Editor’s Note: Instead of our annual CEO breakfast, we’ve invited this year’s honoreees — all leaders of area hospitals — to participate in a virtual panel discussion about the state of running a healthcare organization in 2021. The webinar, sponsored by eBiz Solutions, is March 4th at 11 a.m. and is open to the public. Register here.
For several years, Inside Memphis Business magazine has celebrated CEOs of the Year — those top leaders possessed of insight and vision who have made a difference in our community. The process was straightforward: We would choose four, each representing an organization of a different size. IMB would have a sponsored breakfast honoring the executives, each of whom would speak at the gathering.
Soon after last year’s event, the coronavirus hit our shores and changed everything. When it came time to consider how we’d honor CEOs this time around, we decided to change the format. Instead of limiting it to four bosses from a variety of companies, we’d recognize those on the front lines of battling the pandemic. We chose seven leaders of healthcare organizations in Memphis, each of whom had to react quickly to the evolving situation. They had some issues in common, such as changing the environment for employees and patients, but they also had different challenges and priorities that reflected their missions.
In every case, the CEOs spoke highly of their staffs who went above and beyond, from physicians, to nurses, to administrators, to environmental clean-up crews. Patient care was the first priority, but processes had to change; consideration had to be given to families of COVID-19 patients, to non-covid patients, to newly remote workers. Regulations were coming in fast, from the federal level, the state level, and the county level. Supply chains were disrupted, and information was often incomplete and always changing.
New ways of doing things were implemented, and many of those will stay even after the pandemic, such as telemedicine and the way visitors and patients are processed. Working remotely will be much more common than it was a year ago.
And these CEOs have watched, learned, and guided their organizations to deal with the challenges and, as many of them will say, doing it without a playbook to guide them. But they all have those qualities of leadership, experience, and empathy that allow them to confront the singular trials of this era. — Jon W. Sparks, Inside Memphis Business Editor
photo courtesy methodist le bonheur healthcare
Michael Ugwueke, MPH, DHA, FACHE
President and CEO of Methodist Le Bonheur Healthcare
CEO since 2017 over five adult inpatient hospitals and affiliated companies. He recently received the Harry S. Hertz Leadership Award from the Baldrige Foundation.
Chief executive officers come with plenty of experience before landing the top job, but 2020 changed the entire calculus. “It was learning on the job with pivoting as the way to do it,” says Michael Ugwueke of Methodist Le Bonheur Healthcare. “Being nimble is one thing we learned early on in the process.”
As he recalls it, those days seem so long ago in a way, but one of the early challenges was overcoming the lack of protective equipment. “They say that necessity is the mother of invention,” Ugwueke says, “so we went on and started manufacturing Personal Protective Equipment [PPE] with the help of our community and various other entities.”
A lot of information was coming in, but not so much that the course was always clear. “No one knew exactly how much volume we would be getting, but we wanted to make sure we had enough capacity, particularly on ventilators and ICU bed availability,” Ugwueke says. Elective surgeries were shut down for a time and effort was devoted to studying treatments and what might happen with vaccines. “It was a work in progress and we were learning every day, back in those days.”
“It’s a tough time, but we are in it together, and we are encouraged to fight the fight for however many months before we get all these vaccines in our bodies.” — Michael Ugwueke
One of the less common practices that found sudden favor was that of telehealth or telemedicine. “We quickly pivoted to that when this came about,” he says, “because we wanted to discourage people from coming to the hospital, but at the same time we did not want them to suffer at home without reaching out to their physicians. And that has become one of the things I look forward to continue on with when this is over. Part of innovation is making sure that our patients now have that as one of the options. You can come to see a physician, you can go to the ER, you can be admitted to the hospital — but now you have another option where you don’t have to leave your home.”
The concept goes well beyond just getting a consult online. “There’s something called Hospital at Home, and that is a means of keeping people at home for what I would call low-acuity care,” Ugwueke says. “They don’t have to be in the hospital occupying beds, but rather are in their own beds with family members around them. We know from studies that people tend to recover quickly when they’re in their own element, in their own house.”
