COVID-19 HTM Panel: Yesterday, Today and Tomorrow

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COVID-19 HTM Panel: Yesterday, Today and Tomorrow

In Season 1, Episode 10: This episode will focus on challenges related to COVID-19 impacting healthcare support departments across the United States and what can be done to improve operations, resource availability and staff morale in the midst of a pandemic.

Full Transcript

Welcome to the Healthcare Chats podcast where your hosts Al Gresch and Mike Zimmer will bring you insights to take your HTM and HFM from the basement to the board room. Healthcare Chats podcast starts now.

Al Gresch: Now, while COVID-19 has impacted everyone, certainly everyone in healthcare, it hasn't impacted everyone exactly the same. Our panel today represents a wide range of healthcare organizations. We have represented a community hospital from the West Coast, a university hospital system from the Southwest, a children's hospital from the Northeast, and a community hospital in the Midwest.

Our agenda for this session will be to talk about the greatest equipment needs and how each panelist is addressing those needs, what COVID-19 resources the group has found to be most useful, what measures are being taken to keep staff as safe as possible and prevent the spread of the virus in their respective organizations.

We're going to talk about what each panelist has experienced thus far relative to patient volumes, workload, furloughs, et cetera. We're going to talk about what each panelist has learned through this and what opportunities have been created. And lastly, what things each panelist will continue to do after this pandemic is behind them.

So, let's get started.

Al Gresch: In the early days of this pandemic, there were reports of equipment shortages, especially ventilators, based on the experiences of heavily-hit European countries and hotspots here in the US. Some bought what they could or rented what they could, but supplies were used up pretty quickly. Others rejuvenated retired assets they had or could get.

Al Gresch: What, if any devices, are you seeing a greater need for, both ventilators and beyond vents and how are you handling that need? So, Rob?

Rob Bundick: For us, there was several devices that we looked at that we saw an increased need for. Things such as thermometers, IV pumps, vital signs, for a few outside of the ventilators. For us, we had a unique opportunity in the fact that we had just made a large purchase of replacement equipment for patient monitoring and vital signs. We worked with the OEM to keep the items that we were going to trade in to allow us to have additional items.

Rob Bundick: We also are building a hospital at the moment and we pre-ordered that equipment ahead of time, used it at current facilities, and then the plan was to redeploy that to the hospital once it's built. We were able to use our money wisely and take advantage of some current situations that we were in to keep us at the right level of equipment we needed.

Al Gresch: Salim?

Salim Kai: Yeah. Thanks, Al, for asking. In our experience, the most sought-after equipment are ventilators, anesthesia machines, ECMO systems, PAPR units, beds, and thermometers. What we are seeing is that critical equipment and supplies are being held as the pandemic is evolving, depending on the states. Some states are doing a physical inventory at the state level to ensure adequate capacity and for planning purposes.

Salim Kai: Hospitals are sharing resources, equipment to supplies for those in need like in New York, especially.

Salim Kai: Thank you.

Al Gresch: Gene?

Gene Winfrey: Ventilators were definitely a point of discussion for us. We did evaluate plans to ensure that we had enough. Of course, we're tied in with our university that's next door, and they did a lot to do some research and 3D printing of flitters and all that. But, that never really came to a true need for us.

Gene Winfrey: But what we did find is the patient monitors ended up being a greater need for us. What we ended up having to do in preparation is to turn some acute care beds into ICU beds and so what we ended up doing was one, working with our vendor to prepare to purchase more monitors, but we also pulled monitors from our ambulatory settings and even from our PACU to make sure that we had enough of the higher acuity monitors for the areas that they're designating for the COVID-19 patients.

Al Gresch: Nader?

Nader Hammoud: Yes. We'll start with the vents. One of the first things that we had to do was to go through our inventory and validate it and look for the vents, where are they, because usually we had within the Y-Med workshop, a few vents for repair, venting repair, venting PM. It's not a top priority usually because you always have extra vents for backup. In this situation we made that as top priority and we start working on that immediately, to fix whatever we have and make it available.

Nader Hammoud: And then we start looking for where can we source additional vents. Even though we were able to find a few vendors who can sell us vents, but with four to six weeks of delivery, we still committed to that and we ordered that knowing that the pandemic most likely is not going to end in a day or two.

