Arkansas Hospitals, Fall 2020 by Arkansas Hospital Association

ARKANSAS

HOSPITALS Fall 2020

A Growth Year

ARKANSAS HOSPITALS | FALL 2020 1

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W W W. P O W E R S A R . C O M

The GROWTH Issue GROWTH DURING COVID-19 12 Wartime Leadership 18 From Physician to Patient 22 Telehealth Grows Up Fast

GROWING HEALTHCARE’S COMMITMENT 26 COVID-19 Short-Takes

28 Lessons We’re Learning 35 Member Services Update 45 Rural Hospitals Restore, Reinvent

IN EVERY ISSUE

5 President’s Message 7 Editor’s Letter 8 Events, Virtual Learning 10 Hospital Newsmakers 37 Leader Profile: Matt Troup 42 Coach’s Playbook 48 Where We Stand: Fight Flu!

ARKANSAS

HOSPITALS Arkansas Hospitals is published by The Arkansas Hospital Association

419 Natural Resources Drive | Little Rock, AR 72205 To advertise, please contact Brooke Wallace magazine@arkhospitals.org Elisa M. White, Editor in Chief Nancy Robertson, Senior Editor & Contributing Writer Ashley Warren, Associate Editor Katie Hassell, Graphic Designer

BOARD OF DIRECTORS

Chris B. Barber, Jonesboro / Chairman Ron Peterson, Mountain Home / Chairman-Elect Peggy Abbott, Camden / Treasurer Darren Caldwell, Jonesboro / Past-Chairman Ryan Gehrig, Fort Smith / Director-at-Large Greg Crain, Little Rock Barry Davis, Paragould David Deaton, Clinton Marcy Doderer, Little Rock Jan Gardner, North Little Rock Phil Gilmore, Crossett Vince Leist, Harrison James Magee, Piggott Mike McCoy, Danville Gary Paxson, Batesville Rob Robinson, El Dorado Larry Shackelford, Fayetteville Brian Thomas, Pine Bluff Debra Wright, Nashville

EXECUTIVE TEAM

Robert “Bo” Ryall / President and CEO Jodiane Tritt / Executive Vice President Tina Creel / President of AHA Services, Inc. Elisa M. White / Vice President and General Counsel Pam Brown / Vice President of Quality and Patient Safety Lyndsey Dumas / Vice President of Education

Fall 2020

DISTRIBUTION: Arkansas Hospitals is distributed quarterly to hospital executives, managers and trustees throughout the United States; to physicians, state legislators, the congressional delegation, and other friends of the hospitals of Arkansas. Arkansas Hospitals is produced quarterly by Central Arkansas Media. Periodicals postage paid at Little Rock, AR and additional mailing offices. The contents of Arkansas Hospitals are copyrighted, and material contained herein may not be copied or reproduced in any manner without the written permission of the Arkansas Hospital Association. Articles in Arkansas Hospitals should not be considered specific advice, as individual circumstances vary. Products and services advertised in the magazine are not necessarily endorsed by the Arkansas Hospital Association. To advertise, email magazine@arkhospitals.org.

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PRESIDENT’S MESSAGE

What is Investment? E

very hospital team, everywhere, is constantly engaged in the processes of planning, persevering, and overcoming. Every day they juggle multiple priorities, learning and adjusting to fit the needs of their communities and the people they serve. They plan for emergencies, changes to their business flow, and staffing needs. They persevere when patient populations spike (as during flu season every year). And they overcome every form of adversity imaginable, from changes in government policy and shortage of needed resources to storms of all kinds, natural or manmade. SARS-CoV-2's arrival sent hospital teams into overdrive. Challenges in every aspect of hospital operations intensified. How do you plan for a disease that’s totally unknown? How do you safely separate patient groups, protect vulnerable populations, address limited space, and provide proper supplies? How do you prepare your staff for a potential onslaught of patients? How do you prepare your community to identify the safest paths forward? Hospital teams worldwide have learned from one another, and they’re still doing so. Our knowledge of COVID19’s impact on the human body grows daily. Our nationwide – worldwide – common need for more testing supplies, more personal protective equipment, more trained healthcare staff, and more financial resources to keep facilities operational, helps us realize we’re “all in this together.” Hospitals in Arkansas, as always, are investing heavily in their communities. But COVID-19 stretches and expands our understanding of the word

“investment.” Sure, there’s the normal financial sense of the word: purchasing additional patient support equipment, revamping (and even renovating) hospital buildings to house special COVID-19 units, restocking needed stores of medication and reserves. But at the Arkansas Hospital Association, we’re seeing hospitals invest in so many other ways. Hospital medical personnel, fatigued beyond belief, keep giving of themselves to help heal and protect their fellow citizens. Housekeepers work around the clock to keep COVID-19 at bay and hospital facilities safe. Support staff cover for those who are ill or in quarantine, keeping supply chains, cafeterias, business offices, and building maintenance humming. Administrators continue to plan, anticipating every

conceivable “what if?” so they can be ready for the next surge. These aren’t just investments of self and of time. They’re investments of heart. I’ve seen Arkansas hospital teams plan for, persevere, and overcome unthinkable challenges since early March. I’ve seen them continue to serve with no revenue coming in. I’ve seen them make do when worldwide supplies of PPE and testing reagents were low. I’ve seen them rally to serve the needs of patients and their families in ways they never thought possible: opening off-site testing centers, creating COVID-19-specific clinics, collaborating so that no hospital found itself alone during this crisis. I’ve seen our own team here at AHA help find new sources for hospital funding, devise new ways to communicate quickly and reliably, respond to individual hospital needs in myriad ways, and seek solutions at every level to help our hospitals remain viable. The investment of hospital teams in their communities, and of the AHA team in support of our hospitals, is both heartening and humbling. Collaboration and cooperation are constants. As we continue to fight COVID-19 for however long it takes, challenges will continue. But with planning and persevering – with investment of our hospitals at so many levels – together, we will overcome.

Bo Ryall

President and CEO Arkansas Hospital Association

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EDITOR’S LETTER

Compassion:

The Best Investment T hat tree’s cross section on this edition’s cover really says it all: 2020, however difficult, has been like every other year in healthcare – a year of growth. We know that decades from now, this year’s growth ring may appear like those that came before and after, but right now, it feels like the jagged edges of the bark tell 2020’s story. It is a rough year. Yet, observing from our unique position at the AHA, we daily see remarkable growth at each of our member hospitals. There’s growth in innovation. Developing workarounds when shortages of PPE and testing materials challenge us. Devising new sites for testing, creating treatment units specific to COVID-19. Managing daily financial challenges and new reporting and allocation paperwork. There’s growth in collaboration. Hospitals that regularly compete in “normal” times readily work together, sharing data and resources. Partnerships with area schools and colleges are forming – with standard safety practices becoming key. But where we see remarkable growth is in the area of compassion. Emotional intelligence expert Daniel Goleman reminds us that “true compassion means not only feeling another’s pain but also being moved to help relieve it.” Every person involved in healthcare has within them the “compassion gene.” Hospitals are, by their nature, filled with compassionate people who truly care about others. Yet we are learning that even as the stress of 2020 weighs on our staff and the pandemic continues, their compassion has no boundaries. During this year of growth, we’re investing in our systems, our people, our communities in ways only a pandemic could reveal. We’re focusing on relationships with our patients, their families, and each other. Leadership strategist Jarret Jackson puts it this way: “Compassion is the ‘platinum rule.’ The ‘golden rule’ we all know – treating others the way you would like them to treat you. The platinum rule takes it one step further – treat others the way they would like to be treated.” We’re asking our co-workers what they need. We’re helping

families cope when they can’t hold their dying loved one’s hands. Hospitals are serving as THE sources of trusted health information for our communities. This issue of Arkansas Hospitals is filled with accounts of compassionate investments: of self, of time, of expertise, of resources. But reading between the lines, you’re going to find compassion. Everywhere. It is the best investment we can make. May we carry it forward into each of our years of growth ahead.

Elisa M. White Editor in Chief

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Events and Virtual Learning

To protect our healthcare teams during the COVID-19 pandemic, AHAâ&#x20AC;&#x2122;s in-person educational offerings are on hiatus. But weâ&#x20AC;&#x2122;re hosting a variety of webinars to meet your training needs. Go virtual with these courses and series. For more details and registration information, visit Upcoming Events at arkhospitals.org.

SEPTEMBER

September 22

Governance Webinar Series Session 3 of 4: Health Care Fraud and Abuse

September 23

CAH CMS CoPs 2020: Ensuring Compliance Webinar Series Session 3 of 4: Medication and Infection Control 8 FALL 2020 | ARKANSAS HOSPITALS

September 23

Preparing for the New Normal in Survey Process Webinar

OCTOBER

October 1

CAH CMS CoPs 2020: Ensuring Compliance Webinar Series Session 4 of 4: Informed Consent, Organ Procurement, and Patient Rights for Swing Beds

October 6

21st Century Cures Act Lynda Johnson and Amie Alexander, Friday Eldredge and Clark, LLP Webinar sponsored by Friday Eldredge and Clark, LLP Registration is FREE

October 14

Staying Mentally Strong During Times of Stress Kim Hodous Webinar sponsored by Nabholz

NOVEMBER

November 6

Arkansas Engineers Trust Scholarship Trap Tournament The Arkansas Game and Fish Foundation Shooting Sports Complex Jacksonville

November 18

Serious Self Care (Time Management, Career Care, and Craziness Care) Beth Ziesenis Webinar sponsored by Prime Capitol Investments

November 19

Cultivating Good Health Through Personality Vitality Webinar Series Session 6 of 6: How to Cope with Difficult Emotions

DECEMBER

December 4

AHA Workers’ Compensation Self-Insured Trust (AHAWCSIT) Board Meeting (Teleconference)

December 8

Governance Webinar Series Session 4 of 4: Health Care Fraud and Abuse

December 16

29 Tech Tools to Create Cool Content for Social Media and Marketing Beth Ziesenis Webinar sponsored by AHA Services, Inc.

