UK HealthCare Team Steps Up to Meet Challenges of Patient Care During COVID-19 Pandemic
By Kristi Willett, Director, Medical Campus Public Relations
As early as mid-January, UK HealthCare began taking precautions such as screening patients who had traveled to China during the holiday break and then returned to the University of Kentucky campus. Since then, UK’s Infection Prevention and Control team and the UK HealthCare leadership team has worked with campus colleagues, city and state officials — and throughout the health care enterprise — to continually update procedures and protocols to keep patients, employees and students safe.
“All across UK HealthCare, I have been so proud of how our faculty and staff have stepped up to this unprecedented public health event,” said Dr. Mark F. Newman, UK executive vice president for health affairs. “In every area, from our front-line nurses, physicians and respiratory therapists, to our supply management team and those who help clean the hospital to help make it safe for employees and patients, we’ve seen people go above and beyond to take care of patients and take care of each other.”
Like all health care facilities, UK HealthCare which includes UK Chandler Hospital, UK Good Samaritan Hospital, Kentucky Children’s Hospital and more than 150 ambulatory clinics, was required to make significant adjustments and rethink of how patient care and business functions could be achieved.
From a restrictive no-visitation policy for both inpatients and ambulatory areas to the implementation of a comprehensive telecare system, decisions and modifications to normal procedures had to be made swiftly to keep both patients and employees safe.
On March 23, UK HealthCare announced that to protect our patients, families, employees and the community during the outbreak of COVID-19, a no-visitation policy would be implemented at its hospitals and clinics until the threat of COVID-19 transmission has decreased significantly. “Although we knew it was difficult and a sacrifice not to be with a loved one while they were in the hospital, we also knew that for the safety and well-being of our patients, employees and our community, it was the right decision,” Newman said.
One way to keep patients safe at home and from coming to clinics at all, was the vast expansion of telecare visits.
In late March, UK HealthCare began the move toward providing primarily telecare patient visits for most ambulatory clinics. Using telehealth technology, patients can set up a visit with a UK HealthCare advanced practice provider or physician with Zoom, a web-based videoconferencing platform that is compliant with HIPAA regulations. The process is similar to Apple’s popular “Facetime” video calling. Telecare visits require access to a device with a camera – like a smartphone, tablet or computer – along with access to an internet connection and an active email account. In just a few weeks, more than 11,000 visits were completed in 107 clinics and more than 19,500 telecare appointments had been scheduled for the month of April.
“To help slow down the spread of COVID-19, we want everyone to stay home as much as possible,” said Dr. Roberto Cardarelli, chair of UK HealthCare Family & Community Medicine and associate chief medical officer for population health. “We know that doesn’t mean people stop getting sick and UK HealthCare Telecare provides access to treatment for everyday illnesses while keeping the patient, health care providers and the community safe during the ongoing pandemic.”
As the pandemic began impacting Kentuckians, it became clear that among those at the greatest risk of infection were health care workers. To help test patient care providers, drive-thru testing began the last week in March.
“We want to make sure we take care of our employees so they can take care of our community,” said Newman “With the availability of tests and supplies, we are prioritizing testing for inpatients and health care employees.”
Initially, about 100 health care employee appointments were scheduled per day.
“This drive-thru screening is focused on our health care employees because they are at the most risk because they have the most contact with patients who have COVID-19 and we need to be able to get them back to work so that they can care for our patients,” said Dr. Sarah Schuetz, internal medicine physician at UK HealthCare and co-physician lead for drive-thru testing for COVID-19. “We do not want any of our health care workers feeling like they have to work when they are sick, and we want to be able to get them a diagnosis as quickly as possible.”
One of the most important milestones for both UK and for the state of Kentucky, was the addition of in-house COVID-19 testing through UK’s clinical laboratories.
UK HealthCare’s clinical microbiology lab has been providing in-house COVID-19 testing since March 21. In just the first five weeks of testing, the lab completed more than 3,200 tests.
Having the ability to quickly test and diagnose our patients for COVID-19 is vital in our battle against this pandemic. Clinical lab scientists have always played a huge part in helping patients across the enterprise get the treatments they need and providing COVID-19 testing for us is another way they are making a difference in the health of Kentuckians from behind the scenes, Newman said.
The Abbott M2000 allows UK’s lab scientists to test up to 94 samples in a single run. Samples are held in refrigeration until the batch is ready, then they’re vortexed a second time and placed inside the machine. Large batches of tests are strategically run throughout the day.
“This test requires about six hours of run time on the machine,” said Dr. C. Darrell Jennings, chair of the UK Department of Pathology and Laboratory Medicine. “When you then factor in delivering the sample to the lab, we are generally able to turn that test around in less than 24 hours. Sometimes it’s as short as eight hours.”
Confirming a patient’s COVID-19 status quickly helps free up resources at UK HealthCare by helping the medical team determine the best location for that patient to be while they recover, whether that means they’re admitted to an intensive care unit in the hospital or sent home to self-quarantine.
Along with making modifications for new ways to accommodate patient care and advances in taking care of employees, preparing for taking care of a possible surge of patients throughout Kentucky, also has been a priority for UK HealthCare.
During the first two weeks of April, the UK football team’s practice facility, Nutter Field House, was converted to a 400-bed field hospital.
“As the state’s largest health care provider for advanced sub-specialty and critical care, it is crucial we are prepared for any scenario to ensure that we can meet the needs of our community and the Commonwealth,” said Newman. “During this unprecedented crisis, this means coordinating with state and local health care officials in an emergency preparedness plan – a plan that contemplates and prepares for the worst-case scenario … a surge in COVID-19 patients.”
UK and UK HealthCare officials have been working for weeks to map scenarios to handle patient care needs across the region. That work has continued in partnership with local officials, Lexington regional hospitals, the State Health Commissioner and Gov. Andy Beshear to address how and where patients would be cared for if the number of COVID-19 patients surges in the future.
Models of the trajectory of the virus vary regarding scope and depth of surge, Newman said. In addition, how efforts to “flatten the curve” through social distancing and other measures work will impact the need for a field hospital and other responses.
“Preparedness is vital. Waiting until a field hospital is needed is too late,” Newman said. “We have been called upon and have accepted this challenge to have facilities and people ready if needed. We’ll be prepared for the worst and hope for the best.”