The effects of the pandemic also, of course, impacted every part of the hospital’s operation, including logistics. “We’re looking at our supply chain processes, asking what could we do differently if we’re faced with shortages again. We’re looking at inventories and determining all the things that we could do to better prepare.” He adds, fervently, that “I hope though, there won’t be another hundred-year pandemic happening.”
Ugwueke is particularly grateful for the work done by the people under Methodist’s umbrella. “Our employees truly rose to the occasion and they still are continuing,” he says. He notes that most disasters or crises have a distinct beginning and end. If there’s an earthquake, there may be aftershocks, and then help can go in. Or when a hurricane hits, it blows over and recovery gets underway.
“But this pandemic has been going on since March,” he says. “In fact, it’s gotten much more intense. Day in and day out there are staffing challenges and the volume increases and for employees, there’s fear associated with catching the virus, both for your family and your kids. And you have schools shut down and have to pivot through virtual learning for your kids. Parents are now working from home. Even with all that, our employees adapted in ways that we never could imagine.”
The role of communication, always essential in a complex operation like a hospital, became even more critical. “We have to be totally transparent in everything that we’re doing,” Ugwueke says. “We can tell you exactly how many covid patients are in the hospital, how we’re doing on our PPE levels, because we have dashboards that we share every day. We have to be able to communicate to the staff everything that has gone on at the hospital because it gives them a window to what’s going on across our six hospitals.”
Running a healthcare organization like Methodist requires special skills even in normal times. The pandemic ramped up the challenges even further. And then there was the acquisition. Methodist was all set to take over the two Memphis-area Saint Francis hospitals owned by Dallas-based healthcare system Tenet Healthcare Corporation, which wanted to pull out of the local market. The $350 million acquisition was moving along until November, when the Federal Trade Commission filed an administrative complaint and authorized a suit in federal court to block the merger, claiming healthcare costs would rise and quality of care would diminish. Methodist and Tenet were surprised by the action and strongly disagreed, but decided to abandon the merger plan.
It was just another complicating element in a topsy-turvy year that forced challenges on everyone. But for Ugwueke, he sees Methodist coming out of the era of the coronavirus victorious. “It’s a tough time,” he says, “but we are in it together, and we are encouraged to fight the fight for however many months before we get all these vaccines in our bodies.”
photo courtesy st. jude
James Downing, MD
President and CEO of St. Jude Children’s Research Hospital
St. Jude is one of the world’s premier pediatric cancer research centers, with more than 5,000 employees. It costs about $1 billion to operate St. Jude annually, most of which comes from donations.
Dr. James Downing well remembers when he knew his world would change. “Things were looking good,” he says of the time in early March of last year. There had been a successful faculty retreat and his daughter had taken him to a concert in Las Vegas. And then he was out riding his bike with another person from St. Jude when he got the page. “It said Shelby County had its first positive individual. We looked at each other and said, ‘Everything’s going to change from this moment forward.’”
The campus shut down very quickly. “We knew we weren’t going to be overrun by COVID-19 patients,” he says, “but we knew we had to protect our patients from the virus because we had no idea what the virus would do to the immune-suppressed cancer patients or children with sickle cell disease or the other diseases that we treat.”
“I don’t think any of us did anything but pay attention to the pandemic and work 24 hours a day to make sure that we were responding appropriately, creating the right environment, and providing the right level of protection for our employees and for our patients and for their families.” — Dr. James Downing
St. Jude’s senior leadership group quickly met and established protocols for who could interact with patients, and who was essential to be on campus and who wasn’t. They realized they needed to know right away who was infected and to be able to trace, isolate, and quarantine. Testing would be key, but not the maladroit approach going on in the rest of the country.
