Our COVID-19 Journey
The COVID-19 pandemic has underscored the importance and necessity of robust public health infrastructure to protect the health and well-being of communities and diverse populations. The lack of investment in local, state, and national public health infrastructures in recent decades has reflected, at times, in a confusing response to the pandemic. Our nation must invest and build back the public health infrastructure to be ready for future pandemics.
Holy Cross Health's COVID-19 journey has illuminated for us the need to be a fierce advocate for sustained investment in public health. Our journey is not unlike many other hospitals/health systems in the country, yet we thought it important to share our experiences and lessons learned to date, with the hope we might shape public policy and successfully advocate for more funding in the public health infrastructure, which includes hospitals/health systems. A future of potential and unimaginable public health risks to the nation and the communities we serve compels us to do so.
Holy Cross Health fully endorses the policy recommendations outlined in Trinity Health's Investment in Public Health, Essential Elements and urges Members of Congress to consider the policy recommendations when deliberating the legislative infrastructure package. We invite you to join us in this work by contacting your Members of Congress. Click the link below to get started.
Holy Cross Health’s COVID-19 Journey
Our journey began in 2015 when Holy Cross Hospital in Silver Spring was selected as one of five Ebola or Serious Pathogen Assessments Hospitals in Maryland. In preparing to receive Ebola patients, we created a special unit within the hospital, conducted training exercises, implemented policies and procedures, and strengthened our relationships with Maryland's public health professionals – all of which enabled Holy Cross Health to pivot quickly and respond to COVID-19.
In January 2020, after it was confirmed that the coronavirus had spread to the United States, Holy Cross Health conducted a situational analysis of the coronavirus and issued guidance to our colleagues, based on recommendations from the Centers for Disease Control and Prevention and the Maryland Department of Health.
In late February 2020, we put in place our incident management cadence, activated our Emergency Operations Plan and Incident Management Team, and identified clinical management and infection control processes for pandemic operations. Unique to our regional health system and COVID-19 response is having members of our leadership and on our Incident Management Team who are retired military and first-responders who have brought a wealth of national and global experience and knowledge to our pandemic operations.
On March 4, 2020, Holy Cross Hospital diagnosed the first COVID-19 patient in the State of Maryland.
Through the next 16 months, Holy Cross became increasingly nimble, adapted to changing and evolving guidelines, complied with the county, state, and federal requirements, overcame PPE shortages and other obstacles, expanded facility capacity, supported our colleagues, and partnered with local and state public health agencies and others to respond to the global pandemic in our community – all while caring for critically ill patients and striving to soothe anxious and, sadly at times, grieving families and loved ones.
Holy Cross Health is pleased to share a summary of our COVID-19 response – none of which could have been accomplished without the dedication of our colleagues and medical staff. They accepted the challenges of the unknown and leaned in with compassion, dedication, and expertise. We are exceptionally proud of and humbled by their shared sacrifices.
Summary of Holy Cross Health’s COVID-19 Response: March 2020 through May 2021
- Challenged to find PPE, ventilators, and cleaning supplies; responded with creative solutions
- Cohorted patients, redesigned patient flow, constructed new patient areas, and added bed capacity
- Expanded frontline caregiver teams to meet the overwhelming needs of COVID-19 patients
- Suspended elective surgical procedures (per order of Maryland Governor Larry Hogan)
- Set up tents on the campuses of Holy Cross Hospital and Holy Cross Germantown Hospital to screen for COVID-19
- Implemented a zero-visitor policy and facilitated ways for families/loved ones to communicate with hospitalized COVID- 19 patients
- Deployed telehealth to care for at-risk and vulnerable populations under stay-at-home orders and transitioned to virtual community health education and self-care programs
- Began daily wellness check-in phone calls to all Medical Adult Day Care participants
- Screened community members for social needs when delivering COVID-19 test results
- Established a call center for concerned community residents, providing information, resources, and connections
- Authorized non-patient-facing colleagues to work from home; deployed computers and other resources and helped colleagues establish remote connectivity to work
- Supported and enhanced the public health response to at-risk and vulnerable populations through our established safety-net health centers, community partnerships, and skilled nursing facility relationships
- Treated the most COVID-19 patients in the state of Maryland
- Conducted a "Pause and Learn" exercise to evaluate pandemic operations to date and adjust accordingly
- Resumed elective surgeries
- Began recovering patient volume while addressing patient and community concerns for safety