Nader Hammoud: So we went through that and we're hoping that we will not need more than what we have. And as the vents come in, we will be able to accommodate patients. Definitely as well, we took a look at our non-invasive vents inventory and made sure that everything is ready to go.

Nader Hammoud: Beyond vents, the other things that we kind of didn't know, or you wouldn't think on day one are mainly monitors capabilities. So what we needed to do as an organization is to search our capacity for ICU beds. That means switching one of the floors to be able to handle ICU patients. Not all rooms and all monitors are capable of because it wasn't designed for that. We were faced by a fact that we have physiological monitors but they can only do four waveforms and did not have enough IVP capabilities. That's kind of a simple task to be done during regular days, but in an emergency, in a pandemic, in panic mode, it wasn't as easy to be able to achieve that upgrade.

Nader Hammoud: It's not something that, you cannot have an ICU patient and have four waveforms, but it's not the best to be able to monitor a patient with less than six waveforms, and we had to do that upgrade, and then we had to buy additional modules to make sure that we have enough IVPs.

Nader Hammoud: So that's something we didn't think of and we were hit kind of last minuter, because we said, "Okay, this floor is ready to go," and then the ICU staff came in and then they said, "Oh, we have that issue."

Nader Hammoud: Also, thermometers. Definitely thermometers with the need to monitor and check patients, staff, visitors, everyone. You don't have enough thermometers. So what we have done is buy... We have lots of clinics in urgent care centers, so we centralized those, kind of closed the smaller ones and kept a couple or three of the big ones. And all clinics have been closed, so what we've done, all those thermometers and diagnostic tests in those areas we were able to grab them and use them for that purpose.

Nader Hammoud: So this is how we managed things so far.

Al Gresch: Great.

Al Gresch: There's so much COVID-19 related information being offered from countless sources. What resources have you found to be the most useful? Rob, I'll start with you.

Rob Bundick: AAMI was one that we relied on for some information on the US side. And then some information from our counterparts that were put out through social media sites or publications. We rely on that information, looked at it, brought it back to our senior leadership, and implemented things that we felt were useful for us.

Al Gresch: Okay, I'm just curious if you had an opportunity to take advantage of the ventilator predictor that we pushed out.

Rob Bundick: We did. It was more of a validation of some manual work that we had done. Ahead of that time, we had started looking at the needs that would be coming up and we were manually doing some of that work and once you guys brought the tool to us, we actually used it and it validated some of the manual work we had done. It made it a lot easier to do going forward, I would say, but it's definitely a useful tool.

Al Gresch: Great, thanks. Salim?

Salim Kai: Sure. Some of the best sources we found are the World Health Organization, the CDC, and our own hospital resources, internal resources, like Infection Prevention and Control, Emergency Preparedness, and others that have provided incredible amount of useful related information to COVID-19.

Al Gresch: Great. Gene?

Gene Winfrey: Being that we're a public health organization, and honestly, the only civilian level 1 trauma center in South Texas, we're actually tied directly with…which is Southwest Texas Regional... Council, something like that. I don't do well with acronyms. But anyways, it's tied directly with our state health services. So our resources where we focused on, coming from federal and state levels.

Gene Winfrey: As far as our staff, our organization actually provided daily communication to all our staff and email, giving high level facts based on the numbers that were being collected in our region, and then gave general direction, especially as policies and procedures changed.

Gene Winfrey: And then they also started to add some comforting thoughts and stories, and even songs. We have a trauma floor that connects our garage that actually has our helicopter pad on top, and so that's where all of our trauma patients come through. Well, we had one of those flight nurses draw a whole bunch of different people in charge, just to say, "Thank you," as you're walking through and you're seeing all this, there's a lot of this comforting idea that's coming from a lot of different people, not just from our leadership.

Al Gresch: Nader?

Nader Hammoud: It's kind of happened in a weird way. I had a question, we were facing lots of issues, so I'm going to take from a healthcare technology management perspective, and then we can talk about the hospital if you want to. But from my perspective in healthcare technology management, I was wondering that we're having issues that people are moving equipment and bringing equipment and taking equipment without going through any process that they used to, which is going through the healthcare technology management department.

Nader Hammoud: So I reached out to the leaders in the area, whether it's UCSS, the Stanford, Washington Hospital, reached out to those friends, colleagues, and I said, "Hey, what's going on?", and, "Are you facing issues? What are the issues you're facing, and I'm facing this issue. How are you handling it?".

