Tag Archives: coronavirus

Teamwork and Preparation Most Important in NIHD’s Response to COVID-19

It is an overused analogy, the war against novel coronavirus, but as any employee at Northern Inyo Healthcare District will tell you, the battle is real. Ironically, it is a battle most have prepared for throughout their respective careers.

“Every team member brings something to the fight,” says Dr. Stacey Brown, Medical Director of NIHD’s Rural Health Clinic and current Vice Chief of Staff. “Every department plays a role.”

For NIHD Board President Jean Turner, the show of teamwork fits right into the District’s operational design. “When I came onto the Board, I was told our basic structure is that of an inverted pyramid,”
Turner says. “Leadership at the bottom, the workforce at the top. The top is where the real work goes on; it’s where things really matter. If I wanted our community to remember one thing at this point in time, it’s this: Our staff is disciplined, well-trained, and ready for this challenge.”

The District’s fight against coronavirus began in mid-January. For weeks, Infection Preventionist Robin Christensen, RN BSN HIC, kept an eye on what was transpiring in China. On January 28, she called the first team meeting to talk about coronavirus and its potential impact on NIHD and the community. Everyone in the room knew the odds, had watched the numbers coming in from China.

“It is safe to say we wished for the best, but as healthcare workers, we always prepare for the worst,” Christensen says. “It’s who we are; it’s what we do; it is what the community expects from us at a time like this.”’

As the NIHD team developed needed plans, they carried on with providing day-to-day care. Hallway conversations and internal emails began to refer to coronavirus more frequently. The District conducted a pandemic disaster drill on February 13. The tipping point came March 6 when a two-hour coronavirus meeting gave way to a day-long review of staffing levels, supplies, policies, plans, and shared concerns.

The group met the next afternoon again for several hours. They got a late start, beginning at noon. It gave those who volunteered to help at the Eastern Sierra Cancer Alliance’s Blue Ribbon Walk & Run a chance to meet their commitment. For many at NIHD, it was the last “normal” day of the month.

NIHD initiated an internal Incident Command on March 10 and continues working under it today. Incident Commands use a standardized approach to direct, control, and coordinate emergency response. More importantly, it brings people together to reach a common goal.

Like her co-workers, this was not the first time Allison Partridge, RN MSN, worked under an Incident Command. Partridge, the Director of Nursing for the Emergency and Medical-Surgical departments, knows the system well and aids Chief Nursing Officer Tracy Aspel in keeping the daily meetings on task.

Partridge now spends much of her days working with others to put together workflows for the departments that will be most affected. With guidance from Infection Preventionist Christensen, Partridge
and others closely watch the Centers for Disease Control and Prevention and the California Public Health Department for direction. No area or service escaped review.

“We track daily our current availability of Personal Protective Equipment (PPE), and the recommendations for use,” Partridge says. “Additionally, we have made modifications in how we provide services and how visitors access the campus. All of these measures are in place to protect our teams and community. We encourage all employees to adhere both while at work and at home to the recommendations issued by national, state, and local government.”

Carefully crafted plans address the care of Patients Under Investigation (PUIs). Partridge says the standardized workflows are based on the patient’s level of care, whether that be critical care at the hospital or self-isolation at home. Care of multiple positive COVID-19 patients within the hospital remains an area of concern for the small 25-bed hospital.

“A great amount of planning and preparation has gone into every action, and it’s still ongoing,” Partridge says. She notes that just this week, the team was searching every square inch of the facility for places to place more beds. No space is overlooked. An unused and unfinished room located in the two-story hospital was turned into a four-bed safe patient care area within hours.

As for staffing, the level is adequate at this time. The District is working closely with the American Federation of State, County, and Municipal Employees Union on staffing plans should the virus take hold of the community.

As non-essential services are scaled back, staff in those areas become available for use in others. Nurses and caregivers were surveyed to see if they would be OK to serve in other departments they were cross-trained to work in. Recently retired nurses may be considered for voluntary return to bolster staffing numbers. The dedicated care given by generations of NIHD nurses is legendary in the community.

They were also asked who would be willing to work with critical coronavirus cases. No one will be asked to step into a situation they are uncomfortable with — and to date, no one has opted out.

As for the physicians, Dr. Brown and Dr. William Timbers, NIHD’s Chief of Staff, are relying on the aid and advice of many of the District’s Medical Chiefs – Dr. Richard Meredick (Orthopedics), Dr. Charlotte Helvie (Pediatrics), Dr. Sierra Bourne (Emergency), and others. The Medical Support Staff office issued emergency credentials for other physicians in the area should their aid be required at bedsides.