TRAINING ON-DEMAND

Through December 30,

you and your teams may access the recorded 2020 HCPCS Level II & OPPS Updates for Hospitals:

Session 1:

Staying Mentally Strong During Times of Stress

Join us October 14 from 9:30-11 a.m. to learn five simple habits research says will make a lasting, positive change in your mental health and happiness. These habits are designed to help you attain and maintain mental strength, so vital in the midst of the pandemic. And, you’ll earn 1.5 ACHE Qualified Education Hours and/or 1.5 Nursing Contact Hours when you attend this webinar.* Presented by Kim Hodous, the five habits will be taught in an enjoyable, interactive, and empowering webinar, where current behavioral data is distilled down into habits that can be mastered by anyone. She’ll show you how to apply them in less than a minute, and she predicts they will make a lasting change in both your mental health and your happiness.

WHY THIS PROGRAM?

• 2020 is a time of challenge for everyone - regardless of your role within your organization. • When you’re mentally strong, good things happen not only for you, but also for your organization, your patients, and your co-workers. • Research verifies that success is determined more by human behavior (mind set) than by technical skill (skill set). This program will adjust your mind set for less stress and more resilience.

Sponsored by Nabholz, this program offers a chance to interact with both Kim Hodous and your fellow attendees. Hodous says, “This is not your normal ‘talking head’ webinar! If you need a shot in the arm, a kick in the pants, and want to laugh while you learn, join us for this life-changing webinar October 14.” For registration information, go to arkhospitals.org and click on Education, Upcoming Events.

OPPS Final Rule & HCPCS Level II Codes

Session 2:

Outpatient Surgery, Pain, and Wound Care

Session 3:

Interventional Radiology and Cardiology, Diagnostic Radiology, and Rehab

Visit arkhospitals.org and navigate to Education > Upcoming Events for more details.

*Arkansas Hospital Association is approved as a provider of nursing continuing professional development by the Midwest Multistate Division, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. ARKANSAS HOSPITALS | FALL 2020 9

HOSPITAL NEWSMAKERS AHA has launched the AHA Connectivity Consortium, a cost-effective way for public or not-for-profit member hospitals and their affiliated clinics (and other sites) to access broadband subsidies through the FCC’s Healthcare Connect Fund. AHA’s hope is that the Consortium will help hospitals meet their broadband needs, identifying all possible solutions for doing so. To do this, we’re connecting with the Federal Funding Group (FFG), a company specializing in federal funding applications for building community communication infrastructure. Though support is capped for non-rural hospitals, participation of even large hospitals is encouraged. Federal subsidies are available not only for broadband services but also for routers, switches, firewall services, network management, fiber, maintenance agreements; network design, maintenance, and equipment; and construction, engineering, inspection services, management services, and make-ready costs. Even if a hospital already participates in the Healthcare Connect Fund program with another provider, they may still want to check with FFG to be sure there are not any additional subsidies that could be received. To learn more and to sign up, contact Tina Creel, TCreel@arkhospitals.org. The University of Arkansas for Medical Sciences, Arkansas Children’s, Baptist Health, and Proton International have signed a letter of intent to bring proton therapy – an alternative to radiation therapy for treating cancer – to Arkansas. The proton treatment center will be the first in Arkansas and one of only about 40 in the country. It will be located at the UAMS Radiation Oncology Center. Proton therapy precisely targets tumors, sparing the surrounding healthy tissues, and it is particularly effective in treating solid cancer tumors. It is widely used to treat children with cancer, as children are particularly sensitive to the effects of radiation therapy. The agreement is pending approval by the University of Arkansas Board of Trustees and the boards of Arkansas Children’s and Baptist Health. The Emergency Departments at Northwest Health Physicians’ Specialty Hospital, Northwest Medical CenterBentonville and Siloam Springs Regional Hospital have been named to the Emergency Quality Network (E-QUAL) Honor Roll by the American College of Emergency Physicians (ACEP). All three Northwest Health EDs received recognition for improving outcomes for sepsis patients as well as for reducing opioid harm through safer prescribing and the implementation of evidence-based interventions. The only hospitals in Northwest Arkansas to be named to the honor roll, Northwest Health’s EDs join only 19% of the nation’s participating hospitals which earned the ACEP recognition. 10 FALL 2020 | ARKANSAS HOSPITALS

Results are in for the 2020 Diamond Awards! The competition, which is co-sponsored by AHA and the Arkansas Society for Healthcare Marketing and Public Relations, is designed to recognize excellence in hospital public relations and marketing. Diamond Awards and Certificates of Excellence were awarded in four divisions (hospitals with 0-25 beds, hospitals with 26-99 beds, hospitals with 100-249 beds and hospitals with 250 or more beds) in nine distinct categories. The competition drew 52 entries. Winners have been notified and will receive their awards at a future date. Willow Creek Women’s Hospital is the first hospital in the nation to earn the Maternal Safety Foundation’s Vaginal Birth After Cesarean (VBAC) Center of Excellence award. The hospital received this recognition for its commitment to providing safe, VBAC-supportive care.

Scott Smith is the new CEO of National Park Medical Center. He formerly served as CEO at Western Plains Medical Complex in Dodge City, Kansas, and he has also served hospitals in Louisiana and Mississippi. Scott Taylor is the new Administrator of Ozarks Community Hospital. He previously served as Assistant Administrator at OCH and on its Social & Digital Media team, in which he still participates. He has been with OCH for nearly 12 years. Janette Daniels is the new CEO at Encompass Health Rehabilitation Hospital, a Partner of Washington Regional. She was formerly CEO of CHI St. Vincent Hot Springs Rehab Hospital, where she served as CEO for five years.

The Medical Center of South Arkansas (MCSA) received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Quality Achievement Award, recognizing the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment following nationally recognized, research-based guidelines. MCSA earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for more than 24 months.

MCSA’s Amy Triplet, Chief Nursing Officer; Jordan Turner, Stroke Coordinator; and Sonya Justice, Director of Emergency Services

Washington Regional also received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. This is the fourth consecutive year Washington Regional has been honored with the award, and it is the only hospital in Northwest Arkansas to hold Comprehensive Stroke Center certification by The Joint Commission. The hospital also earned the association’s Target: StrokeSM Honor Roll Elite Plus award for the fifth year and a new award, the Target: Type 2 Diabetes Honor Roll award for meeting quality measures developed to ensure patients with type 2 diabetes receive the most up-to-date, evidence-based care when hospitalized with stroke. We welcome CHI St. Vincent Hot Springs Rehab Hospital, a partner of Encompass Health, as a new AHA member hospital. The American Hospital Association, American Medical Association, and American Nurses Association are launching a new Public Service campaign called “Wear A Mask.” The campaign offers resources on proper mask-wearing and care practices in addition to advice from health leaders to better equip our nation’s citizens with the information they need to keep themselves, their family members, and their communities safe. Hospitals can access materials including back-to-school graphics, social media graphics, video PSAs, and a digital toolkit at www.aha.org. The American Organization for Nursing Leadership (AONL) will host a virtual conference Sept. 24. Nurse leaders from across the country will come together for discussions in best practices, engagement, professional development and more. The conference will feature 30, 45-minute breakout sessions to choose from, with more than 25 credit hours available to earn. More information is available at AONL.org.

STUDIES:

Insurance status affects the amount of treatment received and the patient’s chance of survival in cases of brain injury in children, a team of researchers from the University of Arkansas for Medical Sciences (UAMS) found in a study of national data linked to 12,449 patients under the age of 18. Recently published in Critical Care Medicine, the study’s authors found that insured patients were 25% less likely to die while in care, even after statistically correcting for the possible influence of other demographic factors (race, gender, how the patients presented at the hospital). Having insurance increased a patient’s odds of receiving brain surgery by 32% and having intracranial pressure monitoring by 54%. Both are highly recommended basic lifesaving procedures. The multidisciplinary team is led by Austin Porter, DrPH, MPH, and Analiz Rodriguez, MD, PhD. A pair of faculty members at the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University are new recipients of grants to fund research projects. The first will fund a study by Dr. Troy Camarata, Assistant Professor of Basic Sciences at NYITCOM at A-State, titled “Exploring Causative Relationship Between Agricultural Burning and Negative Public Health Outcomes in the Arkansas Delta.” Joe Ford, Associate Professor at Arkansas State University, will serve as a co-principal investigator on the project. Camarata will look at how air pollution in a major agricultural region where field burning is common impacts the health outcomes of those who live there. The second grant funds a study by Dr. Viswanathan Rajagopalan, Assistant Professor of Basic Sciences at NYITCOM at A-State, titled “Long Noncoding RNAs in Heart Failure Related to Impaired Thyroid Hormone Function.” A-State graduate assistant Sankalpa Chakraborty will work with Rajagopalan on the project. Rajagopalan will study new strategies to treat heart failure. The grants provide $35,000 a year for the next two years to support research, and they are funded through Arkansas State University’s portion of the ABI tobacco settlement funds. An international study including UAMS as a collaborating partner is looking at post-surgery lung complications of COVID-19 patients. The study found that development of lung complications or death were more common in the COVID-19 patient group than in non-COVID-19 patients undergoing surgery. It further found that because of this heightened risk, the threshold for surgery should be higher during the pandemic, with consideration given to postponing noncritical procedures when possible, especially in men with multiple conditions aged 70 and older. The UAMS team was led by Emmanouil (Manos) Giorgakis, MD, and findings were published in The Lancet.

