12 minute read
Leader Profile: Chad Addudell
How “Delta” Changes Caregiving
By Nancy Robertson
The Delta variant of SARS CoV-2 is changing the face of health care in three ways: There are changes in the disease itself, a change in the ages of those being hospitalized with it today, and changes affecting caregivers and their caregiving.
With Delta’s advance comes added concern for health care providers caring for COVID-19 patients. After more than 20 months working around the clock with desperately ill COVID patients, they are physically, mentally, and emotionally exhausted as hospitalization numbers, deaths, and cases of the virus continue to hit new levels, despite the availability of vaccines.
“It’s hard to believe we’re still having discussions about COVID-19 all these months after vaccines became available,” says Chad Aduddell, Market CEO of CHI St. Vincent. “In April, after a few months of people receiving vaccinations, we saw the return of patients who had delayed care during the pandemic’s first waves. It gave us a glimmer of hope that things were changing.
“But in May, we noticed a data blip, and another in early June, showing an uptick of COVID cases being seen in our clinics. It was, of course, due to the Delta variant making its way to Arkansas. Like other systems in Arkansas [and the South], our hospitalizations began to rise, and we continue to treat people who are very sick with the Delta variant today.”
With fellow health care leaders the world over, Aduddell noted with alarm the Delta variant’s rise first in India, then in the United Kingdom, then in the United States first in the Branson/Springfield area of neighboring Missouri. With distressing reports of its more contagious nature and the effect it was having on younger adults and children, Aduddell and his team prepared in early summer for another long wave of COVID hospitalizations.
“We were, and remain, thrilled with the numbers of older folks who chose to be vaccinated with the new COVID-19 vaccines,” Aduddell says. “In fact, we were very excited to offer the shots at large vaccination events throughout our system earlier in the year.”
But adults under the age of 50 – not as highly susceptible to the early variants and less likely to choose vaccination – are the majority of adult cases presenting in late summer and early fall. Hospitals in the CHI St. Vincent system, like hospitals all over the South, are full. The vast majority of adult COVID cases are among the unvaccinated. And the numbers of children being treated are also growing. Aduddell simultaneously expresses confidence in his health care teams’ ability to care for those with the virus and his concern for their rates of exhaustion and frustration.
STILL HEALTH CARE HEROES
“During the first waves of the pandemic, things were different,” he explains. “Yes, there were worries and concern as health care providers learned how to treat patients with this new disease. We dealt with shortages of personal protective equipment (PPE) including masks and eye protection. We worked around shortages of ventilators, of gowns … but we have gotten past these issues. So much has been learned about effective drugs and treatment methods. We’re better prepared and have more information about how to address the cases that present in our hospitals. Though fatigue affected everyone in health care during the first three waves, we looked forward to the day vaccines would be available.”
When that day came, health care professionals around the world heaved a collective sigh of relief realizing that a slowdown in cases would follow. Which it did, for a short time.
“Today’s concerns are turning to frustration,” Aduddell shares. “Health care workers are caring for very sick, mostly unvaccinated people in a time when only kids 11 and under are not authorized for vaccination. All around Arkansas and the country, we see people out in groups without masks and without socially distancing. This just should not be, with the Delta variant thriving.”
Concerning the mental health of health care workers, there’s a vast difference between their treatment as heroes during the first waves of the virus and their treatment today.
“Early on, people in health care felt very supported,” he says. “There was lots of attention to our Health Care Heroes from the community, the government, and various groups. Today, that external support for staff is nearly gone. Our health care workers are exhausted and feel alone. They’ve been dealing with tough schedules and little rest while caring today for more COVID patients than ever before.
“The difference, now, is that we collectively feel these people are dying needlessly,” he continues. “We don’t see vaccination as adversarial or political…we see it as a life-saving mechanism. We’re just trying to take care of people, and to see so much death when vaccines are available is heart-breaking.”
SUPPORTING MENTAL HEALTH NEEDS
CHI St. Vincent is doing all it can to support its health care staff. Aduddell has brought in more caregivers to give the medical and nursing staff much-needed cycles of rest. “We also try to do little things every day, providing rest breaks, free meals at times, counseling when needed. There are also some area businesses that periodically bring in meals to surprise the staff. These all add up to help people feel supported. Sometimes mental health care doesn’t have to be complicated…we just need to show we care and that we’re doing things to help our staff members take care of themselves.” Mental health benefits have always been a part of the CHI St. Vincent employee package, but COVID has made making and keeping appointments with mental health providers easier through telehealth options. “The pandemic has rapidly increased the use of our virtual care platforms,” Aduddell says. “Our communications team creatively promotes these benefits in multiple ways throughout our multi-hospital system, internally through our co-worker newsletter, ‘Ask the Leader’ opportunities, and intranet information.”
Leaders and administrators are not left out of the caregiving channels; they’re supported through special training sessions and leadership programming. Sessions on resilience are proving very useful during the pandemic, team members say.
The system is also reaching out to patients in new ways during the COVID pandemic. Mental health services are expanding, and a new addiction recovery unit is now open to both inpatients and outpatients in partnership with Bradford Health. With the rise of drug and alcohol abuse during the isolation caused by the pandemic, this new unit is proving to be a huge asset to area patients seeking help. The system’s marketing group is active in getting information to the public, detailing CHI St. Vincent’s many areas of patient care, including mental health care and its new addiction recovery unit, through social media.
The difference, now, is that we collectively feel these people are dying needlessly. We don’t see vaccination as adversarial or political… we see it as a life-saving mechanism.