Nader Hammoud: So sharing those expertise and then there's responses from everyone and then we're starting to expand and we use that correspondence to be our go-to place that, "I'm having this issue. How are you handling this? I'm having this issue, how are you handling this?", and then we learn from each other, we educate each other. So that was extremely, extremely useful for me in healthcare technology management that it created lots of shortcuts for me not to go through what they have gone through already, because I know that is all, so I just jump to the conclusion and just take it from there.

Nader Hammoud: So that was extremely useful for me. As I said, from a healthcare technology management point of view. As a general information, I would say our organization did a very good job in filtering the data and communicating with the county and the CDC and bringing down to our level the information that makes sense to us and is relevant to us, so that made a huge difference as well on personal level and as a member in this healthcare organization to understand the impact and what we need to do to be safe.

Al Gresch: Great.

Nader Hammoud: Okay.

Al Gresch: Earlier this month, there was a published news report regarding a large Midwestern health system in a particularly hard-hit area who had over 700 staff members infected with the virus. 20% of those had to be hospitalized. What measures have you taken to keep your staff as safe as possible and prevent the spread of the virus in your organization? Rob?

Rob Bundick: In our organization came up with a checklist and a protocol to ensure that everyone who's coming to work is safe to enter the building, and then daily do those checks. Some of those things include temperature checks, questionnaire regarding headaches, and other symptoms. We were also given PPE based on the area that our engineers worked on. Some engineers that did not work in procedural areas were given just general surgical mask and gloves, while engineers that worked in procedural areas and surgical areas were given additional PPE to ensure they were safe.

Al Gresch: Okay. Any additional processes around cleaning of equipment?

Rob Bundick: For us, our CS department does a lot of the cleaning of equipment, so if any equipment that was deemed to be used on a COVID-19 patient, the hospital had a process in place that it was clean before biomed was actually able to service it.

Al Gresch: Okay, thanks. Salim?

Salim Kai: Yes, thanks, Al. This is a very good question. Really, very early on about seven weeks ago or so, when we first heard of the threat of the virus in the United States, I gathered my leadership team and conducted a risk assessment, where we viewed all available information about the threat, we reviewed our strength and opportunities with respect to continuing to provide support to the hospital in the day-to-day operation of the biomed department, and to ensure continuity without any gaps.

Salim Kai: Specifically, some of our strategy was we divided the department into three teams, each working at a separate physical location. So each team had enough expertise to carry on the operation to support the organization in the event the others were exposed to the virus and were asked to self-quarantine. Each location had a leadership team comprised of the manager and supervisor, and then to help address any issues that arise and manage the team operationally.

Salim Kai: We also identified staff who can work from home. For example, I have a contract administrator on staff and asset manager in an application analysis. Those can work remote from home. We made sure they have the right equipment and the right software applications, and access, and that, and asked them to start working from home.

Salim Kai: Most staffs switched from a five 8s schedule to four 10-hour schedule to reduce the number of times per week each staff come to the hospital. All meetings were switched to virtual, no more in-person meeting, using applications such as Skype and Webex.

Salim Kai: The department leadership switched to a touch-base call every morning for updates and to look back, look ahead, and continue to be in touch, on the same page as we planned every morning of changes to operation.

Salim Kai: Another thing we incorporated, we ensured there's leadership visibility. What I mean by that is we added five-minute daily team huddles, multiple times a day to answer questions for technicians working on the front lines. If you remember early on, there was a lot of uncertainty about the virus, people were scared of the unknown, so we made ourselves available, being visible to answer questions. And obviously to boost the morale of the staff.

Salim Kai: We implemented universal masking policy, where all staff where a face mask during work hours. We reduced the ability of staff to gather in break and conference rooms. For example, by marking an "X" on the floor with tape, where staff can sit, and then keeping staff six feet away from each other. And this has proven to be effective, given that during breaks and meals, staff tend to take their masks off to eat and socialize. This worked well.

Salim Kai: And emphasized the importance of hand washing, social distancing at least six feet to staff, especially at meal time and during breaks, wiping down touched surfaced within the department multiple times per day, door handles, pens, keyboards, equipment that is worked on, all equipment delivered is assumed clean at my hospital, but we clean it to add another layer of safety before working on it, and then staff, the technicians wear gloves for added layer of safety.