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Wartime Leadership

in the Battle Against COVID-1 9 By J. Larry Shackelford, FACMPE President and CEO, Washington Regional Medical System

n leading a healthcare system through this unprecedented pandemic, I find myself reflecting on past leaders who navigated significantly troubled times. While the circumstances these leaders faced throughout history may be different, I gravitate to the lessons we can learn from renowned wartime leaders such as Abraham Lincoln, Winston Churchill, Franklin D. Roosevelt, and General George S. Patton. The challenges of war are different than those we encounter when battling a pandemic, but there are similarities: shortage of supplies, adverse economic impact, fear, and most notably, lives at risk. My friend, Steve Graves, who has authored several articles on leadership says, â&#x20AC;&#x153;Wartime leaders are not better than peacetime leaders (or vice versa), and the same person can be both. You just have to change your approach for leading in a season of turbulence.â&#x20AC;? It is hard to deny that our battle against COVID-19, especially as healthcare leaders, is more than just a little turbulent. This pandemic has required us to change our approach to how we deliver care, manage our workforce, and maintain financial viability.

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Larry Shackelford and his administrative team visit with team members at one of Washington Regional's COVID-19 Screening Centers.

Our leadership team at Washington Regional learned how wartime leaders must make quick and purposeful decisions, and it wasnâ&#x20AC;&#x2122;t easy. Do you pause or pivot? Do you double down on the current path or create a new one? How much risk do you take with so much uncertainty? Is now the time to alter direction or change speed? At the beginning of the pandemic, we had to act quickly to determine our approach. We had to abandon our normal playbook and pivot to a plan that could be executed in a timely manner. Like other wartime leaders, we developed a plan that was as simple and as focused as possible, yet one that our organization could adopt, improvise, and rally around.

THE BATTLE PLAN

The battle plan was not about a mad dash to limit operating losses, but rather an innovative and agile plan to meet the needs of our team members and our community. The key components focused on keeping our team members safe, protecting our patients and community, preparing for a surge of COVID-positive patients, and continuing our overall mission.

Our mission served as our battle cry: to improve the health of our community through high-quality care delivered in a compassionate manner. Underpinning this mantra was a multifaceted goal to continue achieving excellent outcomes in core services to our community while simultaneously waging war on COVID-19. In the initial days of managing the pandemic, we tightened our leadership circle to present a unified command center structure to our 3,200-plus staff members, which includes 55 outpatient clinics. We committed to each other and to the organization that together we could overcome the challenges of the days ahead. That commitment included meeting twice daily in command center meetings â&#x20AC;&#x201C; early and late, seven days a week. At these meetings we built the groundwork for communicating our tactics and strategies and preparing for future opportunities. Realizing that our team members were trying to balance their personal and work lives with emotions running high, it was key to stay focused and have a daily battle plan that could easily be shared in bite-sized pieces with our staff.

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JUNE 10 STATEMENT FROM: BIRCH G. WRIGHT, MPA While most regions in Arkansas have seen a decline in COVID-19 cases, Northwest Arkansas is experiencing a surge in community spread of the virus and is now leading the state in confirmed total cases of the virus, with Washington County at 1,185 cases and Benton County at 1,090 cases as of this morning. Washington Regional views this as a serious public health emergency. Over the past month, Northwest Arkansas has witnessed a significant increase in the number of hospitalized individuals with COVID-19. On May 12, there were four COVID-19 positive patients in Northwest Arkansas hospitals. Since then, we’ve seen the number of hospitalizations double every week, and we now have more than 70 COVID-19 positive patients in area hospitals. Washington Regional is also seeing more critically ill COVID-19 patients, with over 30% of those hospitalized requiring ventilator support. As cases increase, Washington Regional has accepted transfers of positive COVID-19 patients from other hospitals in Northwest Arkansas, North Arkansas and Western Oklahoma. It is important for our community to understand that we are not seeing more hospitalizations simply because more testing is being done. We are seeing more hospitalizations because more people in our area are being infected with the virus. Over the past week, Washington Regional has seen a 170% increase in the number of COVID-19 tests performed at its screening clinics, a 156% increase in calls to the Washington Regional COVID-19 Hotline and a 350% increase in the number of hospitalized COVID-19 patients. To address the rapid spread of COVID-19 in our community, Washington Regional has made two significant operational changes this week. First, on Tuesday, June 9, we opened a second inpatient unit to care for suspected and confirmed COVID-19 patients, which means we can now provide treatment for 38 COVID-19 inpatients with the ability to expand capacity as necessary. Care in these units is overseen by a dedicated team of intensivists, hospitalists and infectious disease physicians.

The message was data-driven, evidence-based, and it resonated [...]. It was the right message at the right time and served to sound the alarm in our community.

WATCHING OVER THE TROOPS

As leaders during a time of crisis, it is vitally important to keep an eye on the emotional and mental well-being of your management team. Our leaders have consistently demonstrated a willingness to disproportionately sacrifice their own well-being and lead by example, to “walk the talk.” That leadership style manifests itself in the form of pausing personal activities, embracing salary- and costreduction measures, and being visible and accessible to staff, including those on the front lines. It means putting on personal protective equipment and rounding in the critical care and COVID-19 units on nights and weekends. However, we strive to maintain balance on a daily and weekly basis. Just as an athlete must rest after running hard, we designate time to take a break, recover, and re-fuel.

COVID-19'S ARRIVAL

(Continued on page 17)

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Initially, Northwest Arkansas did not see the surge affecting other parts of Arkansas and various areas of our country. However, that changed in mid-June when many regions of our state began to re-open and restore operations.

At this same time, many in our community were growing weary of following the recommended best practices of self-quarantine, isolation, universal masking, and social distancing. Some individuals still did not believe the pandemic was real, and their subsequent nonadherence to public health practices caused unnecessary spread once the virus surged in NWA. This created an immense conflict between public policy and private health. Our leadership team sensed a significant disconnect, considering the seriousness of the rapidly increasing number of COVID-positive patients and the sharp increase in the number of patients requiring hospitalization. Northwest Arkansas is blessed to have health system leaders who are truly mission- and community-minded.

In a collegial spirit, these leaders and I also met on a weekly basis, sometimes more frequently. Our efforts to loadbalance critical inpatients among hospitals in our community stretched available resources. The case load and hospitalization rates were high: We were at a crossroads of how to best protect our staff and our community.

COMMUNICATING REALITY

In a situation like this, leaders must dial up the risk to have a chance at not just surviving but turning the tide of public opinion. A common denominator of most wartime leaders is they are willing to take big swings. You must be willing to step up. With my support, Chief Operating Officer Birch Wright stepped up in a

public way that included a very direct letter to our staff, releasing a public statement, participating in interviews with local media, and demonstrating strong advocacy with our state health leaders and elected officials. The message was clear: With the spread of this infectious disease, we were seeing significant increases in both the number of COVID-19 patients and serious health impacts to our community. The message was data-driven, evidence-based, and it resonated not just locally, but around the state and country as Birchâ&#x20AC;&#x2122;s statement was shared. It was the right message at the right time and served to sound the alarm in our community. One of the challenges in the initial days of the pandemic was to be a source of truth regarding the pandemicâ&#x20AC;&#x2122;s reality and provide timely

Washington Regional Medical System President and CEO Larry Shackelford (left), Chief Operating Officer Birch Wright, and Chief Nursing Officer Meredith Green discuss strategies for dealing with COVID-19.

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Larry Shackelford regularly visits in-hospital COVID-19 units and testing clinics, like this one located in Fayetteville.

and accurate communication of our plan to meet it not only with our team members but also with the Northwest Arkansas community. In the early days, important tasks such as standing up an off-site testing center, directing patients with upper respiratory symptoms to a single urgent care location, developing protocols and operationalizing a call center hotline required at least daily communication to our staff and the community. Providing timely information to our community was achieved through local media partners, our social media platforms, and our website. Through these channels we were able to help those in our community understand the state of the pandemic in Northwest Arkansas and Washington Regional’s response.

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A RELIABLE SOURCE

To provide information to our internal team members, we chose multiple modes of communication. Email was the most readily available tool, given that we have a workforce of 3,200 team members spread between our medical center and clinics. We also developed a COVID-19 webpage on our intranet, which is where we post all internal communication, education, and resources related to the pandemic. Our leadership team has also utilized town hall meetings to share updates and answer realtime questions. These meetings are streamed live during the lunch timeframe and are recorded, so that team members who cannot view them live can access them

at their convenience. The goal of these meetings is to provide honest and relevant information in an empathetic manner. One of the greatest wartime leaders in our country’s history was President Franklin D. Roosevelt. During the turbulence of World War II, he used a series of fireside chats to speak to the American people about the response to the banking crisis, the recession, New Deal initiatives, and the course of the war. Following that lead, I began providing a weekly letter to our team members and board of directors. The first letter to the team was in early March, following Governor Asa Hutchinson’s declaration of a state of emergency. That letter followed the format and messaging of FDR’s very first fireside chat during the banking

JUNE 10 STATEMENT FROM: BIRCH G. WRIGHT, MPA (Continued from page 14) crisis. At that time, there had been a run on banks; fear was rampant, and behavior was not rational. Such were the early days of COVID-19. The content and tone of my communications over the last 25 weeks has waxed and waned, as has the battle against COVID-19. The message to our team members has been direct at times, recognizing their concerns for safety, including both their physical and emotional needs. But always, the key focus of these personal letters to our team has been transparency, honesty, and mutual respect as fellow humans.

STAYING THE COURSE

As a leader, transparency is risky. At times you feel vulnerable, and the task of reassuring your team and community that “We’ve got this” is hard. This is especially true when you feel fear in the pit of your stomach as you contemplate how high the hill is that must be climbed and where exactly we are on this uncharted journey. FDR concluded his initial radio address this way, “You must have faith; you must not be stampeded by rumors or guesses. Let us unite in banishing fear. We have provided the machinery to restore our financial system; it is up to you to support and make it work. It is your problem no less than it is mine. Together, we cannot fail.” These words are just as relevant today. We must have faith, and together we cannot fail! As I remind our team members each week, we are united in purpose, committed to one another and our mission, and together we will meet and overcome the challenges that lie in the days ahead. Larry Shackelford, FACMPE, is President and CEO of Washington Regional Medical System headquartered in Fayetteville, Arkansas. Washington Regional, a notfor-profit, community-owned and locally governed healthcare system serving Northwest Arkansas, employs more than 3,200 people across its medical center and 55 clinic locations.