The Rural Health Clinic team launched drive-in coronavirus testing well before some larger, urban hospitals did. The move was based on when the RHC offered drive-in flu shots more than a decade ago.
“Hometown health care can work anywhere, even in the big city,” Dr. Brown smiles.

Dr. Brown’s reliance on RHC Directors Paul Connolly and Jannalyn Lawrence, RN, is evident. Both work closely with the District’s outpatient clinics and played critical roles in clearing barriers for drive-in testing. When offered kudos for the work, Lawrence scoffed. “One Team, One Goal,” she says, incurring the closing line of the District’s mission statement.

Later, as Director of Nursing Partridge studies the endless worklists that paper the walls of Incident Command, she agreed with Lawrence. “Teamwork has played a huge role in managing every aspect of this situation,” she says. “This collaboration has taken place across all disciplines and has included a multiagency approach across Inyo and Mono counties. This great work truly exemplifies our mission of ‘One Team, One Goal, Your Health.’”

Meanwhile, as another day ends for the District team, Infection Preventionist Christensen is in her office. It is quiet in the usually bustling hallway; the result of the District’s temporary telework plan. Almost 80 employees are working from home, practicing social distancing.

Laying across Christensen’s desk are signs of a community lending its support to its healthcare workers: Packages of the valued N95 masks recovered from businesses and home garages, plus several handcrafted face masks. The handcrafted masks, with bright patterns of cacti, cats, and paisley, are especially touching
to Christensen.

NIHD is looking into options that could allow the homemade masks to be used as covers for approved personal protective equipment. That would occur if, and only if, NIHD’s supply of approved masks is
depleted. The covers would help keep the N95 masks free of transferred hand oils, possibly extending the life of the N95s.

“One team,” Christensen says, circling her index finger, gesturing from east to west, north to south. “It’s all of us in the community. Together, we will get through this.”

Coronavirus Arrives in Inyo County

Inyo County has its first confirmed COVID-19 case.

The first Coronavirus patient has been identified as a 42-year old female living in Bishop. According to Northern Inyo Hospital Rural Health Director, Stacey Brown, the patient came down with symptoms including a fever, cough, chills, body aches, headaches, and low-grade fever.

Health officials instructed the female victim to self-quarantine at her house.

When asked about the status of the patient, Dr. Stacey Brown said he was unsure about the health status of the individual. “I don’t know, but I will reach out to her. As far as I know, she is recuperating at home.”

Brown emphasized that just because a person does not have severe symptoms, does not mean there is no cause for concern.  “This is a great example of how COVID can appear pretty mild in a person. She got tested for a flu and that came back negative. Then she tested positive for COVID, and we got results after a four-day turnaround. The spread [of coronavirus] can present itself in many ways.”

So far, NIHD has conducted fifty-five total tests. Out of those tests, twenty-two are negative, while thirty-two are pending.

The Hospital’s Drive-In testing center was where the patient tested positive for the virus. “The drive-in testing clinic that the district put together was successful in finding our first case in a safe manner,” Brown expressed.

Dr. Brown said the staff responsible for testing the female took all proper measures to minimize the risk of contracting novel coronavirus. “I am really proud of what we have done as far as collecting specimens in a safe manner,” said the Rural Health Clinic Director.

The district will be switching from a surveillance strategy into a containment plan. With containment as the top priority, Brown expressed that the way the hospital goes about testing for coronavirus will be different.

“The testing we do for COVID is going to be focused more on healthcare members so we can get staff back into duty quickly. Testing will also be for acute patients, correctional facilities, and long-term care centers like the Bishop Care Center. We are testing right now, but not for the general public.” Dr. Brown stated.

Director Brown encouraged the public to practice the same strategies health officials have emphasized since the start of this pandemic. Nothing has changed when it comes to combating coronavirus. “Now that we know it is here, it is much more about containing the illness and talking about things like social distancing, hand washing, cleaning surfaces, etc. There is nothing new we have on the horizon from a public health perspective just because it is here.” Brown said.

Mono County to Host Meetings About Coronavirus

The Mono County Health Department will host community meetings about the coronavirus (COVID-19) epidemic in several communities over the next few weeks. The purpose of these meetings is to provide community members with locally relevant information about the situation and to promote discussion. We will answer questions and hope to hear and understand community concerns.

