In March, as neighboring New York City became the epicenter of the COVID-19 pandemic, Catholic Health Services, located on Long Island, had one goal: to provide the same caliber of care as always, regardless of circumstance. “We went into action as New Yorkers typically do,” recalled Kim Kranz, president of Catholic Health Services of Long Island’s Catholic Home Care & Good Shepherd Hospice.
For these New Yorkers, taking action meant recognizing the severity of the situation, but also identifying opportunities as they unfolded. “We had an incredible opportunity to create full integration of what we call ‘systemness,’” said Kranz, referring to the unification of various organizations and processes. “We also had the opportunity to help hospitals make sure that those patients who needed to be discharged were discharged as quickly as possible to create surge capacity.”
Kranz noted the incredible need for post-acute care in both home health and hospice. “We saw an increase in hospice where patients and families were making decisions they may not have made before,” said Kranz. “[They say] I want to experience quality of life, I want to be able to utilize hospice services to stay at home as that’s where I’m going to be safest.”
To meet this demand and to aid hospitals with capacity issues, Catholic Health Services created the COVID Home Program. Under this initiative, Catholic Health Services was able to serve hundreds of patients suffering and recovering from COVID-19. To ensure patient and provider safety, Catholic Health Services deployed telemedicine, remote health monitoring and skilled nursing throughout the program.
To mitigate potential infection among clinicians, Catholic Health Services secured the necessary personal protective equipment (PPE) and followed Center for Disease Control (CDC) guidelines for care in the home. “We treated that patient just as if they were in the hospital,” said Kranz. “We ensured all nurses and clinicians, aides and chaplains, were fit tested and had all the equipment necessary to care for patients.”
For Kranz, this kind of flexibility embodies the inherent value of home health and hospice. Catholic Health Services could plan in advance, screening each patient and family member ahead of time. This constant screening allowed clinicians to be prepared to meet any situation and eliminated any guesswork.
To further ensure staff safety, Catholic Health Services eliminated barriers to communication. “We flattened the lines,” said Kranz. “We made sure that every single clinician had direct communication with our chief medical officer, with myself and the program directors every week.” This transparent communication kept employees current with CDC recommendations and department of health guidelines.
As the number of COVID-19 positive patients increased, the numbers of infected employees decreased. “We knew our procedures were all working because we were tracking everyone, every day, seven days a week,” said Kranz.
By enacting the idea of ‘systemness’ and facilitating connection among health systems, employees, families and patients, Catholic Health Services quelled the spread of COVID-19. “The rehospitalization rate was less than 1% of [COVID-19-positive] patients. That is true ‘systemness’ and clinical integration,” said Kranz.
When asked what advice she would share with peers, Kranz suggested looking within the existing community, accepting donations of handmade masks from volunteers and inviting nursing students to join in delivery of care.
More than anything else, Kranz urges other providers to embody that special brand of New York resilience: “Don’t give up. Do everything you can to be a part of the solution,” she said. “Do the things you know how to do best. We went into the hospitals and did grief support for staff. We did onsite debriefing at hospitals who lost colleagues and patients. We didn’t give up.”
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