During the height of the COVID-19 pandemic last year when visitation at hospitals was restricted, the caring staff Presbyterian Saint Luke's Hospital (PSL), which is based in Denver, Colorado, sought to find an incredible way to honor the patients, who had passed away, especially those who did not have family by their side. "We knew that we did not want anyone to die alone," said Laura-Anne Cleveland, an associate chief nursing officer at PSL. "That is always our commitment, but more so when they [patients] couldn’t have visitors at their bedside." So, to help colleagues find peace after a patient passes away, medical staff now gathers in a circle to read a special message created by an unknown ER nurse.
“Our care teams made Olympic efforts throughout the pandemic,” says Tim Miller, president of HCA Healthcare’s urgent care services, which include 157 clinics and 2,000+ colleagues in 10 states. “Our CareNow clinics went through the H1N1 swine flu in 2009, which led to patients swamping our clinics, with lines out the door. But that is not what happened last March. Many people stayed home with minor symptoms and sheltered in place.”
Tim recalls urgent care reaching the lowest point of patients being seen on April 9, 2020. “We were averaging 16 patients a day. It was a substantial drop.” Instead of laying off or furloughing colleagues like other healthcare systems, HCA Healthcare implemented a pandemic pay program which guaranteed that full and part-time colleagues in clinical and non-clinical support services who could not be redeployed to other facilities would continue to receive 70% of their base
pay if they were not scheduled for their full shifts. In 2020, this program has helped more than 127,000 members of our HCA Healthcare family continue to support themselves and their families.
“The way that HCA Healthcare handled the pandemic was so different – really taking care of and protecting employees. It was such an impactful message for anyone working for HCA Healthcare,” says Jaime Bailey, area practice manager for Charleston, South Carolina, and Jacksonville, Florida, in the South Atlantic Division.
But by the summer of 2020, patients were presenting to our CareNow clinics in large numbers. “Last July our patient volume spiked by 70% — a lot of that was driven by COVID-19 testing and it kept going up. The surge was beyond anything I’ve seen in close to 30 years in urgent care,” recalls Tim. “We were able to adapt quickly. Urgent care is always there for patients whether it is allergies, physicals or the flu. Urgent care is convenient so someone can see a provider quickly. What we needed last spring was a way to respond to the massive demand for COVID testing. Our teams had to respond and get creative to find other lab partners, so we could give patients what they needed when they needed it.”
“Thanks to a collaboration with our divisions, HealthTrust and the lab service line, we were eventually able to obtain the rapid test in our clinics, and we were one of the first clinics in the country to do it,” says Tim. As of December 2020, HCA Healthcare urgent care clinics cared for more than 2 million patients and performed more than 706,000 COVID-19 tests.
“We leveraged a really great idea by our operations team to do curbside swabbing for COVID testing on the hour, which kept it really efficient for staff. Our team shared their viewpoints and thoughts because they know they are valued, and we were able to better serve our patients because of it,” says Jaime.
“Also, urgent care services had the technology built for web check-ins – but we needed to set thresholds to manage the volume of testing. We engaged with our developers in HCA Healthcare’s Information Technology Group (ITG) and within a matter of days they were able to set controls at the market and clinic level. This allowed us to effectively manage the work flow and available testing supplies,” says Tim. In 2020, 840,000 patients used web check-in at our CareNow clinics. More than 1.7 million people visited the COVID testing page on CareNow.com in 2020.
Tiffany Ridley, director of urgent care operations for the Gulf Coast Division, says the web check-ins also helped our teams manage social distancing.
“Since Houston was one of the hot spots early on in April and May, HCA Healthcare teams were mobilized to support us,” Tiffany said. “Colleagues across the country in Denver or Dallas were picking up phone calls from patients or helping us with web check-in. I have tears in my eyes thinking about the incredible support we received.” But across the Gulf Coast Division’s 19 locations, they still had people lining up before clinics opened each morning throughout the summer. “Between 15 and 30 people would be waiting ꟷ just wanting to come in. Our urgent care team developed a QR code for patients to scan so they could register, and we would get them in every 15 minutes. It also allowed people to come back for testing and that worked very well.”
“We didn’t have virtual care before COVID in our clinics, but we were able to stand up telehealth in all of our clinics within a week or two thanks to our collaboration with ITG. A lot of patients wanted to come in to be tested for COVID-19 but for those who couldn’t get in due to capacity, or they were afraid — we could still help those patients in their time of need,” said Tim.
“We did a soft launch one weekend in Charleston to prepare for adding telehealth and went live the following week,” said Jaime. “Now in 2021, we still see 20-30% of our patients through telehealth. I believe it will help us reach even more patients, long beyond the pandemic.”
As of December 2020, HCA Healthcare’s telehealth utilization increased 485% from previous years, with 1.23 million telehealth encounters in 2020. HCA Healthcare added 3,000 additional hospital-based telehealth services and supported an additional 6,000+ providers through our telehealth services and network to meet the demands from social distancing and quarantine mandates.
In 2020, HCA Healthcare also distributed nearly 1.2 billion pieces of PPE. This includes 5.7 million N95 masks, 1 billion pairs of gloves, 55 million masks and 1.1 million face shields.
“Our staff was fully protected thanks to HealthTrust and our supply chain sourcing so quickly,” says Tim.
“From gowns, gloves, masks ꟷ it was incredible to be able to have everything for the team and to be able to encourage universal masking without worrying about supplies,” says Jaime.
Tiffany says the resiliency of the Gulf Coast Division CareNow team was astounding. “The staff were amazing as they managed extremely high-stress levels. There were a lot of support conversations. HR was providing resources for mental health. We pulled staff from other clinics, PSG and division teams so we had an additional team member to support if someone was out. There was a lot of intrinsic motivation,” she said. “During our team huddles, we would ask, ‘Are you guys OK? We know it is stressful. What do you need?’”
“We have opened up COVID vaccination appointments now for patients, and we are so grateful for our hospital partners. They were willing to teach us their best practices to offer the vaccine to the community. They show us what works, how they run scheduling, and it’s been a tremendous help,” says Jaime.
Looking towards the future, Tiffany said, “Now it’s time to get back to basics. The pandemic put a wrench in everything — it was all COVID. So now that we have normalized COVID processes, we can do orientations and ongoing training with new staff on what to do when you see a patient who comes in with strep or a bicycle injury. We’ve also developed partnerships with radiology schools for our medical assistants to get X-ray trained. We have pathways for our colleagues to learn, develop and pursue leadership opportunities.”
“It is hard to put in words just how proud I am to have been able to serve the community and see all of our colleagues step up and thrive in taking care of patients and each other. We were close before the pandemic and now there is an unbelievable bond,” says Jaime.