CHANGES GOING FORWARD
What do Aduddell and his team see as changes to health care that will result from the pandemic? “For quite a while, those of us in U.S. health care have been shifting our focus from simply caring for people after they become ill to caring for them with the intention of preventing illness,” he says. “We
are focusing on value-based care, which includes increasing access, improving quality, and decreasing cost and unnecessary utilization. We accomplish this by actively assessing our populations to identify risk factors, then intervening to correct those factors to protect health and wellbeing.” He notes that the workforce population separates itself into three groups: • Those who utilize health care as a means for preventing illness and increasing wellbeing. This is about 70% of the population. • Those who have some health issues and can benefit from interactive connections, including health coaches, personal calls after hospitalization or health care visits (to check on medication usage and questions as they arise, plans to keep impending appointments, etc.), and other means of communication. This is about 25% of the population. • Those who have advanced disease and numerous comorbidities, with little improvement expected in their prognoses. This is about 5% of the population.
“Our focus going forward will really be on that middle group,” Aduddell says. “We want to get them the help they need to improve their health conditions while they can, while helping them be proactive in getting treatment. We’re connecting them with the resources they need to make real improvements in their health.”
Challenges seen for health care, post-COVID, are not surprising. COVID and its toll on health care workers has substantially raised the cost of labor and has negatively affected the size of the health care workforce.
“The cost of pharmaceuticals is also up, currently,” Aduddell says. “The nation will be looking at new options in this area as we move beyond the pandemic.”
TAKING COMFORT IN THEIR MISSION
With the pandemic revealing the extreme need for additional health care access in many groups and demographics across the country, Aduddell and his team take comfort in the work they’re doing. “As we meet the needs of the poor and vulnerable, we’re remaining true to who we are as a health system,” he says. “The Sisters of Charity of Nazareth started the CHI St. Vincent system with humble beginnings in 1888, meeting similar challenges for the poor and vulnerable even then. Today, we draw on that heritage every day to remind us of why we are here. We have more than 4,500 coworkers and over 500 physicians and health care providers serving the people of Arkansas, and it’s a part of our Catholic identity and ministry to accept all who need care. We’re proud to offer community clinics in particular areas of need and to offer bilingual staff where they’re needed.” CHI St. Vincent proudly points to three areas where its providers are recognized internationally and nationally for exceptional care. “Our Neuroscience Institute is unique in the United States, and it is gaining global attention as a center of excellence for those requiring care for neurological disorders and/or neurosurgery. The Heart Institute is known for the quality of results it achieves with patients, and it receives the highest ratings among thoracic surgeons. The breadth of the Heart Institute’s programs around the state gives Arkansans access to the state’s largest and most diverse network of heart specialists. And our Behavioral Health Program offers comprehensive behavioral health services including inpatient treatment and outpatient treatment programs. Whether it’s help through our new addiction recovery program, adult inpatient behavioral health care, or senior behavioral health care, we offer personalized programs for Arkansans’ behavioral health needs."
BEYOND DELTA
Chad Aduddell doesn’t know where the Delta variant will take his teams and their patients as we move into the winter months. No health care leader can know that. But one thing is certain: He will continue to see not only that patients receive the best and most effective care but also that all employees in the CHI St. Vincent system, including the medical and nursing staff members, receive the support and care they need to maintain their personal health in the midst of this pandemic.
Chad Aduddell became Chief Executive Officer at CHI St. Vincent in 2015. As its leader, he oversees the system’s four hospitals (CHI St. Vincent Infirmary, CHI St. Vincent Hot Springs, CHI St. Vincent North, and CHI St. Vincent Morrilton, its Institutes, clinics, and service centers.
For three previous years prior to being named system CEO, Aduddell served as Executive Vice President and Chief Operating Officer of CHI St. Vincent and President of CHI St. Vincent Infirmary in Little Rock. • He came to CHI St. Vincent from St. Anthony Hospital (sponsored by SSM Health Care, the first health care recipient of the Malcolm Baldrige National Quality Award) in Oklahoma City, Oklahoma, in 2012. At St. Anthony, Aduddell served as the President of the Bone & Joint Hospital and as Chair and Administrator of the Saints Heart and Vascular Institute. • He has experience in hospital operations and physician enterprise with CHRISTUS Spohn Health System in Corpus Christi, Texas, and in physician enterprise and physician residency program management with SSM Health Care in Oklahoma City. • Aduddell earned his Bachelor of Science with honors from the University of Tulsa and a Master of Business Administration in Health Care Administration with highest honors from Oklahoma City University’s Meinders School of Business. • He has served on the Little Rock Regional Chamber of Commerce Board of Directors, Arkansas Healthcare
Transparency Initiative Board, the University of Arkansas at Little Rock College of Business Advisory Board, Healthy Active Arkansas, Arkansas United Soccer Club Board, and the Mount St. Mary’s Board.
We Asked...
What is the best advice you were ever given?
Feedback is the breakfast of champions – I learned this from my first boss and mentor at St. Anthony Hospital in Oklahoma City. The challenge is that feedback comes in different forms – compliments are feedback, and criticism is feedback. I have learned to take feedback for what it is, you can’t get too high or too low when you receive it. I try to use feedback to be better every day.
Do you have a favorite movie?
I can’t pick just one. The Lord of the Rings Trilogy: These were my favorite books growing up and were amazing on screen. Tombstone: Wyatt Earp really resonates with me. And Chariots of Fire: This is an incredible film. As a runner and huge fan of the Olympics, I am inspired by Eric Liddell’s story.
What’s on your music playlist?
I actually listen to this when I run: '80s rock, Hillsong United, Elevation Worship, Abba, the Spinners, and the soundtracks to Rocky and Rocky IV.
What is something people don’t know about you?
I have four daughters, ages 12-20, and love to spend time with them, participating in their interests, activities, and sports.
What would you do if you weren't in health care?
I was blessed with great teachers, coaches, and mentors who have had an incredible influence on my life. I love to teach and coach, and I hope to do more of both in the future.
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