Clinical Spotlight: Dr. Andrew Artenstein

This is an update provided for Baystate Health Foundation’s Impact newsletter from Dr. Andrew Artenstein, Chief Physician Executive and Chief Academic Officer, Baystate Health; President, Baystate Medical Practices; Regional Executive Dean, UMMS-Baystate; Professor of Medicine, University of Massachusetts Medical School; Adjunct Professor of Medicine, Tufts University School of Medicine; and Adjunct Professor of Medicine and Health Services, Policy and Practice, Alpert Medical School of Brown University.

How did Baystate Health adapt to COVID-19?

In the six-month period following our first case in mid-March, Baystate Health cared for nearly 1,200 hospitalized patients with COVID-19; tested more than 100,000, of whom nearly 5,000 were confirmed to be positive; and lost nearly 250 lives to this terrible pandemic. Owing to our proactive Hospital Epidemiology and Infectious Diseases teams, we were well prepared. Pandemic preparedness and response—by nature—are dynamic states in which adherence to guiding principles; acting with decisive urgency; flexibility; creativity; acknowledgement of uncertainty; adjusting based on rapidly evolving circumstances and data; transparent, frequent communication; and team empowerment tend to be rewarded with optimal outcomes.  We stood up an Incident Command structure in the first week of March to optimize BH’s pandemic response. Work teams and work streams were rapidly created, directly involving hundreds of team members who were joined in their efforts by a broader team of thousands of BH employees. We were and continue to be guided by a single, overarching principle: to protect the health and safety of our patients, our team members, and our community. Upon reflection, we—our collective team—have forged a tremendous library of accomplishments:

• Entire units within our hospitals changed their identities, were re-purposed and in some cases physically relocated, and were staffed appropriately to address new and rapidly evolving clinical contingencies engendered by COVID-19 The Emergency Department (ED) triaged and managed thousands of patients with confirmed or suspected COVID-19 infection and also developed novel, creative, and highly effective approaches to the clinical respiratory management of COVID-19 patients, leading to improved outcomes in our patients
• Employee Health Services expeditiously stood up mobile testing for symptomatic team members and for several first responder groups and teams worked collaboratively to rapidly establish drivethrough testing sites across all our regions
• New jobs and new duties for existing positions were created, including personal protective equipment (PPE) coaches, employee screeners, and clinical ‘runners’; more than 100 team members were redeployed from their usual pre-pandemic duties to be trained for such service
• Our teams worked tirelessly to rapidly establish new services as the need arose. These included enhanced clinician wellness efforts, augmented spiritual support, counseling, EAP, on-site parking, a pop-up market for groceries and supplies, and palliative care outreach for patients and their families
• With the technical collaboration of I&T teams, nearly 4,000 team members were nimbly transitioned to work remotely in order to further minimize transmission risk within BH and preserve the health of our work force
• The COVID-19 site on our internal portal was quickly created and continuously populated with a treasure trove of useful information, rapidly becoming a ‘best practice’ in education, communications, and information flow
• The PPE story has been a point-of-pride at BH. Our supply chain, infection control, education, technology, and clinical teams worked ceaselessly in their pursuit of our goal to ensure the sustainable safety of our team members through the acquisition of necessary PPE
• In a matter of just a few weeks, telehealth and other types of “virtual” visits were widely adopted and successfully operationalized in our ambulatory practices to minimize the risk of exposure for patients and team members
• While still in the throes of the early part of the surge, we initiated a “Post-Pandemic Strategic Planning” section of Incident Command to better position our organization to rapidly recover from the pandemic. This has allowed us to successfully get back to advancing our strategic goals
• The Finance team engaged early in the pandemic with regulatory and legal experts to assure that BH was treated fairly regarding federal and state programs to acquire reimbursement for unforeseen pandemic expenses

How has some of your expertise played an integral part helping Baystate Health during the pandemic?

Being an infectious diseases (ID) physician, I believe, is especially useful for the organization in these pandemic times because I have a deep understanding of communicable disease and of public health. We are fortunate here in that several of the organization’s top leaders are classically trained ID physicians. I am a student of pandemics and emerging infections, having been the Founding Director of the Center for Biodefense and Emerging Pathogens (CBEP) at Memorial Hospital of RI/Alpert Medical School of Brown University in mid-2001 and having been the author of several books and numerous training materials/curricula in this arena. A major thrust of our work at CBEP was in pandemic/outbreak planning and response—to both real (e.g., influenza, anthrax) as well as potential (e.g., smallpox, SARS, bioterrorism) threats. My previous background in the U.S. Army Medical Corps (1986-1996) was in vaccine research, experience that I am hoping will serve the organization well if and/or when we may need to deploy a safe and effective COVID vaccine.

In what ways has Baystate Health served as an example for COVID-19 care in Massachusetts?

We should all be very proud of the response of this organization to the COVID-19 pandemic. Guided by the principle of maintaining the safety, health, and wellbeing of our patients, team members, and community, hundreds of our team members were galvanized into a variety of cross-disciplinary, focused work streams to address the numerous and dynamic challenges posed by such a rapidly changing event. Through it all, BH proved itself to be a resilient, transparent, “learning” organization in which we nimbly adapted to the shifting environment, using the best available evidence to make informed decisions in an uncertain setting. Our organization was and continues to be a good regional community citizen during this massive event, continually assisting our community stakeholders, partners, and colleagues with education, information, testing, resources, and expert guidance. We continue to work closely with our state public health authorities and political leaders to ensure the best outcomes for the communities we serve.

What has been the silver lining of COVID-19?

It has been a difficult seven months for all, especially for our BH team members who have toiled selflessly, despite understandable fear and anxiety, to provide compassionate, high quality care to the thousands of patients who have sought it. It has been a difficult year for our communities as well; we grieve for the lives lost and for the families impacted by this terrible virus. If there is any silver lining it is that this event has further bonded us to each other, and I believe the strength and dedication of our team members—all 12,500 of them—have helped our community weather this first storm and have made us even more resilient. This will serve us well into the near future.

Donate to Baystate Health Foundation to support COVID-19 efforts at Baystate Health.