“Like all hospitals, we immediately invoked our emergency operating procedures and set up an incident command center, and all the leadership went and lived there for over six months,” Downing says. Everybody worked there, with a big boardroom, computers, printers, meals, support, video, TV, hookups. “We were getting information as it was coming constantly during those first months.”
The campus was zoned and employees badged. Employees on the patient care side were tested every four days. What couldn’t be gotten through the supply chain was made there. Eventually all employees could be tested and get an app that told them their status. They could eventually do up to 6,000 tests a week with a 24-hour turnaround, which makes tracing much easier.
“We created what we felt was the safest environment in the world against the SARS-COV-2 virus, which is what we needed to prevent any chance of our patients or families getting infected from our employees, or employees getting infected from those patients,” Downing says.
A big part of his role was communicating. “Every single day I sent out a communication. It was to tell them why we’re making the decisions that we are making, when those decisions may change, and why they’re changing federal regulations, CDC regulations, or recommendations. It was to provide comfort to the employees and say, ‘Sure this is tough, but here’s what we’ve got to do.’”
Much of the effort was to provide support and encouragement. Downing had lots of town halls with 15 employees in an auditorium that could hold 80, covering anything of concern from protocols, to working remotely, to dealing with children and school.
“We decreased the number of patients that were coming to campus to decrease the risk of those that have to be on campus as inpatients,” Downing says. And part of that, he says, was figuring out the best approach for patients staying in St. Jude’s housing facilities who didn’t need to come in every day. “If we could draw blood at the housing facilities, they wouldn’t have to come here,” he says. “If we could take care of their surgical wounds at the housing facility, they wouldn’t have to come here. If we could do telemedicine, then they could stay in the housing and not have to come every day to increase exposure. So we really beefed up telemedicine services.”
Their efforts never stopped. “For three-plus months,” he says, “I don’t think any of us did anything but pay attention to the pandemic and work 24 hours a day to make sure that we were responding appropriately, creating the right environment, and providing the right level of protection for our employees and for our patients and for their families.”
St. Jude’s considerable research muscle wasn’t going to add much to the resources available to the pharmaceutical companies working directly on treatments, therapies, and vaccines. But, Downing asks, “We’re the world experts in immunology and infectious disease, so can we look at the pathophysiology of COVID-19 and learn something about how it induces illness? And we can look at the immune response and how that reacts to the virus, and see what that might tell us about vaccination in the future and what it might tell us about the pathophysiology of the disease.”
Individual investigators at St. Jude were free to pursue studies on COVID-19, and it received about $6 million in grants from federal or private agencies to fund that research.
Downing says it’ll be a long time until we’re back to normal. There is much yet to be learned about the disease and related strains, and it’s not yet known whether a vaccine prevents infection or prevents disease. And trials on children are only recently underway.
But one thing is certain: Downing will keep up with those emails he’s been sending out. “The communication has really helped build a community,” he says. “As we go forward the next year, it isn’t all about the logistics of COVID, but there are lots of things we can communicate about that help employees realize they’re part of a family, that I’m here, that I’m watching, that I’m listening, that I’m learning, and that I appreciate what they’re doing.”
photo courtesy baptist health care
Jason Little, MBA, MSHA, FACHE
President and CEO of Baptist Memorial Health Care Corporation
In 2014, he became only the fifth person since 1912 to serve as the organization’s president and CEO. The Baptist network offers inpatient, skilled nursing, rehabilitation, cardiac and cancer care, dental, mental health, pain management, and clinical services.
We’ve had 19,000 heroes who have done the real work,” says Jason Little. “It has been a year where heroism has been a word, but I certainly don’t think that it’s misapplied here. Every day our employees put their own safety on the line to show up and take care of patients and fight this coronavirus, and they’ve done a remarkable job.”
It was good to have that staff across the Baptist Memorial Health Care Corporation network, because the challenges of 2020 were enormous. For Little, it was crucial for him to provide support and remove barriers. “There was no operating manual for the pandemic,” he says, “so we’ve had to put our best thinking caps on.”
