10.02.20
MHA Today | October 2, 2020
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MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.
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COVID-19 Updates |
For the latest updates and most current information on coronavirus disease 2019, visit MHA’s website. |
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Insights |
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On March 7, the first positive case of COVID-19 was reported in Missouri. Nearly seven months later, we continue to see community-based spread and high rates of hospitalization in nearly every region of Missouri. In fact, despite efforts to flatten the curve, Missouri has experienced significant COVID-19 spread through the summer months, resulting in record high levels of hospital utilization throughout the last two weeks. Last week, MHA released a Mid-Response Assessment to provide a review of the progression of the virus, and actions in the state related to response and recovery. The assessment surveyed hundreds of hospital leaders, among a variety of disciplines, statewide. The goal was to develop a better understanding of the progress in response and recovery, the strategies hospitals have used to manage resources, and the influence of policy in support of hospitals’ operations during the crisis. The survey found that years of investment in emergency preparedness planning supported initial response at a significant majority of hospitals. However, as the pandemic lingered, the value of the previously developed pandemic plans diminished. The prolonged response revealed gaps in existing plans, including alternative care units, staffing plans, visitor policies, screening systems, supply chain bottlenecks and masking challenges. As the pandemic progressed, new clinical and operational processes have continued to emerge. Nearly all hospitals implemented an emergency operations plan, and more than 80% continue to operate under one. However, emergency operations for internal coordination have relied on additional regional coordination with other community hospitals, physicians and local government. Data remains a critical element of the COVID-19 response. Survey respondents listed MHA as the second “primary source of truth” for pandemic operational and response-related issues, behind the Centers for Disease Control and Prevention. And, MHA data delivery was aligned with hospital-identified response-priority data needs. Waivers were essential to compliance as hospitals prepared for a COVID-19 surge. MHA worked with the state and federal governments to identify which areas of response would require variance, and to craft broad or targeted waivers to remove roadblocks. These waivers remain indispensable, and nearly three-quarters of hospitals continue to operate under conditions requiring waivers. According to survey participants, the most significant challenge to patient care was access to appropriate supplies of personal protective equipment. This was followed closely by the tempo of changes in guidance. Nearly 70% of survey participants indicated that MHA was the first source of information throughout the highly fluid changes. Many of the tools MHA provided — visitor policies, waiver tracking, crisis standards of care, analysis and more — helped shape, and continue to inform, hospital and health system response. Throughout more than a decade, our emergency preparedness systems have provided a foundation for all-hazards response and recovery. The COVID-19 pandemic is global in scale. However, understanding how our Missouri response has unfolded — including what tools and resources have proven the most useful to hospitals and the health care system — will drive not only the ongoing COVID-19 efforts but future emergencies and ongoing quality and infection control improvement. P.S. — Congress is on recess through November. MHA created a “boarding pass” for Missouri’s delegation to frame conversations with lawmakers during their time back in Missouri. It is essential that we continue to engage our delegation on health policy in the interim, to prepare them for the work that will be necessary in the lame-duck session, post-election. Let me know what you think.
Herb B. Kuhn
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