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Hospitals Execs Prep For Coronavirus Surge

Orange County hospitals have bolstered medical staff and prepared safety zones for patients potentially infected with the coronavirus to receive care.

While preparing for a surge in work, executives at the area’s top hospitals express confidence that they’re up to the challenge.

“Our community is shaken,” Barry Arbuckle, chief executive of MemorialCare Health System, the largest nonprofit healthcare entity in Orange County, told the Business Journal.

“Let me offer some reassurance,” he added. “We live in a community that offers exceptional healthcare close to home. Whether you seek care at MemorialCare or another health system, you are getting among the best the world has to offer.” 

Orange County’s largest hospitals last week told the Business Journal they are gearing up for work, as the coronavirus blankets itself across Southern California.

At press time on March 27, there were more than 250 cases and the first death in Orange County. Nationwide, there were more than 1,300 deaths reported.

OC’s hospitals are postponing elective surgeries, opening drive-thru testing sites, switching their doctors to tele-medicine instead of office visits and prepping special floors in case the pandemic widens.

They’re also promoting education about the virus, and stress the need for the local community to make good decisions.

“There is a lot of misinformation and understandable concern about COVID-19,” said Robert Braithwaite, chief executive of Hoag Memorial Hospital Presbyterian. 

“These are unprecedented times for America and the world. Together we are confronting the COVID-19 pandemic and it is more important than ever to take care of one another and be diligent and wise in our daily activities,” he said.

Orange County has 6,507 beds at the 31 largest hospitals, including extended care facilities, according to the Business Journal’s annual list of hospitals published in February. These hospitals have 42,339 full-time employees.

It hasn’t been disclosed if doctors and nurses at any area hospitals have tested positive for the coronavirus; individual hospitals have referred such questions to the Orange County Health Care Agency.

“We are doing everything in our power to protect our caregivers,” said Erik Wexler, executive vice president and chief executive of health and services for Providence St. Joseph’s Southern California Region.

As of early last week, no caregivers or physicians with Providence hospitals—which counts Mission Hospital under its umbrella—have contracted the virus, Wexler said during a virtual town hall meeting, regarding their response to the coronavirus.

“These are certainly unprecedented times,” he said. “As this ramps up, we will be prepared,” Wexler said.

Here’s a roundup of what some of OC biggest hospitals are doing:

UCI HEALTH

UCI Medical Center, OC’s largest hospital by net revenue and the county’s only academic health system, said it is “well equipped to manage the care of patients with infectious disease.”

Earlier this month, it said it became the first health system in Orange County to have in-house testing, which will expedite confirmation for its patients.

No Orange County hospital is encouraging people worried that they have the virus to show up without an appointment.

“That will stretch hospital resources and make it more difficult for providers to assist patients who have urgent needs,” said UCI Chief Medical Officer Dr. William Wilson.

UCI is following its own “special precautions” protocol for isolating and handling patients with suspected or confirmed COVID-19 infections. It has also been monitoring the situation since January and continues to provide necessary update from the CDC and UC system to staff and providers.

UCI has postponed non-urgent surgical procedures.

“We will continue to perform some surgery on patients whose condition causes severe pain or poses a threat to life or limb,” Wilson said. “For example, UCI Health is not denying surgical care to cancer patients.”

UCI reported $1.2 billion in sales for the 12 months ended Sept. 30. It has 402 licensed beds.

HOAG

The hospital said it has “a world class infection prevention team leading our efforts.” This effort includes education, training and drills to properly screen and isolate patients for infectious conditions.

It is advising patients to first call their primary care physician, or if needed, contact one of its 13 urgent care locations throughout the county that have testing capability.

The testing of patients is being prioritized to those at the highest risk of developing complications.

Hoag clinicians are screening all patients for fever, respiratory symptoms and travel history within a month prior to symptom onset. Anyone meeting the CDC-established criteria is isolated and further testing and care is guided by the Orange County health department.

Hoag has reserved floors at its hospital campuses for patients who may have the virus.

It said it is continuously monitoring its resources to determine if it has enough of the appropriate equipment like masks and ventilators.

About a week ago, it got a donation of 5,000 N95 respirator masks from Trevor Theriott, chief executive of Las Vegas-based medical device company ManaMed Inc.

“Please know that Hoag will be with the community every step of the way,” Braithwaite told the Business Journal. “Our commitment to you is that we will continue to share important guidelines, practices and critical updates as the situation evolves, to both keep you informed and keep you well.”

Hoag is the second-biggest hospital on the Journal’s list, pulling in $1.1 billion. It has 6,315 employees and can provide 518 licensed beds at its Newport Beach and Irvine locations.

ST. JOSEPH HEALTH

“Given all the concerns related to coronavirus, we are more steadfast than ever in our commitment to meet the healthcare needs of our community,” Mission Hospital Chief Executive Seth Teigen told the Business Journal.

“It’s amazing to watch people come together during challenging times,” Teigen said.

Mission Hospital has set up temporary facilities outside the emergency departments to screen patients away from the general population.

