On Feb. 28, 2020, EvergreenHealth in Kirkland, Washington, identified the first two COVID 19-positive patients in the United States. Pratima Sharma, MD, executive medical director of primary care, recalls the fear and confusion that spread through the health system. There were no physical distancing guidelines, no masking requirements, and little understanding of how this novel coronavirus operated and how it spread.

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“We quickly needed to understand how we were going to handle these situations, not knowing how to care for these patients,” she said. Her team had to come up with a plan on the fly and communicate it to the rest of the staff.

Dr. Sharma talked more about those early, uncertain days in an episode of “AMA COVID-19 Update,” sharing strategies for ensuring physician well-being and connecting with patients during a crisis.

The Centers for Disease Control and Prevention (CDC) arrived several days after the first confirmed cases. But the agency did not yet “have a playbook for us to use” on masking, personal protective equipment, or treatment, said Dr. Sharma. Information about the virus was also changing rapidly.

EvergreenHealth worked with the CDC to develop a best practices approach that evolved as new information came to light. “This information was then able to be shared by local facilities who were now starting to see COVID- positive patients, as well as nationwide as the pandemic spread,” said Dr. Sharma.

The health system also set up a command center, sending out daily emails and holding weekly town halls to update staff and the community about the latest CDC recommendations and new guidelines.

Visit the AMA COVID-19 resource center for clinical information, guides and resources, and updates on advocacy and medical ethics.

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As one of the first health systems to be on the front lines of this pandemic, EvergreenHealth’s staff faced multiple stressors. Some people got furloughed, others had health problems or child care issues. Solutions called for multiple approaches, modified for individual needs.

The hospital allowed people to use modified benefits, said Dr. Sharma. “People were directed towards the employee-assistance program. A shared leave program was created. We were able to work with some local church organizations and other child care providers in the area to provide free child care for our essential workers.” Employees could donate to an employee-assistance fund to help their fellow co-worker.

“Many of our nonhospital-based physicians were also able to get credentialed on an urgent basis at the hospital,” said Dr. Sharma.

EvergreenHealth quickly realized that patients were deferring care at the beginning of the pandemic. It responded by developing a telehealth option within a two-week period, deploying software, hardware, training, and changes to workflows, billing and documentation.

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“It was pretty remarkable how all departments came together with a common goal. And I think that is going to stay with us. It has been a pleaser for our patients who can access care safely and for our physicians and staff,” said Dr. Sharma.

Learn more about EvergreenHealth's pandemic response.

The summer of 2021 brought some relief, but like many other parts of the country, Kirkland has seen a recent surge in cases due to the more highly transmissible SARS-CoV-2 Delta variant. Continued staff shortages have also been stressing care teams.

EvergreenHealth instituted several new programs such as Schwartz Rounds and Code Lavender (PDF) to help staff and physicians cope with stress and anxiety. They can also retreat to a special quiet area of the hospital to take a few minutes of rest if they need it. “The town halls have continued,” said Dr. Sharma.

Get the latest news on the COVID-19 pandemic, vaccines and variants, and more reliable information directly from experts and physician leaders with the “AMA COVID-19 Update.”

You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version.

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