- Increased the number and variety of COVID testing platforms; instituted testing of all patients entering Holy Cross Hospital and Holy Cross Germantown Hospital for care
- Enhanced medication management
- Implemented and monitored new therapeutics
- Maintained facility and staff readiness for surges in COVID-19 volume
- Participated in research projects of new pharmacologic and biologic therapies so COVID-19 patients had access to cutting-edge treatments
- Screened all safety-net health center patients for food and housing insecurity; provided direct support and referrals
- Wave 2 volumes surpassed Wave 1; our learned experiences and expertise improved outcomes and shortened hospitalization days
- Prepared for "twindemic" – flu/COVID-19 – and for emerging new variants (Brazilian, South African, and UK, and more recently, Indian variant)
- Distributed flu vaccines to vulnerable populations at food distribution sites
- Reviewed infection control processes
- Began sending recovering COVID-19 patients to state-authorized Alternative Care Sites
- Recruited and trained supplemental staff to support care teams and mitigate turnover
- Prepared for the emergency authorization of vaccines
- Set up vaccination clinics on the campuses of Holy Cross Hospital and Holy Cross Germantown Hospital and began vaccinating colleagues, with patient-facing colleagues first being offered the vaccine
- Partnered with Montgomery County to establish a community vaccination clinic in the Physician Office Building on the campus of Holy Cross Hospital (capacity to vaccinate 1,500 individuals/per day)
- Became the clinical partner at Montgomery County's Mass Vaccination Site
- Together with trusted community partners, began establishing "pop-up" vaccination clinics in at-risk and vulnerable communities
Over the course of our COVID-19 journey, Holy Cross Health has also cared for our own colleagues and medical staff by offering additional supportive services inclusive of extended paid time off, childcare coverage, and sources of sustainable food and by creating respite rooms, conducting resilience rounds, and celebrating the recovery of patients.
Lessons Learned and Recommendations
In recent conversations with local and state officials, and based on Holy Cross Health's experiences, we offer a brief synopsis of lessons learned and recommendations to strengthen the public health infrastructure:
- The lack of a national pandemic action plan delays response, care, and recovery
- The nation's PPE supply is precarious and difficult to scale up without an "on-shore" manufacturing base
- The lack of a rotated cache of the nation's PPE stockpile led to preventable shortages of supplies and medical devices
- Modernize the "grid" – increase data capacity for surveillance, epidemiology, and disease control
- Make it easier to share data between local, state, and federal agencies and standardize reporting
- Establish better linkages among public health, clinical laboratories, and hospitals/health systems Develop a system that can report on the full capacity of the health care continuum at any point in time and, further, develop a continuum of non-acute, acute, post-acute, and long-term services to care for contagious patients in a public health crisis
- Establish "health in all policies" and integrate public health assessments and factors in long-term planning across government agencies
- Prepare for long-term health effects of those afflicted by the coronavirus who are still suffering symptoms or who now have chronic conditions to manage
- Encourage careers in public health. The current public health workforce is aging, with a high rate of retirements expected in 10 years. Of note: Focus on informatics/informatic systems and promote the study and use of infection control practices
- Public health is inextricably linked to the community's overall health and economic well-being; investments in housing, food security, education, and transportation are essential for individuals and families to thrive
- In the absence of a strong and sustainable public health infrastructure, hospitals/health systems are increasingly becoming the safety net for vulnerable individuals, families, and communities
- The human toll of health disparities and health inequities has been laid bare, as is the lack of resources and prioritization of behavioral health in our nation's public health, especially for adolescents. We can and must do better.
Holy Cross Health believes that with focus, investment, and sustainable funding, our nation can be ready for the next public health emergency. We know a pandemic will happen again, and likely sooner than later.
As part of our commitment to care for the common good, you're invited to take action and help build a system where public health departments and health systems collaborate in innovative ways to respond to the ongoing COVID-19 pandemic and future public health emergencies while protecting the safety and improving the health of communities. Please join us in this work by contacting your Members of Congress today. Click the link below to get started.
Our Journey Continues
We would be remiss not to share the positive aspects of our COVID-19 journey. Through the last 16 months, Holy Cross Health has been reminded how fortunate we are to have dedicated and resilient colleagues and medical staff, collaborative partners in local and state public health agencies and at other health systems, a caring and supportive community, generous donors, accessible and responsive elected officials, and the support and resources of our parent company, Trinity Health. We are grateful to all as we continue to walk this journey together.