TriHealth Bridge

06 April, 2020

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Hi Team –

You’re hearing from me on Monday this week to allow our nursing, physician and support services leaders to “hit the ground running” with their teams as early as possible this week to complete the work of finalizing temporary role reassignments and adjusted shift schedules — all in support of our surge/capacity expansion plan. As you can imagine, this is another long update with lots of timely and important information, so please read each section thoroughly. Thank you!

Before I begin with updates, I want to, again, share how inspired I am by YOU — our team of more than 13,000 nurses, doctors, clinical and support staff — who have come together as one team, selflessly committed to our mission of service to the community as we work together to battle this virus. I witness this every day, but especially when I visit and round at the front line of our system — as I did again late last week in Bethesda North’s and Good Sam’s EDs, COVID-19 Units and support areas. You are true health care heroes, and I have genuinely never been more proud of any organization and its people than I am of YOU!


As I shared last week, nearly three months ago TriHealth began actively preparing for the COVID-19 pandemic with the development of our comprehensive readiness plan, which marked the first phase of our response efforts. As the spread of COVID-19 expanded to Greater Cincinnati nearly four weeks ago, we began our mitigation and plan activation phase to slow the spread of the virus, conserve critical supplies, and mitigate the multi-faceted impact of this public health and subsequent financial crisis on our patients, our system, and our physicians and team members. And, two weeks ago, we activated the surge readiness phase with the implementation of our 8-week surge/capacity expansion plan. Developed in collaboration with the Governor’s Office and other area health systems, this regional plan is being put in place to prepare for the inevitable surge in local COVID-19 cases. Based on most recent state and regional demand modeling, we now expect this surge to begin in mid-April and result in a doubling in need for medical/surgical inpatient beds, and a tripling in need for critical care (ICU) and ventilator capacity. This week’s Update focuses on the latest developments in our surge/capacity expansion work.

Standing Together as One Coordinated Regional Health System in Service to the Community 
Recognizing that the individual surge/capacity expansion plans of each area health system need to be well coordinated — and also, that they may not be sufficient enough to support the potential, or worst case, influx of COVID19 cases in our greater Cincinnati community — we are now working together with all other area health systems to finalize Level 3 Surge Planning. Our community’s Level 3 Surge Plan includes the proactive conversion of a large community venue into what we are calling an “Alternative Care Site (ACS)” for COVID-19 cases. Many of us have read about this approach in other communities, like New York and New Orleans. As part of our community plan, we will be converting the Duke Energy Convention Center into a 750 -bed Alternative Care Site to supplement the good work being done at all of the area health systems. We are now working collaboratively with other area systems to identify and support staffing needs for the ACS — in addition to finalizing our Level 2 surge plan, which includes doubling acute care and tripling ICU capacity within TriHealth. TriHealth will be responsible for providing approximately 25% of the ACS’s staffing needs, and our own TPP Administrative Executive, Vesta Johns, will play a key role in staffing and operating the ACS. The Ohio National Guard is now at the Convention Center beginning to “stand up” the facility so it’s ready when the anticipated peak surge hits in the coming weeks. Once operational, the National Guard will remain on site to support ongoing logistics. TriHealth’s staffing plans to support the ACS at the Convention Center are being integrated into our overall Workforce Redeployment Strategy, with latest updates below.

Workforce Redeployment Plan Requires “All Hands On-Deck” to Address this Public Health Crisis
As I indicated last week, we will face this surge as prepared and ready as any health system, anywhere, because of the planning and preparations that have occurred for all possible scenarios — and because of you, our people — all of which will enable TriHealth to adequately protect and care for patients, while also keeping front-line team members and physicians safe. Our ability to step up and serve the community during this unprecedented public health crisis will require every single TriHealth physician, nurse and team member to respond with flexibility and a willingness to take on temporary — and sometimes new —roles, assignments and/or schedules over the next several weeks.

  • Staff Redeployment to Support Our Nursing “Team Care Model”:  Every team member who has a clinical nursing background will be called into service at the bedside to support the anticipated surge in inpatient and medical/surgical volume – either within our own system facilities or at the Duke Energy Convention Center. These assignments will be temporary, but cannot be optional, given the magnitude of this public health crisis. Nursing leadership is currently hard at work preparing these staffing and mandatory reassignment plans. Individuals will be redeployed to the area of greatest need that is best matched to their experience level and skill set. Nurses who have not been at the bedside in a while will receive orientation and be “teamed” with other more experienced nurses from the area of expertise to which they are being reassigned. Team members currently in clinical roles will be called upon to expand their hours and/or adjust their shifts. These adjustments in hours and shifts will also be temporary, but again, cannot be optional to ensure we have a minimum or core number of experienced clinical team members caring for our patients during this extraordinary time.

  • Physician and Provider Redeployment to Support Our “Team Medical Management Model”: Plans are similarly underway to transition TriHealth primary care providers to serve as ED physicians and hospitalists, working in teams led by a physician or physicians more experienced in these disciplines. And our current hospitalists, pulmonologists and anesthesiologists will be prepared to take on intensivist roles as needed. 

