In 1918, healthcare was up towards an influenza pandemic that claimed the lives of hundreds of thousands of individuals worldwide. 100 years later, hospitals and suppliers are scuffling with challenges created by this century’s pandemic, COVID-19.

The hospital system I lead skilled a few 50% lower in income throughout the pandemic’s peak earlier this 12 months, together with elevated working prices, as we established new respiratory clinics and particular isolation models to fulfill affected person wants. We additionally noticed will increase within the use and price of non-public protecting tools and different provides. We quickly decreased the salaries of our leaders and physicians by as a lot as 20% and furloughed different workforce members. 

Classes discovered throughout the 1918 influenza pandemic are related as we deal with this ongoing public well being disaster—particularly, that one of the best medical care comes from interdisciplinary collaboration. This idea stems from my group’s beginnings in 1920 when three physicians, motivated partially by the worldwide flu pandemic, created a bunch follow with all medical specialists beneath one roof. This was the beginning of Virginia Mason Well being System and our embrace of “workforce drugs.”

Reflecting on our 100-year historical past and navigating the current actuality, there have been key classes foundational to our work which have been examined and affirmed by COVID-19. 

Make use of systems-engineering: We rapidly retooled operations as a part of our response to COVID-19, together with evaluating workflows to make sure we defend all sufferers and workforce members. These advanced pivots have been guided by our administration methodology, the Virginia Mason Manufacturing System. Adopted in 2002 and modeled after the Toyota Manufacturing System, VMPS provides our workforce members a typical terminology for outlining obstacles and normal processes for innovation and resolution improvement. 

The method guided a nurse-led, companion-support program to facilitate end-of-life household visits with COVID-19 sufferers—one thing that wasn’t provided in lots of hospitals. Whereas it was necessary for guests to comply with our PPE and security protocols, it was additionally vital for us to offer a protected setting during which members of the family might say goodbye.

Leverage interdisciplinary groups: From expertise, we all know that we work greatest as an built-in workforce of physicians, nurses, superior practitioners, pharmacists, technologists and different specialists. This method, during which individuals constantly share what they’re doing, seeing and studying, drives collaboration and care supply that’s applicable, coordinated and patient-centered. Throughout the pandemic, this has enabled us to rapidly and brazenly deal with organizationwide challenges associated to affected person care, staffing and provide chain. For instance, now we have used kaizen occasions—quick workshops targeted on enhancing a selected course of—to arrange new respiratory clinics and isolation models, decide staffing ratios and virtual-care platforms. With digital care, we have been already on a multiyear trajectory that was expedited. Now now we have televideo functionality throughout the enterprise, together with integration into surgical care with preoperative screening and postoperative visits.

Decide to steady enchancment: Initially of the COVID-19 outbreak, we anticipated a decline in income and the have to be modern with staffing and cost-saving measures. In April, we developed a plan to quickly consolidate our outpatient clinics to half as many websites. 

We have been additionally artistic with staffing roles, together with asking some workforce members from anesthesiology, hospital drugs and surgical procedure to step into critical-care roles in response to altering affected person wants. For the beforehand talked about companion-support program to facilitate ultimate household visits with COVID-19 sufferers, leaders reached out to nurses throughout ambulatory areas—a few of whom have been on furlough—and recognized those that have been keen and wanting to take part.

Whereas it’s not potential to totally put together for a pandemic, suppliers can be taught from one another to make sure we ship the most secure, highest-quality care irrespective of the circumstances. Even when occasions evolve day by day or hourly, leaders ought to be taught and adapt, lean into change, and attempt to be higher tomorrow than at this time.



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