COVID-19: How one of Northern California’s largest health systems is responding to the crisis

Editor’s note: This episode of the MGMA Insights podcast continues a series focused on COVID-19 and its effects on healthcare professionals and their patients. Keep up with the latest updates by visiting the MGMA COVID-19 Federal Assistance and Advocacy Center.

In responding to the COVID-19 pandemic, Peter Valenzuela, MD, MBA, CMPE, chief medical officer, Sutter Medical Group of the Redwoods, says that his group’s responses to Northern California wildfires have made being prepared for the worst a priority for Sutter's practice leaders.

“This ain't our first rodeo,” noted Valenzuela, whose acceptance of the 2017 Harry Harwick Innovation Award was cut short by what was then the deadliest week of wildfires in California history. This time around, Valenzuela’s team at Sutter is responding to COVID-19 patients from a cruise ship as well as the general public, all while the effects of the pandemic take a toll on the community where the Sutter team — about 125 multispecialty physicians and clinicians supported by about 450 staff members — lives and works.

“There’s a lot of alarm in the community,” Valenzuela said. “The good news is that we have experience with this, we’ve dealt with these types of situations before.”

Valenzuela said that Sutter's incident command team — comprised of physician and operational leaders — activated to coordinate with the Sutter system’s larger emergency management team. “We have calls every morning at 7 a.m. … We talk about whether there's any new cases, whether we have any [personal protective equipment], and then whether there's anybody out on furloughs or out on leave secondary to this COVID-19 situation. I think it's keeping everybody on the same level as far as what we're doing and what our plans are.”

Setting up a COVID clinic, gathering supplies

In terms of PPE, Valenzuela acknowledges that the Sutter team had a lot of N-95 masks from past wildfires to use in the COVID-19 response, which has included dedicating a specific location for patients who may have been exposed.

“We set up an actual COVID clinic, where we screen out patients who answer positively to the screening questions,” Valenzuela said. “We redirect them to a separate clinic … where we do nothing but COVID-19 screening,” which helps control the use of testing kits and PPE in a single site, minimizing risk for other care center sites in operation for other patients, with staff from some care centers shifting to clinics with the highest need.

Valenzuela gives special credit to Sutter Health of the Redwoods infectious disease expert Gary M. Green, MD, who has educated staff members at the COVID-19 clinic and performed tests, sometimes via patient in-car testing. Valenzuela noted that some private labs that have developed testing kits have helped them test patients faster.

Yesterday, we stood up our drive-thru COVID/Respiratory clinic. As the CMO of our medical group, I volunteered to be the first doctor to work in the clinic and test our new process. It's during these turbulent times that I'm grateful to be a physician pic.twitter.com/XBwC8yox02

— Doc Related (@Doc_Related) March 19, 2020

Education to allay fears

As part of educating the staff, Green has been creating videos for Sutter physicians and staff to have an update on COVID-19 and what to look for in day-to-day care. “He’s done such a great job of allaying that fear for our leaders and our staff,” Valenzuela said. “It’s really helped them to understand that we can take care of our patients in the proper way, without fear of something more serious happening to ourselves to our families.”

To help patients understand how best to respond personally amid the pandemic, Valenzuela said the Sutter team has used messaging via the EHR system to educate and offer advice in addition to answering questions. “We’ve dedicated a nurse triage line to help patients answer those questions and to let them know whether they’re at high risk,” he added.

Despite the seemingly strong response to the pandemic thus far, Valenzuela acknowledges that the circumstances are very different.

“The benefit with the fires for us was that we knew that eventually it was going to come to an end, and then we would be able to start up again,” Valenzuela said. With COVID-19, “we don't know when we're going to reach a peak and when it's going to come down. So that's part of what the fear is with people — is this just going to be a one- or two-week thing or is it a three- to four-month thing? And it's a little early to answer that.”

That’s why communication remains one of the top issues. “Make sure that you continue to communicate with your people regularly, because they’re going to be depending on you to provide them updates,” Valenzuela said. “If you don’t have a proper chain of communication, it’s going to continue to contribute to this fear that’s going on.”

Additional resources:

• MGMA COVID-19 Recovery Center
• CDC: Coronavirus Disease 2019 (COVID-19)
• World Health Organization: Coronavirus disease (COVID-19) outbreak
• Insights: Wildfires, comic strip keep Northern California healthcare executive on his toes
• Tragedy at home takes precedence for 2017 Harwick Award winner

Additional resources in this series:

• COVID-19 Update: An action plan for medical practices and healthcare professionals
• 'COVID-19 has pretty much taken over my life': A practice administrator's perspective
• COVID-19: What healthcare leaders need to know about telehealth and the CMS policy changes
• COVID-19: Flattening the curve for America's elderly patients through quarantine and isolation
• COVID-19: Did the healthcare system let down providers fighting on the front line?
• COVID-19: Keeping ‘a unified voice’ across a multispecialty clinic’s operations during the pandemic
• COVID-19: Practicing self-compassion and leadership under pressure during a crisis

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Credits

MGMA Insights is presented by Decklan McGee, Rob Ketcham and Daniel Williams.

Thanks to Biome, Midmark and SR Health by Solutionreach for sponsoring this episode of MGMA Insights.

• To learn about how the Biome solution, powered by artificial and augmented intelligence, can improve your cardiovascular service line’s performance today, visit biome.io/solutions.
• For more on how Midmark is transforming healthcare delivery through their real-time locating system, visit midmarkRTLS.com. You can also click here to check out Midmark’s recent on-demand webinar titled “Outpatient Design: Using Data to Improve Patient Access and Satisfaction,” which is eligible for ACMPE, ACHE and CEU credits.
• To explore how SR Health by Solutionreach can help improve your organization’s healthcare communication, visit srhealth.com. You can also click here to register for their upcoming MGMA seminar titled “Taking Patient Text Messaging to the Next Level with A.I. and Other Tech,” which is eligible for ACMPE, ACHE and CEU credits.