We have no evidence at this time that COVID-19 is present in the Eastern Sierra and feel that the risk of public gatherings like this is low and outweighed by the potential benefits of keeping people informed. We are of course watching the situation closely and if we determine that there could be some risk from these community gatherings we may opt for other modes of communication.
Spanish language interpretation will be available at the Bridgeport and Mammoth meetings.

Wednesday March 11, 2020 @ Mammoth High School Cafeteria 6:00pm – 7:00pm
Wednesday March 18, 2020 @ Walker Senior Center 12:30pm – 2:00pm
Wednesday March 18, 2020 @ Memorial Hall in Bridgeport 3:00pm – 4:00pm
Thursday March 19, 2020 @ the Benton Community Center 5:30pm – 6:30pm

El Departamento de Salud del Condado de Mono organizará reuniones comunitarias sobre la epidemia de coronavirus (COVID-19) en varias comunidades durante las próximas semanas. El propósito de estas reuniones es proporcionar a los miembros de la comunidad información relevante a nivel local sobre la situación y promover el debate. Responderemos preguntas y esperamos escuchar y comprender las preocupaciones de la comunidad.
No tenemos evidencia en este momento de que COVID-19 esté presente en el Eastern Sierra y creemos que el riesgo de reuniones públicas como esta es bajo y los beneficios potenciales de mantener informadas a las personas son mayores del riesgo. Por supuesto, estamos observando la situación de cerca y si determinamos que podría haber algún riesgo en estas reuniones comunitarias, podemos optar por otros modos de comunicación.
Habrá interpretación en español en las reuniones de Bridgeport y Mammoth.

Northern Inyo Hospital Gives Coronavirus Update

Northern Inyo Hospital held a conference call with media members on Monday morning to discuss Coronavirus.

The call included some key figures from NIHD including Mono County Public Health Officer, Dr. Tom Boo, Rural Health Clinic Director, Dr. Stacy Brown, Infection Control Preventionist, Robin Christensen, Emergency Department of Disaster Planning, Gina Riesche, an acting CEO, Kelli Davis.

To start things off, the district gave a rundown of where they currently stand. Dr. Stacy Brown spoke first saying, “We have not had any cases identified in the area. Late last week, we had a meeting and received information from the California Department of Public Health (CDPH) and the Center for Diseases Control (CDC) to create prevention plans. We have created a drill relating to what areas we we need to identify and where we need to focus our efforts.”

NIHD says they have taken stock of equipment in order to prepare for a possible outbreak of Novel Coronavirus. The equipment will be used for both patients and staff. Brown believes they are more well prepared as far as medical equipment is concerned. “We feel we have sufficient stock when it comes to treating patients with the virus.”

Infection Control Preventionist, Robin Christensen seconded Brown’s sentiments, emphasizing that the hospital has been checking with its purchasing department to ensure they have enough medical supplies to treat a possible increase in cases.

Gina Riesche, NIHD’s Manager of the Emergency Department and Disaster Planning then shifted the discussion toward what procedures the hospital would need take in the event of coronavirus arriving in the Eastern Sierra.

Depending on the number of cases, the district would set up emergency triage centers outside of the emergency room where treatment can begin. After that, an incident command system would be implemented to help manage the crisis of a coronavirus outbreak.

After the rundown by the hospital, a Q&A discussion between the media and NIH commenced.

When asked about how Northern Inyo Hospital would be able to handle a high number of patients suffering from coronavirus, Dr. Boo said they would be able to call in help from medical professionals throughout the state. “Both Inyo and Mono County are apart of the California’s Region 6 Healthcare Coalition, so we would be able to make a resource request if needed.”

There are many actions an individual can do reduce their chances of contracting the virus. To decrease the likelihood of picking up novel coronavirus, one can wash their hands, practice social distance, and not show up for work when he or she is sick. However, it is one thing to tell a person these tips, and it is another for them to actually put the advice into practice.

NIHD have plans in place to try and encourage people to heed their advice. Brown told the media, “I think educating the population is an important thing. At our next healthy lifestyle talk, I am going to talk about the importance of washing your hands. I will spend about five minutes at the beginning of the talk doing that.”

Brown is not only concerned about what the public is doing to take preventative measures, he is also trying to ensure that healthcare workers are following proper protocol. “From a staff standpoint, we are rolling out instructions to make sure we are using equipment properly.”

Though the Eastern Sierra is a geographically isolated area, Dr. Tom Boo does not believe that to be an advantage when it comes to having less coronavirus cases. “We are pretty connected to the rest of the state and the world. We have people coming and going from all over the world, and travel enhances the spread of disease.”