“I think the common purpose and mission that everybody shared, and also the recognition that they are relying upon our nurses and respiratory therapists and physicians and others to get through this time, has really translated into some unique rewards for these caregivers who are sacrificing to provide this care.” — Jason Little
At the beginning of the pandemic, not every decision was the right one. “Let me give you an example,” Little says. “When we were still learning what it all meant, I looked at my colleagues and said that it was important for all of us who don’t take direct care of patients to show up, to work every day, and support those who do. All for one and one for all. Everybody would show up to work every day. But we learned more about how contagious the virus was, and we thought about the essential workforce. For instance, if our two payroll people got sick, people couldn’t get paychecks.”
Organizations who succeeded on the many levels required to fight the coronavirus soon realized that they had to think creatively and quickly. Hence, the ability to break down those barriers and swiftly amend ideas, such as the notion of showing up to work every day.
One of the stunning changes that Little witnessed has also proven to be the wave of the future. “In January 2020, we had about 90 people a month who were receiving their care through telemedicine with a primary care visit with their physician,” he says. “In April that number shot up to 22,000. That meant removing a lot of barriers there, and it took a complete team effort. Certainly the information system technology folks, but also all the care providers that have to figure out how to engage with that. And then the patients who have to learn it and everything else to be able to interact and get their care needs met. It tested all of our mettle across the entire corporation, for sure.”
Another example of a wave of the future relates to new physician clinics that Little describes as “kind of looking like a Sonic on the outside. Think about driving up and placing your order and a car hop coming to your window. We’ve learned with having now done over half a million coronavirus tests that nobody likes to get a cotton swab stuck up their nostrils. However, if you can drive through and get that done by a caregiver through your window, that’s not a bad way to go. And there are a lot of things from a care perspective where we used to bring patients into a waiting room and they’d get lab draws, vaccines, and such that we can now simply come out to their car and administer right from our physician’s office. That is something that will definitely be carried forward.”
Like all organizations who offered elective procedures and who made significant revenues from them, Baptist had to cut back. “We serve three different states — Tennessee, Mississippi, and Arkansas — and each state was slightly different, but they all put a moratorium on elective cases,” Little says. “And at that time, our revenues dropped by about 70 percent. And so you can think about trying to not only take care of our communities, but also figure out how you’re going to continue to fulfill your responsibility to 19,000 team members when your revenues drop 70 percent. Those were uncertain days. We took out a significant line of credit just so that we could maintain liquidity, not knowing what was coming. Fortunately, we never had to tap into that, but we had it there and we were able to start back up again in May with the electives.”
But later in the year, elective cases, particularly ones that required an overnight stay, had to be cut back to accommodate the surge of coronavirus patients. Those surgeries pay the bills, but Baptist had to be able to move staff from the operating rooms to take care of the growing number of COVID-19 patients.
Little says that this has been the year of the healthcare worker. “We had the highest employee satisfaction survey results we’ve ever had this year, and in the middle of a crisis,” he says. “That’s the result of many things. I’d like to think that there’s some good management nestled in there for sure, but I think the common purpose and mission that everybody shared, and also the recognition that they are relying upon our nurses and respiratory therapists and physicians and others to get through this time, has really translated into some unique rewards for these caregivers who are sacrificing to provide this care. And I think all of that really has translated on the bottom line to a good result for us.”
photo courtesy st. francis healthcare
Sally Hurt-Deitch, RN, MSN, MHA, FACHE
Group CEO of Tenet Health’s Mid-South Region, Saint Francis Healthcare Market CEO, and Saint Francis Hospital CEO since 2019.
Dallas-based Tenet Healthcare operates 65 acute-care and specialty hospitals nationwide, including St. Francis Hospital–Memphis and St. Francis Hospital–Bartlett.
When Sally Hurt-Deitch took over leadership of Tenet Healthcare’s Memphis market in late 2019, the parent company was looking to sell off the two Saint Francis hospitals in the area. Little did she — or anyone — realize what the next year-plus would hold.
