Best Health Care Professional honoree brings experience, innovation to role as Johnston Health’s CMO

By RANDY CAPPS

For Dr. Rodney McCaskill, October 2019 was a red-letter month. After all, he had just been named interim chief medical officer at Johnston Health, a position that has since become permanent, and he was about to embark on an exciting new phase of his career.

Of course, those two years turned out to be interesting in ways that were impossible to imagine.

For his leadership and dedication during the pandemic, McCaskill has been named the 2021 Johnston Now Honors Best Healthcare Professional Award winner.

His background in emergency care, both in the clinical and the administrative sense, proved to be useful in the early days of COVID-19.

“Usually, in this role, you come up with processes and protocols,” he said. “They have to be approved and discussed for a year or so. With COVID, it was more like days.”

The pandemic changed his role as CMO in other ways, too.

“I was trying to learn about quality metrics and flow through the hospital,” he said. “I was trying to help length of stay and then, all of a sudden, we have a pandemic with COVID. Then, the hospital’s largely empty because everybody’s afraid to come because of COVID. Then, we have to gear up and decide how we’re going to do testing. Initially, testing was very limited. We only had a handful of test kits. Thankfully, UNC developed a test fairly quickly. ... It was definitely interesting.

“We were definitely limited by supplies, more so than I would have thought. It took a while to get things up and running. We’ve outsourced most manufacturing in the United States to other countries. Masks, test kits, gowns, PPE — the U.S. doesn’t do that anymore. And all the other countries used those things in their countries. So, it put us in a bit of a bind for a while.”

The ebbs and flows of the pandemic in terms of the number of people infected have also created challenges for the hospital.

“We had a little bit of a pause from March to June and July of last year, then we had a big bump at that point,” he said. “Then, things kind of dropped off a little bit, then came right back up in November, December and January where we were really overrun with COVID patients. Then, the vaccine came out. And the vaccine’s been great in the sense that it protected folks from COVID, or at least made it much less likely they get admitted or intubated. But it also gave the public a new sense of safety. So, they’re back at the hospital. The medical patients are now back, plus this big group of COVID patients. So, it really has kept the hospital extremely busy.

“The staff has been awesome. They’ve gone above and beyond. Nurses are working overtime, picking up extra shifts, taking care of patients that, technically, they don’t really have to. The physicians? There are more patients on the hospital census over the past two weeks than there ever has been in the history of Johnston Health. They’re busy, and they just keep going. They just keep doing it, and it’s very impressive to watch.”

Keeping that staff informed on the latest developments on things like the pandemic and making sure the communications lines are open are key components of McCaskill’s duties as CMO.

“It’s definitely different than what I was used to,” he said. “I’ve always done some administrative roles along the way, but this is a much bigger role than I’ve ever taken on before. Normally, it would be half or three-quarters clinical work and then maybe a quarter administrative. This is 90% administrative and 10% clinical. It’s a different set of challenges. When you’re working in the hospital, you’re essentially taking care of a handful of patients at a time. In this job, you’re managing the medical staff. The physicians, the PAs, making sure there’s a good working relationship. Nursing, all that has to work together well. It carries a different set of challenges, but it’s rewarding in the same way.”

McCaskill’s contributions to public health in the pandemic were more than just administrative.

He and other members of the hospital’s COVID-19 steering committee researched and helped implement a program to get COVID patients in Johnston County who were 55 and older bamlanivimab (BAM) infusions with the goal of lessening the impact of the virus.

“It’s a passive immunity,” he said. “So, basically, if you get COVID and you get the monoclonal antibody, it goes into your bloodstream, binds free virus and makes it so it can’t enter cells.”

Or, put more simply, it stops the body’s typical response to the virus — inflammation in the lungs — before that response can cause the breathing problems that it normally would.

Even with the success of the BAM infusions, McCaskill stresses the importance of getting the vaccine.

“We have 70 patients in the hospital (for COVID),” he said. “Only one of them is vaccinated.”