Salim Kai: And then some of the clinical rounds that we were doing in person were switched to phone rounding by calling the unit, checking with the triage nurse, and ensuring they're okay, there's nothing they need, or any concerns.

Al Gresch: Gene?

Gene Winfrey: Our organization actually implemented quite a few measures and we did so early in the process, from eliminating busing of staff from parking garage or parking areas to facilities to actually implementing work from home policies that we've never ever had for any of our staff. To checking every person that's coming into any facility that we have for their temperature and last travel, any symptoms, just make sure that we are all being aware of our own person and the people that we're working around.

Gene Winfrey: Of course, we maintain the social distancing, canceling all in-person meetings to utilizing the typical, Webexes and those likes, including continuing with our projects in that fashion. We did a lot, I think, to make sure that we did not go down that path of potentially having a staff member that got infected and just spread it through the rest of the health system. So we were very aware of at least our individual contacts and how we maintained ourselves from each other.

Al Gresch: Nader?

Nader Hammoud: Thankfully we didn't face that here. Actually, as of today, we had zero staff members positive with COVID. So the first things we've done as an organization is all in-person meetings were eliminated. Whether, either it's canceled, if it's not relevant to the event and the incident that we're dealing with, or it was switched to web-based. So all of our meetings changed that way, in a sense that now I miss my colleagues. When we talk over the phone, "Hey, I haven't seen you in a while," so you do feel that you miss seeing those faces.

Nader Hammoud: But that actually helped, that in-person interaction was eliminated since day one. We didn't wait for the shelter in place orders, we didn't wait for anything. We just took that measure immediately, which helped us tremendously.

Nader Hammoud: Also, what we're doing is we're measuring any person who walks in the hospital building, we control the entrances of the hospital to only two entrances, and then when walking in, he has to go through questionnaire survey like, "Have you traveled, have you had a cough, have you had fever?", those types of questions, and then his temperature will be measured, his or her temperature will be measured, and we have the criteria that if it's above 100 degrees, they are not allowed to get into the building. And then definitely they have to wear masks.

Nader Hammoud: And this comes to question of, "How do you do with the PPEs and masks?".

Nader Hammoud: Thankfully, we were very lucky to have received lots of donations. Organizations opened the door for donations, and lots of donors came in and brought us lots of face masks, which helped us tremendously in being able to perform those measures and help protect our staff.

Al Gresch: Great.

Al Gresch: Reports from various friends and colleagues in the industry range from half-empty hospitals and large numbers of staff being furloughed, to those just slammed to the point of being short-staffed. What have you experienced in your organization thus far? Rob, I'll start with you.

Rob Bundick: We did have an increased workload in our organization. The majority of that was due to newer equipment coming in, or just additional precautions that staff were taking. If there was something they felt was not working right with equipment, we've seen increased calls for us to just check and validate equipment. Things such as filter cleaning for ultrasound machines, we were called on to do additional workloads there. We did see an increase in our workload.

Rob Bundick: Our hospital system has implemented some furloughs, but not within the biomed department. We were deemed as essential employees and we have kept our staff on board and we have actually seen an increase in our work hours so far.

Al Gresch: Great. Thanks, Rob. Salim?

Salim Kai: We have not had any short of staffing issues, thank god. We have been managing well and some staff have been moved in different jobs to address the changing need presented by the COVID-19 virus.

Al Gresch: Great. Gene?

Gene Winfrey: Our organization at the beginning aggressively worked to discharge patients. Really it was to reduce the current patient population. And then of course, we followed state orders and suspended all elective surgeries and so forth. What we experienced... We're normally at about 100% of our capacity on a regular basis. During this time, even though we expected to have onset of COVID-19, we've been consistently at about 60% census. And understanding, again, who we are, the level 1 trauma center in South Texas covering 22 counties, for us to maintain that level of census is... probably wasn't expected.

Gene Winfrey: Now the good thing for us is we didn't furlough or have a reduction in staff, and I know that that was a big thing across the country in healthcare. The staff that were affected by the reduction in surgeries and even some ambulatory closures were actually placed in a labor pool and then ended up assisting in other areas.

