Healthcare organizations face many crises. That is what we do every day. The COVID-19 pandemic, however, is extraordinary. It has caused one of the most challenging times—if not the most challenging time—in history. The pandemic continues to demonstrate healthcare’s vulnerabilities and is a force with such strength that it affects all aspects of care.
Many providers have recovered from the initial impact and are in the recovery phase (albeit in fits and starts), reshaping the delivery of care; others still need to start their recovery and evaluate their operations. Is this a turning point in healthcare? Will organizations make profound changes in the provision of services, producing value with quality outcomes and cost-effectiveness? Opportunities now abound to innovate and disrupt the traditional ways care is provided and services are reimbursed. It is imperative for organizations to move forward from a precarious state and develop stronger systems for their communities.
The authors in this special issue of Frontiers of Health Services Management provide a variety of compelling perspectives and critical information on how they have addressed key issues while living through this crisis thus far. They share their insights on disruption and innovation, restoration of patients’ trust, workforce resilience, continuing care for older adults, the supply chain, lessons from Superstorm Sandy, inner city and rural hardships, and the supporting role of the US military. They share how they are responding to the coronavirus and navigating toward recovery, implementing changes and discovering innovations along the way.
Montefiore Health System in New York is accelerating innovation by applying the principles of “creative destruction.” Jeffrey B. Short, vice president and chief of staff, and Adrin Mammen, FACHE, associate vice president and patient access transformation officer, explain the idea: “Organizations respond to disruption by destroying existing processes or embracing the destruction of the present to encourage new alternatives.”
Ghazala Q. Sharieff, MD, chief medical officer for clinical excellence and experience at Scripps Health in San Diego, California, believes that restoring and sustaining the trust of patients cannot be overemphasized in healthcare’s response to and recovery from the COVID-19 pandemic. She articulates Scripps Health’s approach: “By demonstrating that we are not rushing to offer services but are returning to them thoughtfully and carefully, we build trust.”
Concern for the caregivers also deserves thoughtful consideration. “In healthcare, we train for emergencies,” writes Katie M. Owens, CEO of the Healthcare Experience Foundation. “We practice drills, tasks, and incident command system protocols.” However, she adds, “We have not adequately prepared our workforce for COVID-19.” She shares what she has learned from stressed, sometimes fearful, caregivers and tells how their leaders can respond with compassion.
No population is more vulnerable to the deadly impact of the coronavirus than the elderly. Balancing safety with the significant loss of socialization continues to challenge them and Trinity Health, which serves older adults across the United States. John Capasso, executive vice president of Trinity Health and president of Trinity Health’s Continuing Care, is guided by a commitment to the established corporate value of reverence, which, he explains, “calls us to honor the sacredness and dignity of every person.”
The US Army’s prevent, detect, and treat model serves as a practical framework for planning, coordinating, and responding to major public health emergencies, say LTC Jarrod McGee, FACHE, and COL Tracy Michael, FACHE. They share recent frontline experiences in combining those three prongs into New York City’s response to the COVID-19 pandemic. Their mission showed how military, civilian, and other government agencies can conduct joint operations on short notice. “Pandemics require a whole-of-nation approach,” the authors advise.
COVID-19 has demonstrated that if the supply chain cannot provide the necessary resources for patient care, a critical situation arises. “Despite the difficulties, our organization benefited from many bright spots in the supply chain that lightened the impact of this pandemic,” James R. Francis, FACHE, chair of supply chain management at Mayo Clinic in Rochester, Minnesota, writes. However, COVID-19 evidenced how fragile the healthcare supply chain can become in a few short weeks. He shares many key issues to address in advance of future emergencies.
Maxine dellaBadia Simon, FACHE, contributes valuable lessons learned from Superstorm Sandy as applied to COVID-19 at NYU Langone Health in New York City. She sums up these lessons as preparation, organization, and innovation. NYU Langone was prepared for the worst-case scenario. “We have reaffirmed that the dedication of our staff, layered upon the infrastructure of a solid organization and an established culture of innovation, can meet the challenges,” Simon writes.
When the pandemic struck, Roseland Community Hospital in Chicago, Illinois, had been teetering on the brink of insolvency for years in one of the city’s poorest and most violent neighborhoods. President and CEO Tim Egan remains resolute in finding ways to overcome shortfalls and setbacks to help the hospital and its community survive COVID-19. Meanwhile, Tuba City Regional Health Care Corporation serves three tribes throughout 6,000 square miles in Arizona. “We are independent but cannot and do not work alone,” notes CEO Lynette Bonar, RN, FACHE. Egan and Bonar describe how special community connections have helped their small hospitals respond to urgent local needs in the face of the pandemic.