Two years later, what has COVID-19 taught us?
March 14, 2022
Since the University of Chicago Medicine admitted its first COVID-19 patient on March 13, 2020, the organization has experienced loss, struggle, fear and frustration — and incredible unity.
Two years later, the valuable lessons learned have improved patient care and hospital operations and made the academic health system more proactive, collaborative and unified, leaders say.
“The pandemic posed one of the greatest threats our organization has ever faced and allowed for everyone to come together as a unified team around a common cause and goal," said Krista M. Curell, JD, RN, Executive Vice President, Chief Integration and Transformation Officer. "All clinicians and staff rallied to provide the best care possible to our patients and came up with unique and novel ways to treat them while keeping one another safe.”
We talked with Curell, who oversaw emergency operations and led the Hospital Incident Command System (HICS) during the pandemic, and Rajlakshmi Krishnamurthy, MD, who manages the COVID-19 testing that was key to all hospital procedures, about what they’ve learned from the pandemic these past two years. Here are some of the main takeaways.
Clinician input is key
The clinicians treating COVID-19 patients each day had some of the best ideas about how to improve safety and meet the needs of staff, patients and families, Curell said. Their input became critical to decision-making.
“The voice of our clinicians was heard at every step of the process, and they were at the table defining what the internal policies and procedures looked like. It wasn’t something we were defining for them,” Curell said.
For example, when the pandemic began, the hospital set up isolated COVID-19 units. Only designated staff members could work in this very controlled environment in these units. The clinicians voiced concerns about being cut off from the rest of the hospital, which created challenges and inefficiencies. Upon hearing this, hospital leaders decided to dismantle the COVID-19 units as soon as they were confident with the hospital's infection control practices. From that point on, the COVID-19 patients were placed in private rooms throughout the hospital.
COVID-19 testing process can be streamlined
COVID-19 testing sites and labs were set up across the hospital system for in-clinic, curbside and walk-in patients. At first, each clinical department would have to reach out to the medical center's labs individually for tests and information. To streamline the process, each department started performing its own testing under the supervision of a new testing coordination center.
“It was important because COVID-19 testing was the center of all the operations at the medical center,” Krishnamurthy noted.
The coordination center oversaw test supplies and provided instructions on prioritizing patients, ensuring there would be tests available for urgent cases, such as people in the emergency room.
“We said, ‘Here are the criteria,’ and that way the departments could order their own testing. Those criteria changed week by week,” Krishnamurthy said.
Better use of existing technology, including MyChart
With conditions and priorities changing rapidly, the hospital started using its existing computer programs in new ways.
For example, if a patient wanted a COVID-19 test, they would log into their MyChart account and schedule it. However, during surges in demand, the hospital could limit the amount of testing appointments to ensure there were enough for emergency use. When clinicians signed into different computer programs, the latest directives and priorities for COVID-19 care were already incorporated into their ordering process.
“It’s hard to communicate to 1,000 physicians and tell them what’s changing day by day. This way, the updated information was just embedded in the system,” Krishnamurthy said.
Patient use of MyChart increased during COVID-19, so now the hospital plans to expand its use for activities like self-scheduling and outreach.
“We always had these tools, but we never used them this way. They were a really effective tool to guide people as things changed,” Krishnamurthy said. “We learned from COVID-19 that we could use them for other things.”
Enhanced advocacy in the South Side community works
Knowing that the South Side communities near the hospital would be profoundly more affected by COVID-19 than other areas, the faculty and staff, led by Brenda Battle, RN, BSN, MBA, Senior Vice President of Community Health Transformation and Chief Diversity, Inclusion and Equity Officer at UChicago Medicine, hit the streets.
The teams went out into the neighborhoods and educated local leaders and others in the community about the virus and the vaccine, offering trustworthy information and health resources.
“We did everything in our power to advocate for South Side residents. As a result, we started to see a decrease in infection rates across our community,” Curell said. “When we got the vaccine, they were first in line for it, because we wanted to offer it to those most impacted by the pandemic first.”
More focus on the staff’s mental health and well-being
For many of the hospital staff, the hardest part of the pandemic came almost two years in, when the Omicron variant hit in December 2021 and January 2022.
Before, during and after the Christmas holiday, hundreds of employees caught COVID-19. Staff couldn’t take time off for vacations, and many worked extra hours to cover their colleagues’ shifts. Testing facilities were open for extended hours, including weekends, leaving workers to spend long hours standing in the cold and snow at the drive-up clinics.
Exhaustion and burnout became serious problems, on top of the profound loss and social isolation everyone had already faced the past two years.
“It extended everybody at every single layer of the healthcare delivery system,” Krishnamurthy said. “We had to find that balance between taking care of people and taking care of ourselves. It was hard.”
That led UChicago Medicine leaders to step up their efforts to look after employees’ well-being. They began to offer additional services and resources, including counselors, meditation programs and financial assistance.
Curell said she hopes that people hold on to the friendships, support networks and empathy for others they developed during the pandemic.
“We all moved together as this impressive force of nature. It just demonstrates what we are able to accomplish when we work together. That’s how we come out of this stronger,” she said.
It’s possible to make quick decisions and pivot
Historically, larger organizations struggle with being flexible. But UChicago Medicine became incredibly nimble during the pandemic, Curell said.
COVID-19 rules and hospital conditions changed constantly, sometimes daily, with regular supply, drug or staffing challenges. Leaders used the most up-to-date data available to make quick decisions or change course when something wasn’t working well. Decisions that would normally take weeks or months were made in days or even hours, aided by fast-acting, cooperative departments.
“We had to figure out the best course of action, and we had to adapt quickly because these involved life-and-death situations. It brought about some effective and efficient processes across the medical center,” Curell said.
We can provide daily COVID-19 information updates
Throughout the pandemic, the HICS team was the hospital staff’s main information source. They emailed daily all-staff messages with the latest numbers, rules and information and compiled daily data reports for the hospital leaders. During the peaks of the pandemic, the HICS team met up to five times a day, seven days a week.
“It allowed the leadership to come together with all the information they needed at their fingertips to make very effective and efficient decisions with all of the changing information. It made for a very efficient leadership structure,” Curell said.
We can be more proactive and collaborative
When resources were scarce, departments learned to communicate and collaborate better. “What can we give up? What can we share? How should we prioritize who gets tested?” were some of the questions decided at regular meetings.
“We decided who would get our precious resources, and most of all, we wanted to do right by our patients,” Krishnamurthy said. “The lesson learned is, as a group, we can come together to collaborate and coordinate in ways we didn’t before COVID-19.”
Rajlakshmi Krishnamurthy, MD
Dr. Rajlakshmi Krishnamurthy is Chief Clinical Transformation Officer and Vice President of Population Health at UChicago Medicine.Visit Dr. Krishnamurthy's physician profile