Gene Winfrey: Now for biomed, we remained in full force. We even took advantage of the situation by getting into areas to PM equipment, which we normally have trouble getting to. We also implemented our own social distancing by going to a first and second shift where each shift didn't overlap. That way it gave each shift an opportunity to clean before and aft... and then that way if we did get an onset of COVID-19 in one particular group, it didn't affect the other group, and I could still maintain some sort of business in supporting the health system.

Al Gresch: Great. Nader?

Nader Hammoud: I would say, definitely we're half-empty hospital. We weren't slammed with patients, but we do have shortages in staffing in one area, while another area's employees were furloughed. One of those areas that were short staffed is healthcare technology management. Because we were expected to repair and open new floors and new departments, new areas, new ICU areas that wasn't there. We need to make sure that we do those upgrades that we can think of with equipment to provide those equipment, to test new equipment that we're purchasing to come in to validate, educate nurses.

Nader Hammoud: All of these things we had to do and this is when you feel that we do not have the bandwidth because at the same time, we still need to do our regular work. It's not like you can pause on your regular work, you can pause on your PMs, you can pause on your repairs, and focus on this. No, we still have to do everything plus the additional work.

Nader Hammoud: So thankfully, the furloughed employees and organization were put into a labor pool so we can pull from that pool employees to help us. So we're able to get on each one of our campuses. One employee was a physical therapist and another one was [inaudible 00:32:46] tech, but they were able to help us in at least going through and doing the inventory of incoming equipment and collecting the information to save us time so we can focus on more important things. And they were a tremendous help. So this is how our organization handled that.

Al Gresch: It's times like this that help us uncover our greatest opportunities for improvements in processes to do things differently or more efficiently, or more safely. But, what have you learned through this and what will you continue to do after this pandemic is behind us? Rob?

Rob Bundick: For us, the main important thing that we've learned through this is to have a plan, right? A lot of what we were doing at the beginning was reactionary. We then got ahead of it and started looking at what was coming down the road and what our future needs were. So definitely have a plan is something we've learned from it.

Rob Bundick: Things such as ordering parts and PM kits, understanding what you need, using the data you have to be able to forecast out. Traditionally, you get your PMs at the beginning of the month, you look at what you need, you order it that month. Well, with this pandemic, we knew that there was going to be an increased demand for supplies, there was going to be a reduction of available resources, so part of the plan that we implemented going forward is to project out further what your needs are. You have to have good data to be able to do that. So that is definitely one thing that we've learned from that, is to look at what you have and make sure you have a plan that's more than just 30 days out, or PMs and parts.

Al Gresch: Okay, and any other things that you would continue to do after this is over?

Rob Bundick: For us, it's going to be continuing monitoring our data. Just be a little bit more intoned with the information you have, make sure it's accurate, make sure you're able to find equipment, keeping your Artila system updated if you have one. Just being able to have your finger on the pulse just a little bit more is something that we will continue to do and just be a little bit more better stewards, I would say, for our assets in our organization.

Al Gresch: No, that's great, Rob. Appreciate that. Salim?

Salim Kai: Really, this is a true demonstration of healthcare technology management leadership in action. We are today leading through a crisis, and we are able to be forward thinkers by continuously assessing the threat and the potential consequences that can result from the COVID-19 pandemic.

Salim Kai: I, myself have learned that during these difficult times, I should continue to evaluate a changing situation and adjust accordingly. It is about creating continuity and it's about survival. Also, to disseminate what I learned to others on a daily basis. Continue to evaluate the environment and make changes to keep myself, my family, and my team safe at all times.

Salim Kai: And then also to make time to disconnect for self-care and to recharge and to stay alert. Specifically, COVID-19, my personal routine has been to return home safe every day. For example, aside from keeping my distance from others, practicing hand hygiene, and not touching my eyes, nose, and mouth, I have altered some things in my daily routine. For example, I have reduced the number of items I carry with me and bring to work, I don't wear a jacket to work, a tie, or jewelry anymore. Less surface for the virus to latch on. I don't carry a wallet anymore. I only bring my ID and credit card in a Ziploc bag. I wipe down with disinfectant wipes the things that I touched frequently. For example, my shoes, my keys, my phone, when I get in the car, the steering wheel and the car dashboard.

