By: Max Crampton-Thomas
2 min read April 2020 —Jefferson Health is a multistate, nonprofit health system, including teaching hospitals, centered in Philadelphia. CEO Dr. Stephen Klasko details how earlier actions helped its hospitals get ahead of the COVID-19 pandemic in terms of preparation. Klasko also outlines the actions he would like to see from the state and federal governments to deal with the fallout from the pandemic.
What accommodations have you made to handle the influx of patients due to the COVID-19 outbreak?
No one was totally ready for this pandemic, but Jefferson Health – all 14 hospitals – had a head start in preparing because of two initiatives. More than 10 years ago, Jefferson infectious disease doctor Edward Jasper started leading pandemic drills, and he stockpiled a supply of PPEs (personal protective equipment). In fact, we even sent PPEs to New York City in the early days of the crisis. Second, in 2014, we invested heavily in telehealth, launching JeffConnect, which immediately connects patients by video-call to an emergency department physician. As a result, we didn’t have to rebuild our system when calls went from 50 a day to more than 3,000 a day. Telehealth handled the first wave of the crisis, allowing us to support COVID-19 patients at home, as well as help thousands of people who were sick but not with COVID-19.
How are you working to ensure that patients and healthcare professionals alike are maintaining a safe environment?
Jefferson Health moved very quickly to a “universal masking” policy, requiring all staff to wear masks at work, even if their patients were COVID-negative. We were one of the first hospital systems to adopt universal masking, exactly to ensure we protect our own staff. We were in close contact with our colleagues in Italy, who told us that proper protection for staff dramatically cuts transmission within a hospital.
Because we were prepared, we are able to allow a loved one to attend our patients during end of life situations, even for COVID-positive patients. We even allow a loved one to attend labor and delivery for a birth. This requires a full procedure of having a nurse escort to attend the loved one. We did this because of the long-term psychological trauma of unresolved grief when families are unable to say goodbye in person.
How can the community best assist the local healthcare providers in this time of need?
The first answer is the critical one: Do not spread the illness. Our frontline staff are working horrendous hours attempting to save the lives of vulnerable patients. They are isolating themselves from their own children and families in order not to spread the virus. Do not increase their already heavy workload by getting sick yourself.
But there are also vulnerable populations who need our help. The virus is disproportionately hitting places of congregate living – that includes retirement homes and communities. It is disproportionately hitting people who are poor. And the consequences of staying home are hitting people with medical needs all across society, from uninsured women who cannot get prenatal care, to older people on dialysis. In each case, there is specific advice, which may just be to give money to help not-for-profits that are providing assistance to the poor.
What is your message to the local community that is sheltering in place and waiting for a return to normalcy?
Many of us are concerned that people with urgent medical issues are delaying treatment plans, not collecting medications, not seeking help. Please tell your family and friends: Do not delay getting help for cardiac and stroke issues. Do not delay taking medications. Stay on your cancer treatment regimen, and if you have the opportunity to join an advanced protocol or clinical trial, you should do that. Very important: Use telehealth to get mental health support if you need it. It may take more work today than it did last year, but please get the help you need.
Do you feel you are receiving enough state and federal support and what more is needed?
I believe Congress should immediately convene a COVID Commission along the lines of the 9/11 Commission – it is that serious. We need immediate changes to policy to enhance innovation to fight the immediate threat, but we also need to review the financial implications of this fight for hospitals, and we need to figure out how to ensure the next pandemic doesn’t create a health and economic crisis of this magnitude. On my list of things we need: Immediate access to the internet for all citizens, not just those who can afford a data plan. We need the federal government to lead preparation for surge capacity for intensive care, responding to any crisis. We need to prepare to offer health insurance after massive layoffs. And we need to evaluate the ethics of how we pay for healthcare to ensure equity for disadvantaged communities.
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