Second, beginning today, June 10, we have re-opened the Washington Regional Coronavirus (COVID-19) Clinic at 3318 N. North Hills Boulevard in Fayetteville to address the increased demand for screening and testing. This clinic is dedicated to COVID-19 screening and testing of individuals who do not have any symptoms but who may have had a direct exposure to someone who is COVID-19 positive. We will continue to evaluate, treat and test patients with active respiratory illness or other COVID-19 symptoms at the Washington Regional Urgent Care location in Fayetteville, located in the William L. Bradley Medical Plaza at 3 East Appleby Road. Washington Regional wants the community to be assured that Washington Regional is prepared for this surge. Over the past several months, our team has planned and prepared for this pandemic and we have the staff, supplies and resources to effectively respond while continuing our customary health care operations. We have the capacity to safely provide care for all in our community - not just those who require hospitalization due to COVID-19. We believe it is of great importance that every member of our community hear the message that it is critically important to take the recent surge in COVID-19 cases seriously. In the early days of the pandemic we saw a tremendous outpouring of support for health care workers. Here is what the community can do to help us now – wear a mask when out in public, practice social distancing, regularly wash your hands, avoid large gatherings, and stay home when you are sick. Washington Regional remains here for you. Please, do your part to help slow the spread of COVID-19 and protect our community.

ARKANSAS HOSPITALS | FALL 2020 17

From Physician to Patient:

Coronavirus from the Other Side By Lisa Rowland

n March 18, 2020, 38-year-old Jason Cobb, MD, was feeling great. He saw patients as usual at Jefferson Regional in Pine Bluff, but the next day he began feeling ill. By March 26, he was diagnosed with COVID-19 and was fighting for his life in the University of Arkansas for Medical Sciences (UAMS) intensive care unit. Jason Cobb, MD, is a family practice physician with a wife, three young children, and a busy practice serving the UAMS-South Central Clinic and Jefferson Regional in Pine Bluff. When Arkansas’s first case of SARS-CoV-2 was diagnosed at Jefferson Regional March 11, Dr. Cobb was working in ICU, but he never interacted personally with the infected patient. So he was surprised when, on March 19, he began exhibiting symptoms of COVID-19; he didn’t know he would soon be in a life-and-death battle with the virus.

SYMPTOMS SURFACE

“I knew I was very ill the night of March 19,” Dr. Cobb says. “I had an extremely high fever, severe fatigue, and mild muscle aches and pains. It was far worse than any illness I had ever experienced. I self-isolated at home for about a week, then began having shortness of breath. It was then I knew this was going to be a different course for me.” “I was isolating myself in our home as much as possible,” he continues, “and I came out one morning for a drink of water. My wife – who is also a physician – noticed how out of breath I was and how I struggled to take even one step. She checked my pulse-oxygen level, and it was in the 80s. She suggested we call an ambulance.” The Cobbs live in Little Rock, so Dr. Cobb was transported to UAMS. “When the ambulance arrived, the team put me on two liters of oxygen per minute. When we reached the hospital, it had been increased to three. I was admitted, and by the time I reached my hospital room I was on five liters. Within an hour, I was being transferred to ICU because of my increasing oxygen requirements, and within a few minutes of arriving in the ICU, my oxygen was adjusted to six liters per minute.” Doctors told him that because of his deteriorating condition, he would most likely be intubated and placed on a ventilator if he required any more than six liters of oxygen 18 FALL 2020 | ARKANSAS HOSPITALS

Jason Cobb, M.D.

per minute. “I wouldn’t say I refused the ventilator, but I politely declined,” Dr. Cobb says. “I was familiar with my ICU physician, and I was grateful to be put on highflow oxygen.” Dr. Cobb’s need for oxygen continued to increase, from eight liters a minute to 10, 12, 15 and eventually 20 liters per minute. “Even as I felt myself deteriorating,” he says, “I had faith in my physician, and was confident in the care I was receiving.” Part of Dr. Cobb’s treatment required him to remain almost constantly in a prone (lying face downward) position, which helps expand lung capacity and increases blood flow and oxygenation to lung tissues. “I had to stay prone for at least 20 hours a day for nine days,” he says. “There was also about a 72-hour period where I was in that position constantly.”

DOCTOR AS PATIENT

Dr. Cobb was kept in strict isolation during his hospitalization. In fact, it was thought that the treatment with high-flow oxygen might increase aerosolization of the virus, so precautions were taken to limit his exposure to staff members. Despite being a medical professional, Dr. Cobb says he struggled with the pain and frankly, with the fear that accompanies COVID-19. “I spent a lot of time in meditation, focused on taking my next breath. I was terrified that my next breath would be my last, so I just focused on each one. I was definitely scared. Most of my thoughts were about my wife, Sara, and not having a chance to say goodbye to my family. I didn’t have an opportunity to speak with them before going into isolation.” Dr. Cobb says that COVID-19 afforded him a unique opportunity as a physician. “I experienced how our patients feel during this extreme illness,” he says. “So many COVID-19 patients’ systems are overwhelmed by this virus, which causes many secondary issues. In my case, a severe immune response to the virus was triggered. My lungs’ overly aggressive attempt to fight off the virus was also damaging my lungs and other parts of my body.” Finally, about five days into his hospitalization, Dr. Cobb and his medical team began to see improvement. He was given an experimental medication, an immune modulator that suppresses the body’s own immune reaction, which allowed him to show improvement within 24 hours. “It still took several days to wean my oxygen to the point that I was stable enough to leave the ICU,” he recalls. His total stay was two weeks in the hospital, including 10 days in the ICU. Once he was released from the hospital, Dr. Cobb was tested twice to make sure he was still showing negative for the disease. He spent another two weeks

Almiria Jynes and Ann Wheeler are both RNs on 2 Center East, which is Jefferson Regional’s designated COVID-19 unit.

ARKANSAS HOSPITALS | FALL 2020 19

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20 FALL 2020 | ARKANSAS HOSPITALS

convalescing, and he was able to return to work about a month after falling ill. Today, Dr. Cobb takes all the recommended precautions to avoid COVID-19. “I don’t have significant fear of contracting the virus again, because I think I probably developed some antibodies,” he says. “But as a physician, I lead by example, and I wear a mask, practice proper handwashing, and socially distance. I have a responsibility to everyone else, as well as to my three young children and my wife whom I want to protect, so I absolutely take all of the public health precautions.” He reminds us that he’s living proof that young people can become seriously ill with COVID-19. “I’m the youngest UAMS faculty member at UAMS-South Central, and probably one of the youngest in the hospital. That’s one of the mysterious aspects of this virus – we don’t know why some people get sicker than others.” Dr. Cobb says he is relieved to be back at work, providing healthcare rather than receiving it. And he remains extremely grateful for the support he received from patients and coworkers. “A lot of people here at Jefferson Regional thought about me and prayed for me while I was ill, so I’d really like to say ‘thank you’ for all their prayers and thoughts,” he says. “I can’t tell you how many people I’ve come across here in the hospital who’ve said, ‘Hey, I’ve heard about you, and I’ve been thinking about you.’ It’s really touching, and it means a lot to me.” Those are memories he’ll carry forever, and his experience gives personal insight into COVID-19 that will inform his care of patients for years to come.

Lisa Rowland serves as Advertising & Promotion Specialist in the Jefferson Regional Office of Communications. You may reach her at rowlandl@jrmc.org.

A Growing Health System for a Growing Community

Discover Why We Are a “Best Place to Work” At Conway Regional, we're more than coworkers, we're family. We invite you to join our growing team and see first-hand why we have been named a “Best Place to Work” by Modern Healthcare (2018-2020) and Arkansas Business (2017-2020). Text "OneTeam" to 97211 for more information about our current job openings or visit ConwayRegional.org/Jobs to chat with a recruiter.

We’re not just growing—we’re growing together. ARKANSAS HOSPITALS | FALL 2020 21

Telehealth Grows Up Fast:

Baptist Health’s COVID-19 Journey A Conversation with Kourtney Matlock, Vice President of the Care Continuum

elehealth, which was once primarily used for emergency consults (and to allow people in rural areas to access specialty care), is now widespread. Because COVID-19 is highly infectious, people are taking appropriate measures to avoid indoor gatherings when possible; that, along with new reimbursement policies guiding the use of telehealth visits, has spurred the expansion of telemedicine capabilities and capacity throughout our state. In 2019, the Baptist Health system in Arkansas conducted 2,317 scheduled telehealth visits and 401 urgent care telehealth visits. Contrast those totals with 2020: Through July, Baptist Health providers performed more than 57,000 telehealth encounters. To find out more about Baptist Health’s telehealth growth, we invite you into our conversation with Kourtney Matlock, Baptist Health’s Corporate Vice President of the Care Continuum. AH: COVID-19 has changed the way we think about how we practice and receive healthcare. How did Baptist Health move into widespread use of telehealth? Matlock: In March, we set up 350 providers with telehealth options in a matter of three weeks. Our main obstacle was quickly obtaining the necessary cameras, microphones, tablets, and tablet covers needed to perform the visits. 22 FALL 2020 | ARKANSAS HOSPITALS

Cardiac patients can, with the right equipment, have their ongoing management and follow-up care maintained through telehealth visits.