Salim Kai: I wear a cloth face mask to and from work and I wear a surgical mask while at work at all times. I don't carry my favorite leather bag anymore. It has been replaced by a washable nylon bag that I wash every week. At home, I have established a zone near the garage entry to my house where everything brought home is immediately clean and or discarded. Work clothes, I wear only once, and I put in a special laundry bin and I wash separately from the rest of the laundry.

Salim Kai: I carry gloves, disinfectant wipes, masks, and hand sanitizers in my car at all times.

Al Gresch: Gene?

Gene Winfrey: I personally learned that people handle things differently. And they do so for different reasons, right? Some are concerned about their own care, some are concerned about their family care, some are concerned just about having a job. And it's important that we understand and be compassionate with each other during times like this, and I think it's even more important that we understand and are compassionate when we disagree with each other.

Gene Winfrey: Now, what are we going to do when this is all over? One, we're clean. In biomed, we're notorious for not cleaning our equipment or not having the equipment clean before it comes to us. We're notorious for not cleaning our work areas. Some are not so good at washing their hands on a regular basis, right? Even to the point of the clothes that you're wearing. Some of our staff will come and put on scrubs and they'll wear scrubs for a month. Well, we're going to change that. If you're going to grab scrubs, we're going to go ahead and turn them in at the end of the day so that they can be washed.

Gene Winfrey: It's things like this that really brought some attention to how we look at being clean. The one thing for sure that I'm going to implement within my own area is some stricter cleaning processes. Basically, we need to have a proper cleaning program for what we do with medical equipment maintenance.

Al Gresch: Awesome, thank you. Nader?

Nader Hammoud: This is a tough time for everyone. One of the biggest challenge I would like to share with everyone is when we go back home, we as technical people... Okay, you have to wash and shower and rest and see your family and everything. This is not a viable option for lots of the employees and the nurses that are working on the front line. Even if they go home, they cannot forget about the work that they're doing or the patients they've been dealing with.

Nader Hammoud: So I would say that the personal empathy and affection that we can show to the staff is very important. We cannot just assume that, okay, in regular days, nurses damage equipment and we get upset and then we go and escalate and say, "Why did you do this, why did you do that?".

Nader Hammoud: We have to be much nicer, if you want to, and understand that we have to be a solution for them, not another obstacle they have to deal with. This is what I would have to say. It's not that during regular days we are obstacles. We do take care of our staff and we care about them, but we all know that we get frustrated with how they handle our equipment and we don't want to see this.

Nader Hammoud: Now, during this pandemic, during these incidents, we have to go further in our empathy and understanding to help them go through this.

Al Gresch: Great.

Nader Hammoud: Thank you.

Al Gresch: Thank you.

Al Gresch: So for the group, any final thoughts on this whole situation and things that you might have done differently now that we're coming up on what I hope is the tail end of it? So Rob, let's start with you.

Rob Bundick: I think for us, it's getting in front of our executive leaders. When this happened, we were actually somewhat prepared because we tend to service our equipment at a high level. But our leaders were not really aware of that. They knew we were doing a good job, but when they came to us and said, "We need to be able to understand where all of our IV pumps are," and we were like, "Well, we already know that. We have our talents, we can tell you that."

Rob Bundick: They were not really shocked, they were just like, "Okay," we knew they weren't aware of the details of the level of service we're able to perform. I think that's one of the things going forward to us and we've decided to add that to our monthly dashboard that we report up through leadership, is some of those items that were asked of us during this pandemic, to now actually start actively reporting that to our leadership so they're aware of we're on top of those things.

Al Gresch: Great, thanks. Salim?

Salim Kai: Sure. I will continue to plan ahead. I will continue to lead my team by example, to be with them, supporting them all the time. Be visible as in conducting data rounds and answering questions that they may have, share best practices to keep everyone safe, and then look for creating new ways to meet and work remotely.

Salim Kai: As healthcare technology management leaders, it is important to make time to disconnect from work during this difficult time and create lasting memories with family and for self-care and to recharge. It's been a very humbling experience. It's amazing how the HDM workforce has stepped up to the demand, to the task at hand, to help each other. It's been a very collaborative journey within the profession and within other healthcare professions. It's been a wonderful experience leading through a crisis. Thank you.

Al Gresch: Any final thoughts, Gene?

