Donna Drummond is the senior vice president and chief expense officer for Northwell Health. She spoke with HealthCare Business News about the economic challenges the Coronavirus has created and how her organization has worked to meet those challenges.
Northwell is located in New York, the state that was the first epicenter for the pandemic in the U.S. According to Drummond, the healthcare organization went from zero COVID patients to 3,500 in a matter of days. If one were to grasp for a silver lining, it might be that where other businesses, even some hospitals across the country – were furloughing or laying off employees, Northwell was tapping into a reserve of professionals. “We reached out to clinicians who were working in non-direct patient care,” said Drummond. “Physicians who had become informatics leaders were asked if they wanted to come back. We reached out to retired employees and they came back. We did very little furloughing. We redeployed anyone with a clinical background, and our nonclinical staff on our shared services side, as well as in our hospitals, we had working remotely.”
That isn’t to say that it’s been easy, even once you get past the fact that staff was caring for thousands of patients who had a virus we’re still learning more about today. Northwell ceased elective procedures early on and closed its ambulatory practices, keeping urgent primary care, urgent orthopedic and some other treatment options open. “We were hit very hard financially, but we had to do that to accommodate the significant influx of COVID-positive patients,” said Drummond.
The organization did take action to help mitigate the loss of revenue. Drummond said that much of the work to make the shift was already familiar to staff due to very active efforts to track and plan for natural disasters and other catastrophic events. Northwell’s location meant the organization felt the impact and gained experience from events like the September 11th attacks and Superstorm Sandy. “We unfortunately have had a lot of practice in gathering and planning our emergency preparedness,” she said.
The group met prior to having even one COVID-positive patient. Inventory was reviewed to ensure there was the necessary supply of PPE and that policy was in place for when the first patients started to arrive. Backup plans were created to guarantee staff would be able to keep themselves safe while treating patients. “We created a clinical operations team that was accessible on a moment’s notice. So if I contacted them and said I was having trouble getting isolation gowns and I wanted to use hazmat suits, our infection control leaders would evaluate them,” she said.
One key decision was to move patients from one of their hospitals to another in order to keep those under care safe from further problems that a COVID infection could cause. In all, over 800 patients were moved between hospitals during the outbreak.
The virus peaked in April and by mid-April, Northwell COO Mark Solazzo gathered the team to get everyone thinking about recovery. The conversations covered topics like determining how to cohort patients in order to be able to bring back elective procedures in pandemic-free facilities. “We focused early on to isolate places to make them as COVID-free as possible, so that we could restart our physician practices,” said Drummond.
Another positive Drummond points to is Northwell’s chief procurement officer, Phyllis McCready. “She has a lot of experience and she and her team like to be prepared.” Drummond says that McCready is an advocate for stocking deeper than just what the organization might immediately use, instead opting for the emergency preparedness that Northwell does so well.
While there were some reports of price gouging from vendors, Drummond didn’t see it at Northwell. “Our suppliers, who we’ve had long relationships with did the best they could. Prices never went up. We didn’t experience a shortage beyond having a few days where we had to have extended use within the CDC guidelines. Instead, it was just a slowdown in the supply chain,” she said.
Northwell continues to tweak their planning based on the experience and on Governor Cuomo’s guidelines. Under the guidance, it’s recommended that every hospital has a 90-day supply of PPE. Drummond says Northwell took a look at the burn-through rate of their PPEs to determine what they’d need. “We usually run about a 100k-square-foot warehouse. We have a plan to move into a 350k-square-foot warehouse. Four million masks take up a lot of room.”
Another learning experience has been the real-time experiment of having some employees work from home. Drummond says Northwell is absolutely taking a close look at that and how the organization can incorporate that into its plans going forward.