Becker's Hospital Review

30 POPULATION HEALTH 30 CEO / STRATEGY How hospitals are preparing for future public health crises By Kelly Gooch T he COVID-19 pandemic has tested hospitals' disaster pre- paredness plans and prompted them to assess crucial areas to prepare for future health crises. Some have strengthened part- nerships with local organizations, invested in diagnostic testing plat- forms, and updated workflows and oxygen infrastructure. To dive deeper into how organizations are planning for another pan- demic or public health crisis, Becker's Hospital Review asked hospi- tal and health system leaders to share steps they've taken. Below are their answers: Editor's note: Responses were lightly edited for length and clarity. Nick Duncan. Director of Emergency Management at Tus Med- ical Center (Boston): As a result of the coronavirus pandemic, we have a better institutional knowledge of the hospital incident com- mand structure, to be better prepared to organize ourselves and as- sign leaders roles when faced with a crisis. We have developed stron- ger connections with our local partners and city of Boston agencies to help respond to, and prepare for, events. We also have better capa- bility to engage our neighbors more frequently when things arise and address concerns before they become a problem. As a health system, we are more coordinated than ever and can transfer supplies and re- sources across sites daily, if needed. We now have a warehouse to help stockpile and serve as a central distribution site for key resources. We also have constructed multiple testing and vaccination sites, which can be called a point of dispensing, which are critical to public health responses. We have more leadership depth and have streamlined our communication. Finally, we have operated a command center for months at a time with staff who have the skills to step in so others have a chance to rest. For all these reasons, this crisis has helped us be much better prepared for the next one. John Fox. President and CEO of Beaumont Health (Southfield, Mich.): We believe society's greatest public health risk remains an on- going or a new viral or bacterial infectious disease outbreak. Further, COVID-19 remains at significant risk for becoming endemic to hu- mans, like influenza, requiring ongoing annual vaccine management rather than ultimate eradication. To mitigate these risks, Beaumont has built a strategic large-scale inventory of necessary personal pro- tective equipment for our healthcare teams and has 2 million vacci- nation syringes in reserve. Further, we have invested in multiple diag- nostic testing platforms utilizing both polymerase chain reaction and serological testing capabilities. All of the above need to be reviewed regularly for relevance and periodic adjustment. Laura Iavicoli, MD. Director of Emergency Management at NYC Health + Hospitals (New York City): Being a network of 11 hos- pitals was considered one of our strongest assets to respond to the COVID-19 pandemic, especially during surges. But while we had the flexibility of space, staff and resources throughout our facilities, co- ordination wouldn't have been possible without intricate and diverse modes of communicating between facilities and to our workforce of more than 40,000 brave hospital workers. During the first COVID-19 surge in the spring of 2020, NYC Health + Hospitals built up report- ing tools to help share data between facilities on staffing, patient vol- umes and surge capacity. At the first signs of the spring 2020 surge, we established systemwide briefing calls with our emergency management teams, chief medi- cal and nursing teams, CEOs, communications directors, and more to bring all executives up to speed on where the system was capac- ity-wise and what surge plans were being activated. Additionally, central office leadership has daily planning meetings as well as daily logistics meetings to plan internally. We also established new work- flows to update our employees-only Intranet page to house updated policies and guidance, as well as resources to ensure our workforce felt supported and had access to important amenities in real time. We established a weekly, live COVID-19 webinar, which created a two-way conversation between executives and staff. And we lever- aged our mass notification systems to push out urgent messages to all staff when immediate updates were deemed urgent. Our expanded communication tools allowed New York City's public hospital system to work more as one unified, cohesive network of hospitals than we already were before the pandemic, helping to save more lives. Tami Minnier, MSN, RN. Chief Quality Officer of UPMC (Pitts- burgh): is pandemic has created heavy demand for the use of high-flow oxygen to treat COVID-19 patients, highlighting the criti- cal importance of our oxygen infrastructure, which we took for grant- ed before. Before the recent peaks in COVID-19 hospitalizations, our maintenance team proactively inventoried our oxygen systems across our 40-plus hospitals and deliberately strengthened that infrastruc- ture — even drawing on lessons learned from our facilities in Italy. For instance, every facilities director now receives a daily report that gives the information necessary to proactively monitor and adjust the incoming pressures to avoid failures or interruption of oxygen flow to patients. And we've added multiple and redundant regulators on the incoming bulk oxygen feeds. ese changes and others have ensured that we've had no service interruptions and that we're well-prepared to care for patients long aer this pandemic is over. n CVS to reduce office space by 30% By Morgan Haefner C VS Health plans to reduce its office space by 30 percent as part of a cost-savings initiative, Eva Boratto, the company's CFO and executive vice president, said during a Feb. 16 earnings call. The change is the result of the COVID-19 pandemic and workforce management changes, Ms. Boratto said. The reduction in office space, in addition to an ongo- ing digitization of CVS' business, technology improve- ments and operational efficiency initiatives, will help CVS save between $900 million and $1.1 billion in 2021, Ms. Boratto said. n

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