AH: Was it difficult to find the devices because so many were making the move to attending virtual school and working from home? Matlock: It seems that was the case. Most personal protective equipment (PPE) and telehealth components are built in and sourced from China, and there was a worldwide run on both. But we prevailed! AH: How did you decide which platforms to utilize? It seems like a huge undertaking. Matlock: Our providers were set up to use one of five platforms for their telehealth visits: Vidyo, EPIC, Doxy. Me, AmericanWell, or FaceTime. Every practice is different, and while we wanted to streamline the platform, the pandemic’s onslaught made it difficult to require the use of one single tool throughout our system. We analyzed what platform would best work for each practice based on the in-place scheduling software, technologies available to the practice at the time, and how many existing patients utilized EPIC MyChart (our patient portal). AH: How about HIPAA requirements? Matlock: Each of the platforms, except for FaceTime, is HIPAAcompliant. FaceTime’s use is permitted during the pandemic, so we didn’t discourage its use. But to be ready for ongoing telehealth visits, we’re working with our providers on moving to a substitute platform in case the current permission is removed. AH: Were telehealth visits readily accepted by your patients? Matlock: In April, we averaged 1,031 telehealth visits per working day throughout our system. Later, as the state opened up and patients became more comfortable visiting their doctors in person, our average dropped to 657 per day in May and 400 per day in June and July. AH: Seeing that it’s so popular, do you plan to continue offering this service? Matlock: Yes. We’re dedicated to keeping telehealth integrated into the

Baptist Health's use of 432 Amazon Echo Show devices installed in COVID-19 units system-wide improves communication between clinicians and their patients. The devices also add a level of safety to patients and caregivers while conserving use of personal protective equipment. Here, a nurse and patient converse through use of the Echo Show.

menu of our patient care options. It’s something our patients really enjoy. And though we know virtual care will never completely take the place of an in-person clinic visit, we believe that at least 20% of both primary care and cardiac visits can be successfully conducted virtually.

AH: How do your cardiac patients utilize telehealth? Matlock: When cardiac patients are set up with the proper equipment at home, it’s very convenient for them to have their ongoing management and follow-up care maintained through telehealth visits. Many of ARKANSAS HOSPITALS | FALL 2020 23

Matlock: Absolutely! In late August, Baptist Health installed 432 Amazon Echo Show devices in patient rooms we designated for current and future COVID-19 care. We’re grateful to the Amazon corporation for their gift of both the equipment and setup support. The gift is part of its $5 million global initiative to help frontline healthcare workers, patients, and communities impacted by COVID-19.

our cardiac patients must travel an hour or more to an in-person appointment. By offering outpatient cardiac virtual visits to patients (as well as virtual inpatient consults across hospitals), we are saving the patient time, travel, and the physical stress of leaving home. AH: There are telehealth applications for inpatient care?

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24 FALL 2020 | ARKANSAS HOSPITALS

AH: So, you’re using this equipment on COVID-19 units? Matlock: Yes, we believe they’ll improve the communication between clinicians and their patients. Each Echo Show device, mounted on the wall across from the patient’s bed, features an 8-inch touch screen video display for drop-in video visits. Just like the Amazon Show you use at home, ours have microphones and speakers that allow for immediate, two-way voice communication. Our intention is to allow physicians, nurses, therapists, and other clinicians to virtually drop into the patient’s room at any time; the patient doesn’t need to have any technical knowledge or operate anything mechanical. AH: What’s the advantage to virtual visits? Matlock: It adds a level of safety we haven’t previously been able to offer our staff, physicians, and patients. We can still enter the patient’s room when needed, but use of the Echo Show reduces the number of inroom visits, lowering the chance of caregivers developing the virus. It also allows us to conserve PPE, which is still a necessity even this far into the pandemic. AH: Which hospitals in the Baptist system are implementing the new devices? Matlock: We’re using them systemwide, and they’re specifically designated for areas with the potential of housing COVID-19 patients. Looking to the fall and winter when more cases are predicted, we’re installing these devices in COVIDdesignated ICU areas, med-surg floors, emergency departments, and labor and delivery rooms. AH: Do you see more uses for virtual inpatient care beyond designated COVID-19 units? Matlock: Yes, in fact we’re working out effective ways we can integrate virtual care into other inpatient areas right now. One use, of course, could be to easily connect patients with

This chart shows the trending use of telehealth options in the Baptist Health system over a four-month period earlier this year.

their family members. We also want to expand specialty care capabilities to more areas of our hospitals. This will help specialists get in touch with their patients immediately, when necessary. AH: It seems like COVID-19 is opening the door to using everyday technologies in new ways. Are there other projects you’ve launched, besides the use of the Echo Show in units dedicated to care of patients with the virus? Matlock: COVID-19 changes every unit in every hospital, no matter its focus. The newborn intensive care unit (NICU) is one area that is especially at risk from outside visitors. Baptist Health has purchased a camera for every NICU bed in Little Rock, mounting it so that family members can check in on their newborn at any time. Each family

receives a video link to their baby’s crib, accessible 24/7. The parents can share that link with loved ones, helping them stay connected even when hospital visitation by extended family isn’t possible. AH: What other ideas are coming to light? Matlock: Virtual translation services are now being used in Baptist’s Fort Smith regional hospitals and clinics. The area around Fort Smith is home to a high volume of non-English speaking COVID-19 patients, and our ability to virtually connect patients in a timely manner with translators is proving to be lifesaving. AH: So, virtual care, at many levels, is here to stay in the Baptist Health system? Matlock: It certainly is! We’re currently assessing ways we can support

smaller surrounding hospitals and ED services prior to patient transfer. This will allow for earlier intervention and better outcomes. As we continue our fight against COVID-19, the added tool of virtual technology is helping us better serve patients, family, and healthcare staff across the board.

Kourtney Matlock, MHSA, serves as Corporate Vice President of the Care Continuum for Baptist Health. She is responsible for Virtual Care Services, Case Management, Home Health, Hospice, Transitions of Care Management, and PACE at Baptist Health. Her focus is ensuring a smooth transition for patients from inpatient to home in a safe and easy manner. You may reach her at Kourtney.Matlock@ baptist-health.org.

ARKANSAS HOSPITALS | FALL 2020 25

COVID-19 Short Takes Committed to Our Communities

NORTHWEST HEALTH

Have you ever wondered how hospital rooms are cleaned between COVID-19 patients? Paul Mallard, Director of Environmental Services at Northwest Medical Center-Springdale, Willow Creek Women’s Hospital and Northwest Health Physicians’ Specialty Hospital recently explained how Northwest Health environmental teams work diligently during COVID-19 to keep patients and their families safe. He appeared on KNWA and FOX24 this summer to spread the word, and Northwest Health then posted his interview on its Facebook page.

JEFFERSON REGIONAL

Are you wearing your mask the right way, or are you frustrated with people who don't? The Jefferson Regional team put together a humorous video – complete with horror show musical soundtrack – to demonstrate the many wrong and the one right way to wear your mask. It’s a hoot! Find it on the Jefferson Regional Facebook page.

SALINE MEMORIAL HOSPITAL

At Saline Memorial, the “patient perspective” was brought into new visitation policy discussions. New strategies allow one visitor per patient (except in areas of enhanced precautions). In excepted areas, visitation can occur from other parts of the hospital, where “conversations” between visitor and patient are made possible through the use of iPads.

26 FALL 2020 | ARKANSAS HOSPITALS

ARKANSAS HOSPICE

Doctors can keep in touch with their Arkansas Hospice patients residing in nursing homes, assisted living centers, and rehab centers with the help of a new telemedicine program and electronic tablets provided by donors and the Blue & You Foundation. Keeping patients connected with their doctors, nurses, and loved ones is all-important, especially with visitation restrictions brought on by COVID-19.

MENA REGIONAL HEALTH SYSTEM

The Mena Regional Health Systemâ&#x20AC;&#x2122;s new ICU computer carts improve bedside care with the addition of 20-inch screens, computers fitted with the latest Intel processors, new antimicrobial work surfaces, and hot-swap battery systems that can be utilized 24/7. All cart components can be sanitized to align with stringent infection control compliance measures.

BAXTER REGIONAL MEDICAL CENTER

To address shortages of testing supplies and high levels of need, laboratory personnel at Baxter Regional Medical Center developed a pooled sample strategy. Pooling samples is an approach first used during World War II which combines samples together to test, and only testing individual specimens if the pooled sample is positive. Baxterâ&#x20AC;&#x2122;s laboratory team designed and tested a pooled approach using the Cepheid Xpert Xpress SARS-CoV-2 molecular diagnostic test, writing the results up as a white paper and using them to submit an EUA to the FDA. They anticipate the strategy can help them allow greater access to testing in their community, while conserving scarce resources.

ARKANSAS HOSPITALS | FALL 2020 27

Lessons We’re Learning: COVID-19 Teaches Us How We Can Improve Healthcare By William Gerry Jones, MD

he effects of the COVID-19 pandemic, catastrophic as they are in the present, will ripple for years to come. The emotional toll on families and communities grieving lives lost is excruciating, and our knowledge of COVID-19’s potential future harm to survivors only continues to grow. As a nation and as a planet, we’re also dealing with the pandemic’s severe economic and social outcomes, jolting twin blows that will have lasting cultural repercussions. In healthcare, we have, of necessity, focused on the difficulties the pandemic has created: shortages in supplies, staffing, beds, ventilators, and testing. However, if we take a step back, I believe we’ll discover that the challenges the pandemic poses to healthcare – and the lessons we’re learning – offer us opportunities to improve and the potential to fundamentally change the way we deliver healthcare in Arkansas and across the country.