The hospital is encouraging people with mild symptoms to refrain from coming in for a coronavirus test. The only patients currently being tested are those who are symptomatic and in a healthcare setting or elderly population.

It has what it calls the Providence Express Care Virtual to allow patients and providers to meet a nurse practitioner who can screen, assess, prescribe, and advise the next steps in treatment.

A spokesperson for Mission said that they anticipate “great challenges in providing the level of care that will be needed in the coming weeks and perhaps months, if the community does not cooperate with the required safety measures.”

Mission Hospital, which runs hospitals in Mission Viejo and Laguna Beach, is part of the Providence St. Joseph Health System, whose OC operations also include St. Joseph Hospital-Orange and St. Jude Medical Center. Mission Hospital, which reported $727 million in revenue, has 523 licensed beds, St. Joseph 491 and St. Jude 320.

Wexler said last week that Providence St. Joseph expected a shipment of 300,000 masks to be made available in the immediate future.

“We are stable from a supply perspective,” Wexler said in last week’s video town hall. “We are seeing an increase in supply every day.”

MEMORIALCARE

The hospital chain, which has four hospitals and 200 clinics throughout Southern California, has suspended nearly all elective and non-urgent procedures based on criteria and the surgeon’s clinical review. It has implemented work-from-home options, restricted visitations and set up screen sites at entrances.

It has set up “isolation rooms” at various units among its four hospitals.

“The care and safety of our patients and staff is of utmost importance and we have the supplies we need to test for symptomatic patients” Chief Medical Officer Dr. James Leo said.

“We have sufficient supplies only to test suspected COVID-19 patients who require admission,” work in skilled living facilities, or are providers who need to get back to patients, he said.

Regarding the mask shortage and lack of medical equipment, MemorialCare currently has enough for its medical professionals to be adequately protected. However, it is being “diligent in how we use them, as we are challenged with the rest of the nation in getting orders filled in large quantities,” Leo said.

“Our clinical and operational leaders have planned for the likelihood of a surge,” Arbuckle said. “We all need to be prepared for the continued challenges with access to testing and supplies and we are doing everything possible to address these issues.”

MemorialCare’s Saddleback Medical Center in Laguna Hills has 248 beds while its Orange Coast Medical Center in Fountain Valley has another 222 beds. Combined, the two reported almost $800 million in revenue.

KAISER PERMANENTE

Kaiser Permanente said it’s been in constant planning for more than three weeks. It has opened “command centers” at the local, regional and national levels to monitor changing conditions. 

It “has been actively planning for the expected surge in COVID-19 patients for the past few weeks now,” Kaiser Area Manager Mark Costa told the Business Journal.

“This preparation includes, but is not limited to evaluating our staffing needs, supply and equipment needs as required to keep our community and staff healthy and safe,” he said.

Kaiser is encouraging its members to speak in phone appointments with their primary care providers regarding coronavirus symptoms; patients can be screened to determine if they need to be tested.

Kaiser’s emergency departments at both its medical centers have special units that are solely used for Patients Under Investigation, also known as PUIs. In each pod it has 12 beds for a total of 24. 

It has set up a comprehensive drive-thru testing site at its Anaheim facility for Kaiser members who have seen a physician and received a referral for testing. It is prepared to expand to a second site should demand require.

If a person shows up at its hospitals with suspected coronavirus, the person is placed into isolation or sent home for self-quarantine.

The hospital chain has canceled all elective procedures. Kaiser said it has enough masks and ventilators.

“We are prepared,” Costa said. “Kaiser Permanente is fortunate that we have national resources that we can call upon should we need them. Locally, we continue to monitor our supplies on a daily basis and currently have an adequate quantity to continue our healthcare delivery and protect our staff.”

Kaiser is the third-largest hospital in Orange County, reporting $1 billion in revenue and 3,912 employees. It has 478 beds in Anaheim and Irvine.

Tuberculosis, to Cancer, to COVID-19

City of Hope, which has opened a cancer treatment facility in Newport Beach and expects to spend $1 billion in Orange County in the next decade, said it is working to develop a vaccine to fight the coronavirus.

“Given the urgency of this pandemic, City of Hope is employing its vast expertise using the immune system to fight viral infections,” said Dr. Don Diamond, a virologist and professor at City of Hope.

In the past, COH developed the Triplex vaccine against cytomegalovirus (CMV), a type of herpes virus that is like the coronavirus in that it can cause pneumonia and other serious complications in patients that are immunocompromised.

During Phase 2 of the Triplex vaccine, patients who were given the inoculation were 50% less likely to experience complications. Diamond believes that he and his team will be able to develop a vaccine using the CMV data for the novel coronavirus.

“Serving others during a medical crisis is part of who we are,” said Annette Walker, president, City of Hope Orange County, who notes that the hospital was born out of a necessity for helping those impacted by a tuberculosis outbreak more than 100 years ago.

“Now, as our country faces the COVID-19 crisis, we are rallying our best medical minds to meet the urgent needs of the communities we serve and beyond,” she said.

—A. Leigh Corbett

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