Gene Winfrey: I think in general what this has also brought up, at least what we're doing here, is learning how to share our experiences, learning how to network better. There's a lot of people that are coming together to do some good things for the community in itself. Not just, "Oh, the healthcare industry, these guys are on the front line and they need to be supported," and yeah, absolutely they do. But at the same time, there's many people that need to be supported and there's a lot of people that are doing that.

Gene Winfrey: Even something like this, where we're all talking about what we're doing as we're learning new things, because we don't learn unless something happens, right? And that's exactly what's going on here. I think as a community, as an industry, we're learning a lot and it's really good to be able to say we can sit down, talk through our lessons learned, talk through our issues, and really grow.

Gene Winfrey: Like I said, I take advantage of situations like this as much as I can for my own learning, but as well for my staff and my family. There's a lot that we've definitely learned through a situation like this.

Al Gresch: Nader?

Nader Hammoud: Yeah, so the first thing that come to my mind is emergency drills that we do during throughout the year. Those are helpful. It gives you an idea how you want to handle, how you want to act, how do you want to set up the incident command center. But when the incident actually happens, everyone is in panic mode. And panic mode is not a good thing to work with. So that's something really interesting we learned, that, even though we have a processes, we are asking people to follow that process and to follow the instructions and to go through the incident command center. You still see outliers here and there and it causes issues.

Nader Hammoud: No matter what we do, you will still see those types of issues that are happening. So what we've done is, or what we're trying to change and make it efficient, is if someone is coming to us [inaudible 00:47:20], and not going through the incident command center, we will redirect them, "You have to go through there."

Nader Hammoud: Because they would come to us, "You know, we've been asked to prepare this area to be an ICU," and then you go to the command center, "No, that was like an hour ago," because things are changing by the hour, so we can't just respond and do without going through the right processes. So that was one thing we learned.

Nader Hammoud: Another thing is, you would think that nurses and physicians will be able to comprehend your instructions easily, or given technical information easily, that it's like, "If you press the "on" button on this device, it will turn on."

Nader Hammoud: In these type of situations, we've noticed that this is not the case. Not that they're under capable of understanding, but just they're overwhelmed with what they're dealing with, they don't want to hear anything about it. They just want you to take care of it and give them the end result. We had to go and educate them and help them that, you know what? On one of the occasions I want them preparing a speech to explain why and how we do things and how this can help us, and I was surprised that once I said, "If you do this, it will be safe," before I say "because," they're, "Oh, perfect, that's fine. This is what we need."

Nader Hammoud: All that they needed was just to hear it from someone who knows it to tell them that this will be safe. So that was interesting for me to see that I don't have to explain myself much. Even though it made sense to me in my head, they are in a different boat. They're fighting a different fight and they need my confirmation that it's okay for them.

Nader Hammoud: As for the second question, what is it, the things that we'll keep doing behind this pandemic? Now, we are preparing for a new department. We're expanding, [inaudible 00:49:25] is expanding. We're going through a new department to create a med-surg unit. So one thing now we're doing as a standard, that, even though it's a med-surge unit, and it's not going to be centralized. We don't need to have central station. We are still equipping and meeting with the architects and the design team that we want to have cabling ready if we want to install, instead of that vital sign monitor, we want to have a ICU level physiological monitor with a central station.

Nader Hammoud: One thing that we're doing is whatever we're doing, in any department, in any area, think of how easily can we switch that to be an ICU area? Even though we're not going to need it, maybe, hopefully, we're not going to need them the next 10, 20 years. But this is something we learned that if we had had those very basic, simple additions at the beginning of any project we're dealing with, it could have changed the outcome tremendously.

Nader Hammoud: And another piece that we will take advantage of from this pandemic is the healthcare technology and management, no matter how much you promote for your department and you promote the importance of what you do and you engage with leadership to understand and see your importance, there's always missing gaps and people who do not understand what you're doing. In this situation, that was eliminated. Everyone can see the importance of what the healthcare technology and management is doing.

Nader Hammoud: I would like to take advantage of that to keep promoting the importance of our department and be able to expand and offer more help to the organization.

Al Gresch: I want to personally thank each of the panelists for taking time out of their very busy schedules to talk with us today, and for sharing information that could benefit others in the industry.

Stay tuned for more episodes from the Healthcare Chats podcast, submit your questions online and let us know what topics you'd like us to cover. Peace out.