. Quickly, your ICU fills up. I remember ventilators being an issue. Also, we never ran out of ventilators but we got very close, once again, and then but it didn't take long. It seemed long because you're the one down here, you know trying to do the best you can for your patients. But it probably took three or four days there where it was a little close and then we started receiving a lot of support from the state, including ventilators so that helped.
Luckily, we had a hospital a mile and a half from our main campus that the system had purchased about 10 years prior and it was continuing to function but it did not have a lot going on down there and so we were able to re-up, reinstitute, redeploy those beds and turn them and it did have an ICU that had been closed but we reopened that ICU, reopened a couple of floors. The state even came in and built us a 24 bed modular unit and that basically is shipping containers that are all bolted together but they wound up giving us another 22 bed or so capacity.
We received some staffing help from the state. They hired a company that was able to help us with some physicians, respiratory therapists, some lab personnel, all of which we absolutely needed. And we even converted the post anesthesia care unit, the PACU, one end of it. Since we weren't doing our normal surgery volume, we converted one end of it into a non-Covid unit. It had all the proper gas lines and suction and things that you need and so we converted one end of it into a 10-bed non-Covid ICU and that functioned very well.
But I wish you all could have been here. It was amazing to see how planops, biomed, information services was able to turn that around so quickly and our EMR just handled it without question. I mean it was built solidly and we just deployed it right away and asked it to do the same things it had been doing. It went very smoothly, probably that conversion maybe took 36 hours, maybe not even that long. The other point about the EMR is all these folks that you bring in, you have to train them. You have to get them used to the Phoebe way and it was amazing how well they could pick up what we had built and what we were doing here.
Christine: That's really an incredible story and it sounds like you had a lot of state support during this time and I love the concept of all of your departments really coming together to solve these complex issues and creatively come together. I know the community of Albany, Georgia had a big role in supporting your organization during this time, really helping staff push through this crisis both with physical and emotional support. When you reflect back on the support that you received and how the community came together, what resonates most with you at this time?
Jesse: The community realized the importance of a hospital like this, an organization like this, how great it was to have it in its backyard because the community was hurting. This is one of the worst places in the world in terms of per capita disease and they saw the value of having an organization like Phoebe.
Dr. Sewell: We have live oaks down many of the streets we drive down to get to work, been here hundreds of years and there were red ribbons tied around each of those live oaks and that really, that really spoke to you when you were driving to work every day. There were a few times that some of the churches came in the evenings and they were all parked around, drove around the hospital and parked around the hospital with their lights on, flashers on and were just praying for us. That was very moving and very strong, makes you feel like we were going to make it.
The other thing I noticed through this all was how resourceful our employees are. You know, we're not going to break our arms, pat ourselves on the back, but I think we have a pretty good team around here. But this sort of proved it. This sort of made them, you know, earn their keep. Just continually coming up with innovative ways to do these things. The fun camp, something we've done in the summer for the kids, you know for the same reason so that their moms and dads could come to work but we since the kids were getting now an extended summer, an unexpected immediate summer you know somebody just thought and it was in HR but said hey we just need to start the fun camp now in April instead of in May. And so the fun camp ran for a while like that.
The masks, that was actually our CEO's idea. He wound up on CNN talking about it and the entire medical records department. Of all people, who would have thought they knew how to sew but a lot of those ladies knew how to sew and we wound up making over 30,000 masks. It's just amazing how people were able to step up and do things they didn't usually do. While there was a real emotional time going on, folks were scared, they didn't know. They're worried about their loved ones. They were worried about themselves. Was this ever going to end? All of that was going on but it was almost an excitement. You know how when you're at work and you get to do something that's not in the routine, something you don't do every day. You actually get excited about that. Well these people were excited to be doing something different. But more than that, they were excited to be contributing, to being able to help everybody to a person everybody here wanted to help in whatever way they could and I just that just makes you feel good to work here.
Christine: Well those are incredible stories and you know they always say that health systems really are the heart of the community and so the community really came out to support you during this time. And I have to agree with you, Dr. Sewell, that fun camp sounded pretty good. Especially if you're a parent and you know that your child is being well taken care of, you can focus on the task at hand. So well done.
Thanks for listening. Next time, we'll continue our conversation with Jesse and Dr. Sewell to hear about their vaccination strategy and community outreach. Stay informed and subscribe to MEDITECH podcasts and be sure to check out our resource page for links from this episode. We'll talk to you next time.