UH St. John Medical Center: A Call to Action

The global coronavirus pandemic and national shutdown has impacted one and all.

At University Hospitals St. John Medical Center in Westlake, preparation for every scenario has been a call to action.

The 204-bed acute care hospital has been asked to increase its capacity in the event of a surge.

While that has not happened as of today, UH St. John President Robert David reports that the hospital has been in the midst of another kind of surge – a surge of compassion and preparation.

“The employees here – the physicians, the caregivers, the providers – our people have been so resilient, positive, upbeat throughout this whole pandemic,” says David. “They are truly wonderful people. It is an absolute privilege to work with them every day. We have really come together as a team through this.”

UH St. John, along with other University Hospitals locales, began preparations over 2 months ago at the request of Dan Simon, MD, Chief Clinical/Scientific Officer & President, University Hospitals Cleveland Medical Center.

“Dr. Simon started the UH Interdisciplinary team in February,” reports David. “Each of the UH hospitals started putting together a plan for the expected surge.

“These plans are very, very well thought out. We each created surge plans that start at 100 percent of our volume. Then we go up to 125 per cent, 150 per cent, all the way up to 300 percent.

300 Percent

“The governor (Mike DeWine) asked each of the hospitals to come up with a 300 percent expansion plan – basically, all hands on deck,” explains David. “How do you do that?

“You utilize every square inch of the facility. You utilize the post-anesthesia care unit, the outpatient surgery area, other locations within the hospital as temporary locations to see patients, everything.

“We have gone over every square inch of this hospital to create space if and when it is needed.”

The Interdisciplinary Team

“This effort has been the work of an interdisciplinary team of physicians who have been on incident command and have been on call every single day,” reports David.

“This is a team of people who have had input on the Surge Plan. When you go from 100 to 300 percent capacity, you need a lot of people involved. The governor asked for every one of our Surge Plans. We presented them to our UH senior leaders. I am really proud of the document we developed. When you get up to 200-300 percent that is very difficult. You need additional resources that UH is able to provide to us. I am very confident in what we prepared and the care we are able to provide our community.”

Thank You Staff

Inside UH St. John, employees and staff have nimbly maintained their commitment to community healthcare.

“When you talk about increasing capacity, you are also talking about staff. So, as certain elective procedures like endoscopies are being postponed right now, 100 staff people in these areas have been retrained and stand ready to serve,” reports David.

“We’ve cross-trained many of the people who work in the surgery department, people who work in outpatient surgery, so they can assist in the ER or the patient floors or other areas. That is how we are able to increase our volume.

“There are about 100 people we’ve cross-trained. So when we get a surge, we are going to take these folks and move them. They are ready. We have competenced every one of the people so they can seamlessly go over to a different department and we can function with a higher census.

Community

David is moved by the outpouring of care expressed by the community.

“The generosity of the community has been absolutely humbling,” says David. “People have donated masks, gloves, shields. Even monetary contributions. Bringing in meals for the staff, cookies, cupcakes, personal protective equipment.

“I have personally written so many thank you notes. I am humbled to write every single one of them. There are just so many people who want to say we’re thinking about you.”

Effective Strategy

David believes that the strategies enacted by Gov. Mike DeWine has helped communities like Westlake and hospitals like UH St. John weather the coronavirus threat.

“Just as Dr. Simon told the advisory board, I think Ohio Gov. DeWine did a fantastic job being one of the proactive governors throughout America, beginning with social distancing and limiting visitor and travel and cutting down on elective type surgeries,” says David. “I truly believe that the work he and his colleagues have done at the state level has really flattened our curve in Ohio. I think we have been blessed by some really great leadership by our colleagues in Columbus.”

“Ohio, as a state, got out in front of this earlier than others, and UH St. John has already taken the steps to respond as needed,” adds Ernst Weninger, Director Regional Marketing. “Rob and our senior leaders are in touch with the local Health Dept. and the Ohio State Dept. of Health to monitor events of any kind.

“Many of our EDs have erected tents as screening sites to maximize capacity. All of these steps that Rob and the senior leaders have taken have prepared us very well.”

Supplies

UH St. John is well-equipped with ventilators and anesthesia units that are ready to deliver oxygen. UH St. John also takes inventory in every department twice a day for every kind of supply.

“We take inventories and metrics twice a day to the system level. And each day all the hospital presidents on both sides of town get on a call and we go over what we need and what our colleagues need,” says David.

“Most of our supplies are done at the system level, but if another hospital needs masks we can take them over. It feels like a family, that we’ve been able to do this for one another.”

“We understand our mission here, and that is to take care of our community,” adds Weninger. “We are here for our community and we are prepared for our community, whether it is a Covid outbreak or day to day operations. We see this as a challenge, one that we have been able to prepare for and one that we are confident in our preparation because it is a privilege to be here for our community.

We Will Get Through This Together

David credits each and every member of the hospital team for making a difference, from the housekeepers and environmental services who keep things safe to the food service workers all the way up the line to nurses and doctors who put themselves in harm’s way for the health of the community.

“I have been able to round more than ever. When I see the smiles of our employees and hear them say, ‘Rob, we’re going to get through this and we’re going to get through this together….’ The motivation that gives me the excitement…that people are smiling!

“They are taking care of patients who are very sick and they are still smiling. That is how we are getting through it.

“When I hear someone say, ‘We are dropping off boxes of Girl Scout cookies because we care about you guys…

“When you have people in the community doing these things with that kind of generosity and your employees are smiling – I can’t put into words what that feels like.”

Numbers

From a numbers standpoint, UH St. John has been at about 65 percent capacity, or 2/3rds of the normal in-patient volume.

Out-patient activities like doctor appointments and lab tests have been reduced to limit visitations and there has been an increase in telephonic care.

Testing

Testing for the coronavirus started at UH St. John this week.

“We can now do 15 minute rapid tests. If anyone comes through the Emergency Dept. with symptoms, we have a limited number right now. But it has already been a game-changer for people who have signs and symptoms of Covid-19 and it just happened this week,” reports David.

Clinical Trial

UH St. John is also among the first in the nation in a clinical trial for the antiviral drug Remdesivir for hospitalized adults with pneumonia due to a documented novel coronavirus. While it is too early to report on effectiveness, it is a boots on the ground research opportunity. This drug is exciting because it is an active anti-viral treatment, not simply supportive care.

“We are very excited to do this at the community level,” says David. “And, thankfully, all of our patients currently are recovering.”

How You Can Help

If you really want to make a difference, please register for the May 19 Blood Drive which will take place in Auditoriums A & B.

In March, we literally filled every slot thanks to the generosity of our community,” says David. “We had people on a waiting list. So we are going to do it again.”

Sign up here: Donors can make an appointment at www.vitalant.org/OhioDonorPortal or by calling 1-877-25-VITAL. Donors interested in the UH drives can use the sponsor code sjmc.

Conclusion

“We planned for the worst and we are praying for the best,” concludes David. “Because of the work the governor has done sooner rather than later, the curve is being flattened.”

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