In 2020, the COVID-19 pandemic forced healthcare providers all over the world to think on their feet and make grand, sweeping changes as swiftly as possible. Certain aspects of patient care will eventually return to normal, allowing COVID-driven changes to become a thing of the past, but the pandemic also led to some significant changes that will likely remain in place going forward.
This trend—updated policies destined to outlast the pandemic—was the focus of an on-demand session at Cardiovascular Summit Virtual, an online conference hosted by the American College of Cardiology.
David H. W. Wohns, MD, division chief of cardiology at Spectrum Health in Grand Rapids, Michigan, presented the session with Ginger Biesbrock, an executive vice president of MedAxiom. The two hosts explored different ways that cardiovascular care changed at Spectrum Health as a result of COVID-19, noting that some of those changes have been incredibly positive—and may have never even happened if not for the pandemic.
After all, as Wohns said at the start of the session, one thing you never want to do is “let a serious crisis go to waste.”
Taking advantage of advanced practice providers
A lot of COVID-driven changes at Spectrum Health were related to alternative care delivery practices. For example, Wohns noted that advanced practice providers (APPs) saw their roles shift significantly due to the ongoing crisis. APP-only rounding became common, though attending physicians were still required to check in on their patients every three of four days. Exceptions were also made when a patient or their loved ones specifically asked to see the attending physician.
“This was transformative for our APPs,” Wohns said. “They felt empowered, they had more autonomy and—quite frankly—attendings were rarely requested by anybody, because of the relationships APPs were able to create with patients and their families. So it was a very effective model.”
Embracing e-consults
At Spectrum Health, like many other health systems, e-consults became especially powerful tools for treating patients while still keeping the potential for anxiety at a minimum.
Biesbrock noted that providers should make sure they understand how reimbursement works for these new-look appointments. If the specialist is in the same building as the patient and still able to complete a full chart review and talk to the ordering physician, Biesbrock explained, they can go forward with using the typical code. If you’re not in the same physical location, on the other hand, you’ll want to use one of the billing codes designated for e-consults.
Developing new and improved pathways
Providers at Spectrum Health used the pandemic as an opportunity to re-examine the roles and responsibilities of every member of every care team.
“Teamwork is more important now than it has ever been,” Wohns said, echoing the sentiment of countless other healthcare providers over the last 11 to 12 months.
One new pathway the team established was the Early Access Cardiology Clinic, which was designed to treat patients who need an appointment within 48 hours. Also, significant changes had to be made to how ICU patients were treated due to the high number of COVID-19 patients seeking care. Again, APPs were used to make the most out of a challenging situation. Ambulatory APPs were redeployed to the inpatient rounding services, and inpatient APPs were redeployed to the ICUs.
“This required quite a bit of change in management and conversations and ended up being an incredible success,” Wohns said. “Fear and apprehension were surpassed by joy, fulfillment and a sense of teamwork that enriched people.”
Supporting employees in a challenging time
Spectrum Health also responded to the pandemic by focusing more than ever on the needs of its employees. Multiple programs were quickly established that focused on providing childcare to the children of employees, for example; there was a partnership with the YMCA and a program that brought in tutors when necessary to work with school-age children.
“We’ve all learned that our workforce is incredibly important and we need to think about how to maintain their needs,” Biesbrock said.
More information on Cardiovascular Summit Virtual is available here. Attendees can access numerous pre-recorded sessions, including the one discussed in this article, with the click of a button.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.