“The year 2020 was like no other, and I’ve been in this field for about 30 years,” she says. “It raised different challenges for all of us that we’d never really thought through. It affected healthcare, whether emphasizing the need or shifting and changing the dynamic and the way people look at hospitals and health systems.”
As the pandemic seized global attention, the focus, she says, was almost like doing disaster preparation. “We were looking at mobilization, how you do everything from triaging patients and figuring out our resources. The initial issues with running low on PPE — would we have enough to protect our teams waiting for giant surges and influxes of patients? The beginning month was the adrenaline rush of adrenaline rushes.”
“In the past, a typical community event was a gathering. Now it has forced the issue of how to create a virtual type of offering and an education that is still available, but with different precautions.” — Sally Hurt-Deitch
Dealing with internal communications had to be rethought. “The days of giant town hall meetings and the ways of communicating in-person with your teams was really halted for quite a while,” she says. “How do you continue that communication flow so that nobody ever gets to a point of feeling like they don’t know what’s going on?”
When you fast-forward, Hurt-Deitch says, it becomes the long-term normal. “It changes the way you have to look at the hospitals and the way you have to run hospitals or health systems. It’s all based on what we need to do for the community and the realization that, while we’re having to live and understand and learn how to deal with a pandemic and a novel virus and the health effects of that, what else has this made an impact on?”
Hurt-Deitch offers the example of patients with other conditions, such as heart disease or lung disease. “It’s a total curveball,” she says. “People say they’re afraid to go to the hospital because they might catch COVID, but they need to seek emergency care. So how do you make sure the community feels that hospitals are a safe place to come to seek care? It changed the dynamic of our communication pattern and style.”
People needed to know that the hospital was safe, but they have been processing so much more information on surges, coordination with public health agencies, community leadership, and institutes of higher education. Hospitals, she says, have to help the public distill all that and prepare for what the future may or may not hold.
Hurt-Deitch says that some changes are likely to become permanent, something most organizations have found to be true. The way that her hospitals register patents, identify people with needs, and create outreach have all been impacted. “In the past, a typical community event was a gathering,” she says. “Now it has forced the issue of how to create a virtual type of offering and an education that is still available, but with different precautions.”
Beyond community events, she says there’s the larger challenge of community education. “It’s unfortunate, but so much of the healthcare world and services have become politicized, and whether there’s distrust of government or vaccines, there’s rhetoric from multiple areas feeding information to so many people. As CEOs and healthcare providers, we really have to put out one message that resonates through multiple communities.”
And as for that planned acquisition by Methodist Le Bonheur Healthcare of the Saint Francis hospitals? In November, the Federal Trade Commission announced it would oppose the deal. The two healthcare organizations disagreed with the FTC’s action but decided to abandon the merger plan.
For Hurt-Deitch, it was crucial that whatever happened, her job was to make sure the staff was not distracted by the business goings-on. “The staff shouldn’t become concerned about a potential sale or merger or anything else,” she says. “The messaging all along had been and continues to be that we are a hospital and are here to serve our community. It should never take our focus away from the patient.”
photo courtesy regional one health
Reginald W. Coopwood, MD
President and CEO of Regional One Health
Appointed in 2010. Recipient of Inside Memphis Business’ CEO of the Year in 2014. Regional One provides services to residents from all backgrounds in a 150-mile radius from its main campus. It has the only Level 1 Trauma Center in the Mid-South, its burn center is verified by the American Burn Association and American College of Surgeons, and it has delivered more high-risk pregnancies than any other Memphis hospital.
The normal course of operation at Regional One has long been devoted to dealing with the urgent. It routinely handles a high volume of trauma cases, high-risk OB situations, and critical burn cases. For Dr. Reginald Coopwood, the onset of the pandemic was when “all of a sudden, the world laid COVID in all of our laps. We didn’t stop what we normally do, but it added a whole new dynamic on top of it. We were in a position to continue doing our normal while trying to navigate the abnormal.”