Physician and nursing leadership across the system will be keeping their respective teams informed as our redeployment plans are finalized and staff is reassigned. Please work closely with your immediate leaders to understand how these plans will impact your area and/or your current role and schedule. 

Site Capacity Expansion Efforts Well Underway
Since last week, we’ve made solid progress in our site expansion plans to prepare for the anticipated surge in inpatient, ED and medical/surgical volume. As shared, we will increase inpatient bed capacity by transitioning private rooms to the extent possible at our flagship hospitals into double occupancy rooms for the duration of the surge. To further increase inpatient capacity, we will convert PACUs, ENDOs and ORs into temporary inpatient units. To further support expanded medical/surgical volume increases, we are now planning to re-open Evendale, exclusively for non-COVID-19 medical/surgical patients. This conversion work is now well underway and will be supported by our staff redeployment strategy outlined above.

Protective Measures Evolve and Expand to Ensure Patient and Team Safety 
As Drs. Joseph and Blatt and I shared in a memo to all team members late last week, we continue to evolve our Personal Protective Equipment (PPE) protocols, which remain in full compliance with CDC guidelines to ensure all of our patients, caregivers and front-line staff are properly protected. Last week, we expanded the use of surgical masks to all team members, providers and patients in clinical areas to further enhance protection and reduce transmission. At the same time, we continue to conserve the very limited, essential supplies required to provide safe, effective care throughout the duration of the expected surge. Click here to review and adhere to the latest TriHealth COVID-19 Mask Guidelines. To help those unaccustomed to using PPE, we will include a short tutorial in Dr. Joseph’s Monday Daily Video this week (available on Bridge), which will show how to properly put on and wear the protective surgical masks in clinical settings and cloth masks in the non-clinical environment. And finally, we should all feel comfortable putting into action our high reliability principle of “peer checking” to remind team members to wear masks when necessary to ensure the safest work and care environment possible!

Temporary Housing Options for Our Team Members and Doctors
As our front-line nurses, physicians and other patient support teams prepare to be in more direct and prolonged contact with COVID-19 patients, it’s understandable that some may be concerned about exposing loved ones at home to the virus. To support those seeking temporary out-of-home living arrangements while actively caring for COVID-19 patients, TriHealth has proactively arranged a number of options for our team members and providers. With our partner organization, Xavier University, we will be setting up FREE on-campus accommodations for any interested TriHealth team member or physician, which will be ready early next week. We have also negotiated significantly discounted rates at areas hotels for those who might prefer to stay at a hotel over a student apartment or dorm room. Anyone interested in reserving a room at Xavier, or receiving more information on hotel options, can do so by emailing: John_Jacobs@trihealth.com.   

Weekly Communications Continue to Keep You “In the Know”
Please continue to check our COVID Hub on Bridge for up-to-the-minute news and updates, including any changes to TriHealth policies and protocols. Below is a reminder of this week’s schedule of COVID-19 communications:

  • Monday, April 6:  CEO Weekly Update
  • Monday, April 6  – Friday, April 10:  Daily Dr. Joseph video updates will be available on Bridge
  • Tuesday, April 7 @ 12pm:  Team Member/Physician Town Hall livestreamed and archived on Facebook and Bridge. PLEASE NOTE:  We have decided to combine the Physician Town Hall (previously held on Wednesday evenings) with the Tuesday Team Member Town Hall, since most physicians and providers were already participating in the earlier Tuesday sessions.
  • Friday, April 10 – Weekly COVID Update email

“Far and away the best prize that life has to offer is to work hard at work worth doing.”
– Theodore Roosevelt

There is NO work more worth doing than the work we face ahead. THANK YOU for your flexibility, compassion, and heroic acts of courage as we rally together – ONE TEAM, ONE MISSION, ONE GREAT HEALTH SYSTEM – to fulfill our sacred work to safeguard the health and wellbeing of the community and people we love!

 

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Comments:

I'm so proud of my Trihealth family ,praying for everyone.
Posted by: Andrea Lawson on 08 April, 2020

Thankful for the foresight of Trihealth, under your leadership, and the State of Ohio in putting things in place early to minimize the impact of Covid-19. Praying daily for our country.
Posted by: Florence Turley on 08 April, 2020

Prayers and praise to all of our front line employees who are sacrificing their own health as well as the health of their family to fulfill their obligation to safeguard the health and wellbeing of our community.
Posted by: Tamara Correll on 08 April, 2020

Thank you and I am praying for all of us, family, friends, communities, those who put their lives in harm's way to take care of us, those protecting us, and all of you for your kind words, gestures, and assistance. Wonder work done by our doctors and nurses, and to Our Leadership who oversees the big picture. God Bless You All!
Posted by: Shirlene Mattocks on 08 April, 2020

So proud of TriHealth! Thank you for the update.
Posted by: Michael Berens on 08 April, 2020

Thank you for the updates. Proud of our TriHealth Team!!
Posted by: Donna Baker@mhmh.trihealth.com on 08 April, 2020

Thank you for all the efforts of Leadership, Management and Team Members to help keep us safe and informed during these constantly changing times. Sincerely, Judy Hamilton
Posted by: Judy Hamilton on 08 April, 2020