28 FALL 2020 | ARKANSAS HOSPITALS

I offer five ways we can use our pandemic experiences to improve healthcare: 1. We must prioritize doing more than one thing at a time. In mid-March, hospitals voluntarily (and, later, under governmental directive) postponed elective procedures in order to increase available capacity to treat COVID-19 patients and to preserve personal protective equipment (PPE). Inadvertently, this decision sent a message to our communities: Stay away from hospitals and medical offices. Americans saw the risk for contracting COVID-19 infection in healthcare facilities as too great. While postponing elective procedures and “shutting down” our hospitals and clinics was appropriate, based upon the information available to us at the time, the unintended consequence was that patients delayed much-needed care and stayed home. Now, a few short months later, our ICUs are full of high-acuity, non-COVID patients who sought medical attention later than they otherwise would have. We know that significant numbers of COVID-related admissions over the coming months remain likely, so it’s imperative that we communicate these messages: Our hospitals are safe, we are following more precautions than ever to protect patients and healthcare workers, and we are able to address all of the healthcare needs of our communities – not just those related to COVID-19. The risk of becoming infected with COVID-19 is likely far less in a medical setting, with strict adherence to hand hygiene, masking, and social distancing, than practically anywhere else; approaching wellness from both the individual and societal perspectives, we cannot again afford to ignore or postpone necessary care for the many non-COVID-19 medical conditions of our patients. 2. We must embrace new ways of delivering healthcare. For various reasons, telemedicine was slow to evolve in Arkansas prior to the pandemic. Since COVID-19’s appearance in Arkansas, we have

We cannot again afford to ignore or postpone necessary care for the many non-COVID-19 medical conditions of our patients.

ARKANSAS HOSPITALS | FALL 2020 29

Quality Care Rooted in Arkansas

hope Is The Foundation. recovery Is The Journey. In response to the growing needs of our community, The BridgeWay has expanded its continuum of care for substance use disorders. The acute rehabilitation program will provide hope and recovery for adults struggling with substance use disorders. Led by Dr. Schay, and a Board Certified Psychiatrist and Addictionologist, the Substance Use Disorder Rehabilitation Program is for adults at risk of relapse. Rehabilitation requires the supportive structure of a 24-hour therapeutic environment. To learn more about our continuum of care for substance use disorders, call us at 1-800-245-0011. Physicians are on the medical staff of The BridgeWay Hospital but, with limited exceptions, are independent practitioners who are not employees or agents of The BridgeWayHospital. The facility shall not be liable for actions or treatments provided by physicians.

Dr. Schay

Medical Director Of Substance Use Disorders & Patriot Support Program

all seen a massive increase in the numbers of outpatient healthcare visits conducted via telemedicine. This move was made possible, in part, by two things: the decision of payers to reimburse providers for such visits and the widespread availability of video conferencing platforms. We need to continue to promote and expand virtual visits in the outpatient setting, while considering ways similar technologies can be used in the hospital. This will allow us to extend the availability of consultants and other services that may be in short supply, increase the ability of providers and patients to communicate with families, and make administrative duties more efficient. Telehealth solutions improve our ability to provide earlier follow-up after hospital discharge, resulting in decreased hospital readmissions. They can assist in outpatient management of medications and chronic diseases. And they can provide new, less labor-intensive means of providing services such as home health, behavioral health counseling, and physical therapy and rehabilitation. It is incumbent on us to work closely with payers to emphasize the value that telemedicine solutions offer and the opportunities they provide for reduction in overall healthcare costs. The goal is ensuring fair reimbursement for these functions, which is necessary for their development and growth. 3. We must become more proactive than reactive. Despite worldwide reporting of COVID-19 infections for at least two months prior to major outbreaks in this country, we found ourselves caught flatfooted by the pandemic in many respects. Supplies of PPE were dangerously short early on, and the availability of reliable rapid testing remains a major issue more than six months later. People will continue to debate whether we should have seen COVID-19 coming, but in the meantime, those of us in healthcare know we must find ways to more adequately prepare for new future illnesses, viral and otherwise. The best quarterbacks are experts at reading defenses; leaders in healthcare

30 FALL 2020 | ARKANSAS HOSPITALS

Arkansas Heart Hospital Bryant, Arkansas (currently under construction)

CHI St. Vincent Arkansas Neuroscience Institute Sherwood, Arkansas

CARTI Cancer Center Pine Bluff, Arkansas (coming in 2021)

UAMS South Central Campus (at JRMC) Pine Bluff, Arkansas

Little Rock | Bentonville | Dallas

ARKANSAS HOSPITALS | FALL 2020 31

must be able to look downfield at what is likely to confront us and devise anticipatory responses. We need to pre-conceive plans that will make communication and response faster and more effective. Primary care providers (PCPs) are our first lines of defense, facilitating not only early detection and treatment of disease, but also the management

of chronic conditions that increase morbidity in COVID-19 and other acute illnesses. On a national level, improved disease surveillance and greater investment in testing, drug, and vaccine development will keep PCPs and all of healthcare better prepared to respond to the next inevitable crisis. As we move past the pandemic, PCPs can also keep us informed as to the

long-term cardiopulmonary and other effects of COVID-19. These as-yetunknown effects represent a major challenge on the horizon. On a systems level, we should also reconsider operational practices such as supply chain management. While it has become commonplace in healthcare and other industries to keep a 24-48-hour inventory of many supplies on hand, this practice did not serve us well when a massive increase in PPE supplies was needed. Cost is always an issue but consider this cost as well: Surgical and N-95 masks, which were readily available in January 2020 for 20-50 cents apiece, became difficult to obtain 60 days later at even 10-20 times that cost. 4. We must standardize yet maintain flexibility and nimbleness. Standardization in healthcare through protocols, algorithms, order sets, and other means has proven effective in improving outcomes in many different diseases and healthcare settings. However, in the past it has taken us months, if not years, and countless meetings, emails, and discussions to agree upon standards and develop plans for their implementation. Once established, those protocols are changed only reluctantly and slowly. During this pandemic, we have learned that what seems best today may be drastically different than what is needed tomorrow, and weâ&#x20AC;&#x2122;ve discovered we must be nimble and flexible not only to learn from our experiences but also to adapt quickly in the best interests of the patient. Since the first COVID-19 cases were reported in this country, vital decisions that were inconceivable six months ago have been made in mere hours or days at the governmental, hospital, and individual practice levels. We have been forced to think on our feet yet be prepared to reconsider our actions when the situation changes. A good example is pre-operative testing of patients undergoing elective procedures. When the

32 FALL 2020 | ARKANSAS HOSPITALS

Arkansas Department of Health first allowed hospitals to reopen for elective procedures, a negative COVID-19 test was required within the 72 hours prior to each procedure. With the availability of tests increasingly more problematic, that 72-hour time frame was extended to five days, and when later data showed the positivity rate to be very low in carefully screened asymptomatic patients, the requirement was lifted altogether and left to the discretion of individual hospitals and physicians. Such continued standardization agility in response to the constantly evolving healthcare landscape will serve us well into the future. 5. We must embrace a new spirit of cooperative competition among healthcare providers. Competition breeds innovation, efficiency, and better outcomes, yet in the midst of the pandemic, we have learned in Arkansas that there is a clear role for cooperative efforts in addressing our collective challenges. During this pandemic, Little Rock hospitals came together in a task force created by Mayor Frank Scott, chaired by Dr. Dean Kumpuris, and greatly assisted by the Arkansas Hospital Association and other groups. Initially created to plan for a surge, this cooperative group of otherwise competing hospitals later worked with business, health insurance, and other leaders to encourage the public not to postpone needed care through the Take Care Arkansas campaign. In the ensuing months we have shared PPE, testing, data, and strategies in our effort to provide our city and state with the best possible care. As the pandemic fades, and it will, this may be the greatest lesson of all – that while our hospitals and healthcare providers may compete vigorously, we are all here for the patients, whose needs must always come first. Healthcare will change as a result of the present pandemic. We can implement lessons we’re learning right now to make our work more effective now and into the future.

William Gerry Jones, MD, is a cardiothoracic surgeon who also serves as Chief Medical Officer for CHI St. Vincent Infirmary in Little Rock. He concurrently serves as Vice President for Medical Affairs, a role he accepted in early 2019. He oversees all clinical operations at St. Vincent Infirmary as well as dayto-day operations of medical staff at all CHI St. Vincent facilities in central Arkansas, and he is tasked with guiding transformational leadership for the CHI St. Vincent system and its healing ministry.

Over the past three years, HealthTech Arkansas has brought 17 companies to Arkansas to conduct pilot projects and clinical trials with members of our provider coalition. Each of these emerging technologies have strong potential to improve clinical outcomes and improve efficiencies within our providers’ operations.

Thank You To Our Provider Partners For Making Arkansas A Center For Healthcare Innovation!

www.healthtecharkansas.com To learn how your organization can participate, please contact Jeff Stinson at jeff@healthtecharkansas.com

ARKANSAS HOSPITALS | FALL 2020 33

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LEADER PROFILE

Service During the COVID-19 Pandemic By Nancy Robertson

“O

n New Year’s Day 2020, I wrote an email to our staff, looking ahead at what we believed was going to be OUR YEAR,” says Matt Troup, President and Chief Executive Officer at Conway Regional Health System (CRHS). “We were engaged in a $60 million clinic/hospital expansion, were set to add a Family Practice residency program, about to achieve accreditation as a Nurse Magnet Organization, and were ready for our Joint Commission survey. In my five-year tenure here, we had worked hard to build a strong staff culture. 2020 looked to be our biggest year ever. “And then, COVID-19 re-focused us.” Immediately upon learning of the COVID-19 pandemic, Troup and his leadership team set about to form a threepronged approach to challenges it would bring: 1) Serve the needs of the community, 2) Serve the needs of CRHS staff, and 3) Address organizational and operational complications that might occur. “When people are stressed, they need to be assured of their status, autonomy, relationships, certainty, and fairness,” Troup says. “Knowing that the pandemic is a stressor for our community, our patients, our staff, and our leadership team, we charted our course forward with a strong dedication to not violate any of these five areas.”