For example, Regional One has a department that handles protective equipment, but that rapidly became a top priority when PPEs became scarce. “We were scrambling around trying to find source product in China,” Coopwood says, “and that was the first wave of how our life changed, because what happened was it didn’t take away what we’d normally do. It just added on this complexity.”
“We’d always thought that the patient wanted that touch when seeing the doctor, and to have a nurse take their blood pressure, but now that they’ve seen that they can have that physician interaction through a computer or on the phone, the public will get a little more comfortable with telemedicine as well.” — Dr. Reginal Coopwood
And then the COVID cases ballooned in early July, slowed down, then went up again around Thanksgiving with the weeks after the holidays keeping everyone on high alert. “It has kept us focused on the immediacy while we’re trying to manage the strategic imperatives that are always before us,” he says.
One of Coopwood’s challenges came because many working at the hospital decided to help out at the hotspots around the country. “Some people didn’t give notice,” he says, “but just said, ‘I’m going to New York, see ya.’ And there we were with a workforce shortage that had to be replaced, and trying to keep salaries competitive so the next group of people don’t leave.”
On top of all this was handling typical CEO duties in a decidedly atypical situation. “We were in the process of putting our budget together, one that’s based on a five-year run rate, last year’s experience, projecting growth here and there,” he explains. “But in the middle of last March we were shutting down elective procedures and volumes go down. So we met with our board and instead of having a full year budget, we said we couldn’t predict quarter to quarter — the best we could do was give a quarter budget.
“And so we had a three-month budget approved at the end of June for July, August, September, which was as far as we could see. And it was still a guess. We’ve been fairly good at it, but it’s a scary thing to not be able to see the future like we normally see it.”
The future also arrived a bit sooner than expected. “We will continue to grow our telemedicine impact,” Coopwood says. “We tend to figure out how to do stuff when we know that we’ll get paid for it. Telemedicine wasn’t well reimbursed prior to the pandemic, but during the pandemic they agreed to reimburse for it. Now it becomes a part of all of our strategy going forward.”
And like other organizations, the notion of managing people by watching their productivity while working at their cubicles has changed. “We’ve transitioned a lot of our billing and collecting functions off-site,” he says. “Now we’re managing people by outcomes and that’s really how we should have been managing people, but we’d never envisioned that part of our workforce could function well outside of a hospital environment. And some of those areas we won’t bring back in.” For example, a patient’s electronic medical record is easily accessible now, and there’s no need for physicians to haul around a thick paper chart.
“We’d always thought that the patient wanted that touch when seeing the doctor, and to have a nurse take their blood pressure,” Coopwood says. “And I think to a high degree they did, but now that they’ve seen that they can have that physician interaction through a computer or on the phone, the public will get a little more comfortable with telemedicine as well.”
photo courtesy UTHSC
Steve J. Schwab, MD
Chancellor and CEO of the University of Tennessee Health Science Center (UTHSC)
The Center, headquartered in Memphis, contains all six of UT’s doctoral-degree-granting health science colleges and has locations around the state. It employs more than 6,000 people statewide.
As chancellor of UTHSC, Dr. Steve J. Schwab oversees the sprawling educational operation largely at the doctoral level at four main campuses in the state’s largest cities. UTHSC trains most of the state’s doctoral healthcare workforce, including physicians, dentists, pharmacists, physical therapists, nurses, and more.
“Education was hit hard by the pandemic,” Schwab says. Maintaining the Center’s mission required a lot of face-to-face work, since “more than half of our training is usually clinical and done in clinics and hospitals. We maintained our clinical enterprise using PPE and had to adapt our educational programs to go full-speed in our partner hospitals.”
The Center also educates residents and fellows before they go into practice. “Those physicians and dentists stayed working full-time and they were on the front lines,” Schwab says. “We adapted to decrease our density, maintain everything we could do online, and do our laboratories, simulation, and clinical care face-to-face. We had a near-hospital-like experience, but with an educational flavor, and I think we’ve successfully adapted.”
