It Takes a Team

Facing huge odds, regional hospitals are fighting the good fight against COVID, and leveraging the power of collaborations to do it.

By Dennis Boone

The arrival of COVID-19 in March 2020 compelled area hospitals to pivot—quickly—to meet an unprecedented public health threat. The solution for many was the creation of new teams across hospital disciplines to focus on providing urgent, intensive care, as well as safeguarding their staffs from the viral threat.

If you have COVID-19 and you can’t get care or if you don’t have COVID-19 and you can’t get care—those are both bad outcomes. — Steve Stites, chief medical officer, The University of Kansas Health System

Throughout that year, and Year Two, what started as a crisis response has morphed into a new operating reality for health-care providers. It’s no exaggeration to say their business models, and operational structures, have been forever changed.

To what impact? For one, fatality rates from the illness have consistently fallen since the original outbreak. That’s the good news. Of course, if you’re inclined to recognize the good work of providers—as Ingram’s does with its annual Heroes in Healthcare awards—it’s evident that individual achievements are taking a back seat to shared successes.

One area hospital executive, in fact, summed up what’s transpired by addressing an institutional shyness about offering candidates for consideration in this year’s crop of Heroes:

“To be really honest,” said the executive, sharing a sentiment you’ll find in hospital C-suites across the metro, “when we were trying to identify folks to nominate this year, it was harder than usual. Not because there aren’t great things going on and really great people on the team, but so much of what has been done this year has been done by teams, making it hard to single any one person out. … It is truly humbling to witness and be a part of.”

From large medical centers to community hospitals, methods of care and other processes had to change, new communications channels were formed, the very concepts of personal protection for staff and facility cleaning were altered. Often, those changes were the result of collaborations by departments that had traditionally operated more or less independently, if not entirely siloed.

It was hard, exhausting work, executives, say, but with two years’ worth of data now in hand, you can easily track the results of what they and their staffs have poured into the fight against an invisible killer.

Through the end of January 2022—a period of 647 days since all hospitals in the MARC region began reporting daily data—the health-care system averaged 447 COVID-19 patients under care on any given day. The region, in that same span, averaged about six COVID deaths a day—less than one-half of 1 percent of the daily admissions figure.  

That’s a long way, and a vast improvement, over the numbers generated early in the outbreak. A study reported in the Journal of the American Medical Association at the one-year mark of the pandemic, covering nearly 193,000 hospital admissions, showed that on average:

• More than 1 in 8—13.6 percent—died in the hospital. Adding the numbers discharged to hospice settings raised that to 16.6 percent.

• Roughly 28.9 percent required an  ICU bed.

• The median length of hospital stay for ICU patients was 15 days.

• The average cost of an ICU patient’s care was nearly $40,000.

Throughout three pronounced waves of infection surges, hospitals have seen their utilization of beds for COVID patients hit thresholds that the health-care sectors consider “severe stress” on a system—anything above 15 percent of bed capacity, on top of non-COVID cases. The year-end build-up with Omicron pushed that share above 30 percent at several points in December and early January, straining resources more than at any time since the March 2020 outbreak.

How bad was it? At one point, executives were openly discussing prospects for employing triage, the military practice of separating those who will survive without immediate care, those who will survive only with immediate care, and those who are unlikely to survive in any case.

Such was the stress on resources as bed space dwindled and hundreds of health-care workers were knocked out of the job by the illness, as well.

“If you have COVID-19 and you can’t get care or if you don’t have COVID-19 and you can’t get care—those are both bad outcomes,” said Steve Stites, chief medical officer of The University of Kansas Health System.

For two years, he and other physicians in the region have been preaching a gospel of avoidance and prevention, stressing the need to wear masks in public, maintain social distancing, frequently wash your hands, and avoid touching one’s face and eyes. Over the past year, they have encouraged vaccinations as the next critical step to slow the spread.

A rapid decline in cases nationwide during the first month of the year, along with lower death rates overall and shorter hospitalizations for Omicron patients, offers hope—but just some—that the worst of the pandemic may soon be over.