FOR THE COMMUNITY– A RELIABLE RESOURCE

Matt Troup, President and Chief Executive Officer at Conway Regional Health System.

For the community, this meant being a constant and reliable source of information regarding COVID-19 and its effects on the CRHS service area. It meant communicating through many venues to reach people where they seek information: Facebook posts, Facebook Live broadcasts, the local news outlets, even a podcast where Troup discusses issues relating to the hospital and the pandemic.

ARKANSAS HOSPITALS | FALL 2020 37

We Asked... What’s on your music playlist? Everything! I tend to associate music with memories. For example, David Allen Coe’s classic “You Never Even Called Me by My Name” always reminds me of my days at Texas A&M … Travis Tritt and “Drift Off to Dream” is from my days courting my wife, Melissa. A more recent example is “My Sharona,” because it sounds a lot like “My Corona.” I like to make up my own words to songs.

What is the best advice you were ever given? Philippians 4:8

comes to mind. Basically, stay positive and focus on the blessings in your life, rather than focusing on the negative. There is no utility in choosing to be a downtrodden victim. I will always choose to be the overcoming servant leader who has a great story to tell through adversity.

Who is someone you greatly admire, and why? Theodore

Roosevelt. He was tough, smart, and a moralist. He took on difficult issues because it was the right thing to do. He believed in action and deplored idleness.

Matt Troup (left) and his wife, Melissa (right) with sons (from left) Duncan, Jacob, Barrett, and Gabe.

don’t know that I am a huge fan of t-shirts and well-worn shorts!

What do you like to do in your downtime? Spend time with family,

read, run. I don’t “do” down time much. I don’t like to sit still for very long…unless I’m very tired.

What’s on your desk right now? I believe you can tell a lot

Assuming I had the talent – which I clearly do not – I’d love to be a professional musician. I love music but have zero talent.

about someone by looking at their desk. I try to keep mine as clean as possible, and at this moment, I have an outbox (stuff to file), a paperweight from my parents’ desk, and The Simple Living New Testament with the Psalms.

What is something people don’t know about you? I believe

What are you reading? (nonwork-related material) I just

What would you be doing if you weren’t in health care?

administrators should look professional while at work. Most people think I dress like that all the time, and they

38 FALL 2020 | ARKANSAS HOSPITALS

finished “Knowing God” by J.I. Packer, and just started Michael Medved’s book “God’s Hand on America.”

Where would you travel, if you could go anywhere? Probably

Disney World…or Colorado…or a beach. All with my family.

What’s a life-changing lesson COVID-19 has taught you? In

the midst of all the challenges and things I don’t like about COVID, there is immense blessing. My wife and I spend more time together, our four boys have been home more, and I’ve been more spiritually grounded. Professionally, COVID has been a re-reminder of why I chose to serve in healthcare. I like to ponder the question – at some point years from now – “Grampa, where were you during COVID? What were you doing?” I’ve been reinvigorated to boldly pursue, with excellence, the calling I’ve been blessed to pursue during COVID.

“In the absence of trustworthy communication, people will make weird stuff up,” Troup says. “We always want to be a reliable resource and take steps to stop disinformation before it can take hold.” As classes resume this fall, working with the area’s schools and colleges is a major CRHS community focus. “Together, we’re monitoring progression of the virus, working to achieve quick testing turnaround times, and CRHS is supplying important infection prevention information so schools can formulate effective policies,” Troup says. “We support the schools’ efforts and meet weekly to share data and trends. It’s important that we all follow the same rules to keep community spread to a minimum.”

FOR THE STAFF – NO FURLOUGHS, NO LAYOFFS

For CRHS staff, the course forward began with making certain people who wanted to work had that opportunity, in whole or in part. “We saw healthcare organizations in other regions of the country struggling financially as the pandemic hit,” Troup says. “We didn’t want our people to lose their jobs, yet we needed to be certain CRHS retained financial stability. We set up a temporary (six-eight week) policy where we froze contributions to our 401(k) plan, froze PTO accrual, omitted overtime, and delayed hiring any new employees. These and other tough decisions helped us to attain a 20%+ reduction in operating expenses.” Pledging early on not to utilize mandatory furloughs or layoffs during the pandemic response, members of the leadership group knew they would need to use “outside-the-box” creativity to manage their workforce. “We redeployed some staff members, on occasion,” Troup says, “and the pandemic has caused us to create a few new roles in the organization.”

We’re coming up with solutions that will re-invent the way we offer healthcare. One new role is that of screener – for staff and those entering the hospital and its clinics. If you have had your temperature taken and answered questions about exposure to COVID-19, you’ve encountered one of the system’s health screeners. “We also established one of Arkansas’s first drive-through testing sites, where some of our caregivers were deployed to new positions in off-site testing,” Troup explains. Other new roles include serving in telehealth positions and conducting discharge phone calls for follow-up

care. “We’re finding it very helpful to be proactive at checking in with patients post-discharge,” he says. “Through these in-person calls, we are also identifying people who are uninsured, and we’re helping them find ways to get coverage. That can be a big stress relief for families, especially during a pandemic.” The important thing, Troup emphasizes, is innovation. “The pandemic gives us opportunities to pivot quickly – more quickly than we otherwise might,” he says. “We’re coming up with solutions that will reinvent the way we offer healthcare.” One operating room nurse who redeployed to a resource team says she found a lot of positives in temporarily accepting a new role. “She told me she got to know our organization and many of our people in a way not available to her before, and it caused her to view CRHS in a whole new light,” Troup says. He is quick to offer praise for the entire CRHS workforce. “As we set up our COVID-19 treatment unit, we asked for volunteers to staff it,” Troup says. “We were immediately able to fill the needed positions with volunteers, which is a credit to our great team.”

Caring for staff members is a big part of the CRHS response to COVID-19. Here, taking a few minutes to relax in the CRHS Relaxation Room's massage chairs helps weary staff members rejuvenate.

ARKANSAS HOSPITALS | FALL 2020 39

People from across the hospital workforce continually step up for the benefit of the team, he says. “We see many personal sacrifices – of time with family, time at home, helping cover positions other than their own – and, just like in every hospital, they’re all working their tails off during this very challenging time.”

HOW CAN WE HELP?

Troup and his leadership team constantly look for innovative ways to make staff’s lives easier. “We think about what is needed, and we look for creative ways to be of help,” he says. As examples, here are some of the solutions they devised: • Hospital staff members receive free meals during COVID-19 surges. “One of our re-deployment positions is “meal delivery,” Troup says. “By delivering their meals directly to them on their units, we preserve PPE and reduce the number of people our staff members encounter.” • When the staff fitness center had to close last spring due to COVID-19, its space was turned into a day care center for workers’ children. “With school closed in the earliest days of the pandemic, our team members needed help with childcare. Over one weekend, we were able to revamp the space and obtain a temporary license to open a day care center. We offered it free of charge for our hospital staff members, and then we continued that service through what would have been the end of the normal school year.” Again, some of the newly-created redeployment positions were in this center. • Those who served on the front lines in the early days of the pandemic – more than 100 people – received gift baskets filled with snacks, thank-you notes, gift certificates for lawn mowing service, and other goodies.

MATT TROUP earned his Bachelor of Science in Business Administration from Texas A&M University, College Station, and his Master of Science in Healthcare Administration from Trinity University, San Antonio (Texas). His administrative residency was completed at Presbyterian Hospital of Greenville, part of the Texas Health Resources System, which he served in varying capacities for an additional four years. His last position at Presbyterian was Associate Administrator. 40 FALL 2020 | ARKANSAS HOSPITALS

“We knew that just the necessity of keeping up with yard care during the growing season would be tough,” Troup explains, “so we worked with two lawn care services in Conway and Greenbrier to arrange for them to mow lawns for our employees.” • A relaxation room with massage chairs was set up for staff, so they could get away to a quiet place and ease muscle tension during breaks. • Knowing that at the end of busy shifts hospital staffers are worn out, CRHS offered a take-home frozen meal service. Workers were able to take meals home, enough for a family of 4-6 – at the end of their shifts for around $7.00, a reduction in price of 50%. Troup says some of these services continue though COVID-19 response is the new norm. And during periods of surge, depending on local circumstances, CRHS can pivot to quickly offer similar services again, as needed.

ONGOING FLEXIBILITY

The Conway area saw a spike in COVID-19 cases from midMarch through May, then cases began trending downward. After the Memorial Day holiday, though, cases again spiked, as they did in many regions of the U.S. Cases through the summer increased, and as school opens, infection trends will be closely monitored. “We’ve set up our action plan for flexibility,” Troup says. “When cases spike, we go into surge mode. When they retreat, we move back into our more normal mode. The pandemic continues to shine a light on the strong culture at CRHS and the dedication of our people to the work we do. I feel called and led to this work; I’m so glad to be able to tell our story.”

Accepting the role of Vice President at Charlton Methodist Medical Center in Duncanville, Texas, he became a part of the Dallas-based Methodist Health System. After two years in Duncanville, he was named Vice President of Clinical Operations for the system. Re-joining Texas Health Resources in 2005, he first served as President of Texas Health Presbyterian Hospital of Winnsboro, then as Vice President of Operations at Texas Health Presbyterian Dallas.

A move to Tulsa, Oklahoma with Ardent Health System included a two-year position as Chief Operating Officer at Hillcrest Medical Center. A year-long stint as Chief Operating Officer and Site Administrator for Holmes Regional Medical Center in Melbourne, Florida preceded his move to the CHI St. Vincent system headquartered in Little Rock, where he accepted the position of President and Chief Operating Officer for Conway Regional Health System, a role he has served for five years.