“We had one of the 11 regional biocontainment labs in the United States and that lab literally went into 24-hour operation. We almost doubled our staff doing COVID-related research, usually collaborative projects with the Oak Ridge National Laboratory and major pharmaceutical manufacturers on either aspects of vaccine development or therapeutic interventions.” — Dr. Steve Schwab
More than a thousand physicians are faculty who are active in clinical care and, Schwab says, the Center didn’t miss a beat.
“There was some slow-down such as the elective procedures like plastic surgery,” he says, “but the inpatient setting dramatically expanded. The intensive-care units were full, the hospitals were full, but they weren’t full of elective cases, they were full of covid cases. So it put not only work stresses, but financial stresses on all of our clinical practice groups, but we worked our way through that.”
UTHSC does more than $100 million of research a year, and the changes last year meant it needed a new set of guidelines on how to do research in a pandemic. In addition, he says, “We had one of the 11 regional biocontainment labs in the United States and that lab literally went into 24-hour operation. We almost doubled our staff doing COVID-related research, usually collaborative projects with the Oak Ridge National Laboratory and major pharmaceutical manufacturers on either aspects of vaccine development or therapeutic interventions.”
So Schwab needed to keep the operation functioning on as many levels as possible. “We did so with social distancing, masking, and everything else, and we learned what everyone else learned is that if you pay attention to the rules strictly you really limit transmission dramatically,” he says. The UTHSC community was often tested and used PPE rigorously, which limited occurrences of positive test results.
However, being able to continue in that way was expensive. It added costs but didn’t bring in revenue. “And unlike the hospitals, we got very little CARES money, but we were able to make our way through it by tightening our belt,” Schwab says.
Some of the changes forced on the Center in the last year can be useful to carry on even after the pandemic passes.
For example, UTHSC has learned that a lot of work can be done at home and it will be more flexible in encouraging that, Schwab says. Didactic teaching will be available face-to-face, but even before the pandemic, in-person attendance wasn’t required. Lectures will continue to be podcast and broadcast and students can always use email and the telephone to talk with faculty. Some hands-on teaching will always need to be that way, such as surgery and pharmaceutical compounding.
“You’ll see us doing more things remotely than we did before,” he says. “It will be not a revolution, but a matter of degree.”
The last year has provided more than the usual learning experience for students. First- and second-year students, Schwab says, had “an opportunity to participate both in terms of diagnostic testing and in terms of administering vaccines. They’ve risen to the occasion in a major way — nursing students, doctoral nursing students, pharmacy students, and the dental and medical students.”
He says he was impressed by the way faculty, staff, and students stepped up and did what had to be done. Students had to learn additional things in a more difficult environment, the staff was tasked with sterilizing rooms every day, and the faculty worked longer hours teaching the same number of students, but in smaller groups to keep distance.
Schwab is particularly proud of one achievement in particular: “We graduated everyone on time last year, and we’re on track to graduate everyone on time this year.”
photo courtesy le bonheur children’s hospital
Michael Wiggins, MBA, FACHE
President of Le Bonheur Children’s Hospital
Appointed in April 2019. Le Bonheur began in 1923 as a charitable organization and eventually grew its mission to give medical care to children with a promise to never turn a child away. It now has a network throughout the Mid-South and has been rated one of the top children’s hospitals in the nation.
Michael Wiggins appreciates the challenges that have threatened to overwhelm adult hospitals. He also notes that the experience of the pediatric world brings its own needs for quick thinking and the ability to respond quickly to a changing situation.
“We’re still seeing a number of children with COVID-19, but thankfully with kids, their symptoms are not nearly as severe as adults, so fewer children are requiring hospitalization and intensive care,” he says. “But some of our challenges are dealing with covid-positive parents, grandparents, or other caregivers. Our teams have certainly been on the front lines, but very often with children, the outcome is much more positive than what we’ve seen in the adult world.”
