Just like COVID-19 has done with so many other industries, hospital and medical care systems also have needed to bob and weave, since the entire world changed around March.
AdventHealth Zephyrhills and AdventHealth Dade City president/CEO Amanda Maggard outlined the medical community’s COVID-10 response — and what the future may hold for the pair of East Pasco hospitals that are part of one of the nation’s largest nonprofit health care systems.
“It has definitely been an interesting year, hasn’t it? 2020 is a year I don’t think we’ll soon forget,” Maggard said, as the opening speaker at the Zephyrhills Economic Summit, held on Oct. 14.
The hospital administrator detailed many of the initial challenges when COVID-19 cases spiked in March, during the event organized by the Greater Zephyrhills Chamber of Commerce, and convened at Zephyrhills City Hall.
A major issue involved procuring as much personal protective equipment (PPE) as possible.
“We have had a lot of PPE to serve, but COVID really escalated the amount and types of PPE that we needed,” the hospital executive said.
As a result, the hospital supply chain system has been forever altered. Now, it emphasizes partnerships on domestically produced PPE, while moving away from a just-in-time delivery model for such equipment and inventory, she explained.
In short, the pandemic offered “lessons learned” on how health care conglomerates handle and manage workforce, products, equipment and so on.
“We will never go back to operating our supply chain the way we did before COVID,” said Maggard, who’s had her role since 2017. “We have much more of an inventory across our system today than we did before, and that will stay.”
Since the pandemic touched down in the spring, hospitals have stopped many elective surgeries and procedures, including outpatient physical therapy.
Instead of laying off those employees, workers were re-deployed in any and every way possible. Some tasks included handling temperature checks, child care services, cafeteria and nutritional services, and even organizing fun activities for other team members, Maggard said.
“I’m so proud of the work that our team has done during this time,” she added.
Local hospitals are “continuing to learn and apply the latest clinical, evidence-based best practices, so we’re taking lessons from all of AdventHealth and around the country, and trying to apply those to make sure that we’re giving the best possible care to patients with COVID,” the hospital CEO said.
For example, the hospital is using Remdesivir, convalescent plasma therapy and “a number of other treatments, as we continue to learn and evolve,” Maggard said.
Remdesivir is a broad-spectrum antiviral medication; convalescent plasma therapy involves using blood from people who’ve recovered from an illness to help others recover.
Best practices to attack and treat COVID-19 have likewise involved ongoing learning because it began and still remains a relative unknown virus to the medical industry, Maggard said.
“We’ve been learning new things every day, and every week and every month,” she said, adding “guidance has changed, as the science has changed and evolved.”
The entire AdventHealth system actively monitors the volumes of COVID-19 cases throughout its various hospitals. The “biggest surge” of cases was seen in mid-July, Maggard said, adding: “It’s declined since then, (but) we saw a little bump up recently.”
Going forward, the hospital system is continuing its myriad health and safety protocols — such as markers on the floor to remind people to maintain six feet of social distance; temperature checks and screening everyone who enters the facilities every day; requiring masks; and regular deep cleanings throughout entire facilities, as well as other measures.
All patients who are COVID-19 positive, or suspected of being positive, are kept in a separate space — away from other patients — “to try to keep everyone safe,” she said.
Long-term health care consequences
A noteworthy consequence of the pandemic, Maggard said, is how many people have delayed routine or more serious health care issues — largely out of fear of going out to a public hospital or medical facility.
Between March and April, emergency rooms saw a 30% to 40% reduction in visits pertaining to heart attacks and strokes, Maggard said.
“The truth is, people were still having the same amount of heart attacks and strokes, but they were waiting and not coming to the ER,” Maggard said.
Because of those fear-driven consumer behavior changes, people who recently have been coming back to the hospital have more serious clinical issues, because they chose to delay care.
The same goes for routine screenings, primary care visits and procedures, such as colonoscopies, she added.
“My concern long-term with COVID is not just the immediate impact of COVID, but what is going to be the impact of health of folks around our country and around the world over the next few years, when we may have started to put off that routine care because we’re afraid to go be seen,” said Maggard.
“Don’t put your health care on hold. We want to continue to be here and not see your long-term health suffer because of not getting some of the screenings or preventative care that you may need today.
“If you’re experiencing any of those symptoms, you want to get into the hospital. We want to assure people that we are a safe place to be, we have a number of precautions in place to keep you safe, and we don’t want you to delay that care.”
Another related question is how newly jobless people will get their needed preventative services if they’ve been laid off and therefore lose their employer-sponsored health insurance.
“With the impact to the economy and the number of jobs being lost, what impact will that have in the coming 12 to 24 to 26 months?,” Maggard said.
Another looming question is how the hospital system’s financial losses amid the pandemic — due to postponing elective surgeries and decreased emergency room visits — will impact available capital in coming years. As a nonprofit, Maggard explained such capital would otherwise would be reinvested into the facilities for operating room expansions and technology and equipment upgrades to adequately serve in a growing community, such as East Pasco.
“There have been a number of financial losses,” Maggard said, “and that is something that we’re struggling with right now, is (how) our financial impact due to COVID is going to restrict the amount of capital we have available in these coming years,” she said.
Perhaps one of the positive developments in result of the pandemic is the increased accessibility and availability of telehealth services for physicians, primary care and even specialists.
Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies, allowing for long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions.
Simply, it allows patients to virtually see a physician or specialists without having to physically visit a hospital or medical office.
Telehealth, Maggard said, is “really, truly a positive thing in health care that could increase access for a number of folks.”
“That’s actually one of the really great things that has come out of COVID,” Maggard said. “The number of guidelines and allowances that came out from CMS (Centers for Medicare & Medicaid Services) are allowing more telehealth than we were able to do before, and we get reimbursed for that. I hope that’s something that stays out of COVID.”
Published November 04, 2020