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COACH'S PLAYBOOK

Innovation During a

Pandemic by Kay Kendall

s healthcare innovation happening during this pandemic? You bet it is! Articles in this edition of Arkansas Hospitals are full of examples that can be adapted by organizations of all sizes. Folding this into your Quality journey, consider the Baldrige Excellence Framework definition of “innovation” (sidebar), and you’ll see that there’s never been a more urgent time than now for senior leaders to encourage imaginative input from all levels of the organization. At BaldrigeCoach, we’re participating in The Institute for Healthcare Improvement’s (IHI) daily Nursing Home Huddle. Along with reviewing data and discussing relevant changes in state and national regulations and guidance, the agenda always includes the presentation of a Best – or Better – Practice. Many feature true innovation, often generated by front line staff. And, why not? Those on healthcare’s front line know their patients – in this case, nursing home

42 FALL 2020 | ARKANSAS HOSPITALS

residents – better than anyone else. They are attuned to small, seemingly insignificant changes in patients’ condition or cognition that might seem insignificant to others. And they often have creative responses to address these changes if provided the right opportunity and if a supportive environment is established by senior leaders who believe that anyone, anywhere can come up with a good idea. Some of our favorite examples have now been adopted nationally by many hospitals, like staff taping large photos of themselves to their PPE so that patients can recognize their caregivers behind the masks and face shields and the use of social media and various apps to create “virtual” visits with family members and friends. Infection prevention protocols are creatively adapted: Nursing homes are creating indoor walking routes where patients are assigned exercise times that consider their mobility and ensure they maintain social distancing.

SENIOR LEADERS’ ENCOURAGEMENT

The IHI calls also point out that in these stressful times, it’s important that senior leaders be especially intentional about promoting innovation. Here are some questions posed at the recent Huron/Studer Group’s “What’s Right in Health Care” conference to provoke ideas that might lead to innovation: • What gets in the way of providing better care for your patients? • If you could change one rule around here, what would it be and why? • What would make you feel safer at work? • What is concerning you at home, and how can we help? • If you’ve worked someplace besides here, what did they do that we might benefit from adopting or adapting? • What do you do when you have an idea for an improvement? We all know that we need some breakthroughs to conquer COVID-19. How are you going to tap into the innovation residing in your staff?

The team at BaldrigeCoach would be glad to help guide your hospital’s quest for process improvement. As CEO and Principal of BaldrigeCoach, Kay Kendall coaches organizations on their paths to performance excellence using the Malcolm Baldrige National Quality Award Criteria as a framework. Her team, working with health care and other organizations, has mentored 23 National Quality Award recipients. In each edition of Arkansas Hospitals, Kay offers readers quality improvement tips from her coaching playbook. Contact Kay at 972.489.3611 or Kay@Baldrige-Coach.com.

INNOVATION, BALDRIGE-STYLE In the face of COVID-19, these are particularly relevant Baldrige definitions of innovation: INNOVATION. Making meaningful change to improve health care services, processes, or organizational effectiveness and create new value for stakeholders. Innovation involves adopting an idea, process, technology, service, or business model that is either new or new to its proposed application. The outcome of innovation is a discontinuous or “breakthrough” improvement in results, services, or processes. Innovation benefits from a supportive environment, a process for identifying strategic opportunities, and a willingness to pursue intelligent risks. Innovation also involves taking intelligent risks and devising strategic opportunities. Again, from Baldrige: INTELLIGENT RISKS. Opportunities for which the potential gain outweighs the potential harm or loss to your organization’s future success if you do not explore them. Taking intelligent risks requires a tolerance for failure and an expectation that innovation is not achieved by initiating only successful endeavors. At the outset, organizations must invest in potential successes while realizing that some will lead to failure. STRATEGIC OPPORTUNITIES. Prospects for new or changed services, processes, business models (including strategic alliances), or markets. They arise from outside-the-box thinking, brainstorming, capitalizing on serendipity, research and innovation processes, nonlinear extrapolation of current conditions, and other approaches to imagining a different future.

2019. 2019–2020 Baldrige Excellence Framework (Health Care): Proven Leadership and Management Practices for High Performance. Gaithersburg, MD: U.S. Department of Commerce, National Institute of Standards and Technology. https://www.nist.gov/baldrige.

ARKANSAS HOSPITALS | FALL 2020 43

More Than A Medical School New York Institute of Technology College of Osteopathic Medicine (NYITCOM) at Arkansas State University is committed to training talented physicians who aspire to become servant leaders that positively impact their communities. Located in Jonesboro, NYITCOM at Arkansas State is uniquely situated to improve access to health care and health education in the state and the greater Mississippi Delta region. NYITCOM students are eager and ready to address the regionâ&#x20AC;&#x2122;s significant health care needs through research, outreach, wellness initiatives, and superior patient care.

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Rural Hospitals Restore, Reinvigorate, Reinvent During COVID-19 By Michelle Sharp and Joe Schaffner

ith new challenges across the healthcare landscape come new opportunities for innovation and growth. The current pandemic is proving that when faced with the uncertainty of providing healthcare to those who need it, Arkansas rural hospitals rise to the occasion. No stranger to the virtual interface, Arkansas Foundation for Medical Care (AFMC) works in partnership with the Arkansas Department of Healthâ&#x20AC;&#x2122;s Office of Rural Health and Primary Care (ADH) to underscore the value of utilizing technology to reach rural Arkansans. In late July, more than 100 healthcare professionals across the state convened via a virtual meeting

platform to listen and interact with state and national leaders to address rural healthcare during a pandemic. The meeting started with a State of the State address, provided by Dr. Jennifer Dillaha, State Epidemiologist at ADH, followed by a detailed and informative national perspective by Brock Slabach, Senior Vice President of the National Rural Health Association. Slabach commended Arkansas on our development of the Rural Health Association of Arkansas and encouraged rural healthcare to get involved in becoming a voice for rural Arkansans. Jordan Murdoch, PharmD, representing the HIV and Antibiotic Stewardship Programs, Infectious Disease Branch of ADH, shared

ARKANSAS HOSPITALS | FALL 2020 45

what can be done to further antibiotic stewardship practices in our rural hospitals. He highlighted our progress with nearly 80% of our hospitals meeting all seven of the Centers for Disease Control and Infection Core Elements in 2018 compared to only 58% doing so in 2017. Hospitals also heard from Sarah Brinkman, MBA, MA, CPHQ, from Stratis Health/Rural Quality

Improvement Technical Assistance who covered several topics including the importance of reporting and improvement among rural hospitals in providing value-based care. To highlight a technology-rich perspective, Dr. Kathy Wibberly, Ph.D., with MidAtlantic TRC shared the timeline of healthcare delivery and how technology is advancing the way rural health does business by imagining care anywhere.

The day transitioned to the topic of telehealth with Dr. Hari Eswaran, South Central Telehealth Resource Center and Dr. Curtis Lowery, UAMS Institute for Digital Health & Innovation (IDHI) sharing their expertise. Much of the work being done by IDHI centers around distributing software and technology to patients to 1) improve access to providers and other healthcare professionals, 2) collect

Will rebuild to print clear.

Supporting you, supporting patients. The COVID-19 outbreak is an evolving crisis, and we want to support hospitals and other frontline health providers with the latest tax and accounting updates to help them navigate the inevitable economic effects. Visit our COVID-19 Health Care Resource Center at bkd.com/ covid-19healthcare for relevant news, changing guidelines, and new regulations.

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data to improve cognitive support in decision-making, and 3) reduce the need for hospital visits to the emergency department. IDHI brings more than 20 telemedicine and 10 distance education programs to rural providers and patients in Arkansas, with programs classified as clinical, educational and/or research-oriented. The earliest of the core IDHI programs is the IDHI High-Risk Pregnancy Program, a high-risk obstetrical telemedicine program administered in partnership with Medicaid. This program helps Medicaid extend care through interactive video consultation to rural beneficiaries experiencing high-risk pregnancies. IDHI is also home to the Stroke Program, which extends real-time, interactive neurological consultation within 55 of the state’s rural emergency departments 24 hours a day. Live video communication and digital transfer of CT scans enables neurologists to directly treat distant patients for stroke. Governor Asa Hutchinson directed IDHI to lead the state’s telehealth response to the COVID-19 pandemic. In response, IDHI has helped screen thousands of patients through UAMS HealthNow, a program that allows Arkansans in any area of the state to access a nurse practitioner 24 hours a day for primary/urgent care. “We have seen an exponential growth in requests for our services as we help both newcomers and more established users navigate the neardaily changes in how they can provide digital health care,” Eswaran said. “By a number of measures, our work has doubled or tripled.” IDHI’s other programs include the UAMS e-Link telemedicine network, the statewide trauma image repository and live remote language interpretation; clinical digital health programs such as hand trauma, tele-mental health, school-based health and prison-based obstetrical services; LearnOnDemand. org and PatientsLearn.uams.edu, online educational platforms for providers and patients; and the South Central Telehealth Resource Center, which provides telemedicine guidance and support to Arkansas, Mississippi

and Tennessee. You can find more information about the IDHI at https:// idhi.uams.edu/ and several telehealth resources at http://learntelehealth.org/. Authors’ Note: All recordings and slides from the Annual Rural Health Conference can be found on the ADH website for the Office of Rural Health and Primary Care at https://www. healthy.arkansas.gov/programsservices/topics/rural-health-resources.

Michelle Sharp, MSN, RN, CPPS, serves as Outreach Specialist and RN Team Lead at AFMC. Joe Shaffner is the Assistant Director of Outreach at the South Central Telehealth Resource Center located at UAMS.

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C O N S T R U C T I O N | I N D U S T R I A L | C I V I L | E N V I R O N M E N TA L | S P E C I A LT Y

WE BUILD PLACES FOR FAMILIES

The Ronald McDonald Family Room at UAMS provides respite for the families of infants staying in the NICU. With a kitchen, bedrooms, bathroom, living room, and area for children to play, families can find a comforting sense of normalcy while staying close by to their babies. 1 . 8 7 7. N A B H O L Z | n a b h o l z . c o m