“I think if I did anything it was to try to inspire the confidence in the team’s own abilities, the confidence in our mission of providing healthcare to kids, and to know that we were indeed going to get through this together.” — Michael Wiggins
Le Bonheur still took steps from the beginning, such as cutting back on elective procedures and offering more telehealth visits. “We do whatever we can to continue providing care to the chronic high-acuity types of patients we have so that they would not have any delays in care.”
He says the facility noticed from the beginning that families were concerned that bringing their children in would risk exposure to COVID. The physicians, nurses, and therapists quickly adapted to provide care. Wiggins says, “And I’m just as proud of our hospitality team, our housekeepers for developing new cleaning protocols and new ways to create safe environments so that no family would feel like they needed to delay care out of fear for contracting covid.”
Nonetheless, surgeons at Le Bonheur noticed consequences of people reluctant to bring their children in for treatment. “They were seeing more ruptured appendixes than they had ever seen,” Wiggins says. “Other physicians were telling me they’d seen other childhood illness that was more progressed than what they’d seen in the past. And so we wanted to make sure we were creating environments that families didn’t worry about seeking care. I’m confident that today you’re much safer coming to Le Bonheur than you are going to the grocery store.”
Certain practices brought about by the pandemic are likely to remain even after the crisis has passed. “We’ve put in place protocols around how we schedule appointments, how we deal with waiting areas, how we deal with cleaning our environment. Those are going to be with us from now on, I think,” Wiggins says. “And there’s the work that we’re doing in the community that we’ll continue to see going forward.”
Beyond the hospital’s mission of caring for sick and injured children, there is a focus on how to keep children well and safe.
“Through telehealth, we’ve been able to interact with children and families in a new way,” he says. “Some of our chronic families that in the past would make an in-person clinic visit are now making that visit via tele-health. And we’re able to actually see their environments in the home and find better ways to care for them. We’ve had community health workers who have identified issues through those virtual visits, such as food insecurity or other needs in the home. They’ve taken it upon themselves to deliver food to some of these families, take paper products to some of these families, anything we can do to maximize their health status.”
Wiggins lauds his staff for “stepping up in a remarkable way and demonstrating flexibility and resilience. We’ve had to follow what felt like ever-changing policies from the Centers for Disease Control and others, but the staff has just been tremendous in finding new ways to provide care to the families who need us.”
A side benefit of COVID prevention practices, he notes, is that masking and distancing also limit the spread of flu and some of these other seasonal illnesses we might see in children. That has allowed some of Le Bonheur’s staff to go to adult hospitals in the community and help provide care.
As the leader at Le Bonheur, Wiggins reflects that, “sometimes you get into these crisis situations and the best thing that you can do is be a calm and reassuring presence that we’re going to get through this together. I think if I did anything it was to try to inspire the confidence in the team’s own abilities, the confidence in our mission of providing healthcare to kids, and to know that we were indeed going to get through this together.”
Wiggins also tapped into the national network of children’s hospitals to mine for information on what was going on elsewhere. “The Children’s Hospital Association is a professional organization for the various children’s hospitals across the country,” he says, “and we had routine discussions at least weekly about handling particular situations and providing the best environments.”
Wiggins says that he also serves on the board for the Children’s Hospital Alliance of Tennessee. “Those are all the CEOs of Tennessee’s children’s hospitals, and we likewise would be together virtually every week to discuss how we were responding to the situation, whether it was visitor guidelines or how we were dealing with testing, and how we were dealing with providing isolated environments for our patients who were COVID-19.”
Meanwhile, vaccines for children typically lag behind development of those for adults. Le Bonheur researchers are involved in that, and when vaccines finally do arrive, Wiggins will urge parents — particularly those who may be reluctant to allow vaccinations — to understand the science. “Vaccination is the right decision for the children and for our community. We want to help them understand that.”
