In December 2019, China began experiencing a mass infection in the city of Wuhan. The United States had watched this before with SARS and MERS, and the infections seemed to barely limp across the ocean, never causing much problem here. But December rolled into J
anuary, then February and the virus – now called COVID-19 or a novel coronavirus — wasn’t fading. It was spreading and growing more deadly.
Recognizing the crisis on the horizon, Karen Funk, Clinica’s chief medical officer, put together an Incident Command (IC) group that began meeting on Mar. 12 to discuss Clinica’s plan to address COVID-19. Just four days later, a statistical analysis showed that without rapid and radical action, the virus was likely going to infect millions and kill hundreds of thousands of people around the globe. Clinica needed to be part of the response. We needed to keep our staff and patients safe while treating those who got sick. The IC group and key Clinica staff created a plan allowing us to pivot from our usual model of primary care to one more like an urgent care. We built three medical teams at each site: a dental team to provide acute care that would keep patients out of emergency rooms, a team to provid
e acute medical care to patients without COVID-19 symptoms and a third team for those with symptoms of the virus (respiratory sick patients).
Teams built around each of these areas of work:
• Planning
• Dental
• Communications
• Telehealth
• Safety/HR
• Liaison
• Operations
• Logistics
• Finance
The planning group determined how to create the three lines of service. The dental group decided which services could be provided during the pandemic and how. Communications made signs and helped create patient messages. Telehealth stood up an entire tele-care system for medical, dental and behavioral health. Human Resources/Safety determined which staff could work from home and how to manage staff who might get sick during this outbreak. Liaison worked with community partners to find funding and additional resources for Clinica. Ops staff cancelled appointments for well patients and spreading out the communications center staff so they wouldn’t get sick. Logistics was busy acquiring person protective equipment (PPE), COVID-19 test kits and outdoor shelters for the respiratory sick providers. Finance managed the impact of COVID-19 expenses and the loss of revenue from seeing well patients.
As in almost every aspect of Clinica’s decision-making, these decisions were informed by the best available data and our experience. The Planning group developed a daily situation report (SITREP) so we could
Daily SITREP report tracking staff, COVID-19 tests, PPE, and other vital information.
track the number of patients seen, COVID-10 tests performed and quantities of PPE. Additionally, the team monitors the daily reports from the Colorado Department of Public Health and Environment, the Centers for Disease Control and Prevention, the World Health Organization and county health departments.
For the first few weeks of this new model, the IC team met several times each day to work through new challenges, getting staff and equipment updates and determining what changes needed to be made to our systems.
When social distancing recommendations were implemented, the Incident Command group moved to the Shepherd Training Center so we could sit six feet away from each other. And when Lafayette became a “hot spot” due to the number of positive COVID-19 tests, we moved online. Now we are meeting just once a day, and Incident Command gatherings look like this.
Incident Command began meeting via Zoom once the Lafayette medical/admin building became a COVID-19 hot spot.
Everyone on the IC group deeply understands that while we are making decisions about how to provide care to our patients during this pandemic, it’s all of you in the clinics and those of you working from home who are making this possible. We are so grateful for your tireless work and the trust that you’ve put in Clinica’s leadership to get us through this situation. Hang in there. We are in this together!
#bringourfriendsback
By Susan Wortman, VP of Development