Tackling the Challenges of COVID-19

Cahmeil Edmond, age 5, and Tiffaney Wallace, of Portsmouth, have their temperature taken by Meaghan Minori during screening for COVID-19 in the CHKD hospital lobby.

Providing care safely while protecting patients, staff, and families

On any given day, operating a regional health system with more than 3,000 employees in more than 40 locations is a complex endeavor. We have to be ready to deliver the care we’ve scheduled along with whatever unplanned challenges may come our way, from a hurricane, to a school bus accident, to a virus no one has ever seen before.

When COVID-19 hit in early 2020, CHKD quickly implemented a Hospital Incident Command System (HICS), an emergency response structure designed by the government specifically for hospitals. Our HICS team consisted of approximately 20 individuals from across the organization, including clinical, administrative, and logistical representatives. Karen Mitchell, CHKD’s chief nursing officer and vice president of patient care services, stepped up to serve as incident commander, overseeing CHKD’s response to the COVID-19 threat.

In daily meetings, which included CHKD’s senior leaders, the HICS team shared guidance from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the Virginia Department of Health as well as feedback from our physicians, support staff, and patient families, to develop policies and guidelines to treat COVID patients safely while working to protect other patients, families, staff members, and the public from the illness.

“It was a monumental effort since everyone needed to continue doing their regular jobs, which were already very busy,” says Mitchell.

The work involved every branch of the health system, from the main hospital, to the health centers and urgent care locations, to the offices of every CHKD pediatrician and specialist along with physicians outside of CHKD who turned to us for guidance. To ensure the safety of our care, CHKD rapidly deployed telemedicine options for patient visits across the system and established protocols to make in-person visits as safe as possible. Many office workers transitioned to remote work environments, and virtual meetings became the norm to keep operations going.

Collaboration and communication, both within the health system and with our colleagues, patients, and families, were essential to keep everyone on the same page and up to date on rapidly changing guidance. The HICS team issued frequent communications and our pediatric experts offered regular guidance and advice to families through media appearances, news stories, online blogs, email communications, and more. Our clinical staff shared data and guidance with regional, state, and national organizations to help strengthen COVID testing, tracking, mitigation, and treatment.

Thankfully, CHKD never experienced the massive influx of critically ill patients that some adult hospitals had to grapple with. We were ready for them; but, as a group, children fared better than adults in the pandemic. After a spike of cases in the fall, a glimmer of hope came for all of us in December with the FDA approval of two COVID vaccines.

CHKD received its first vaccine shipments before Christmas. Vaccines were offered to all staff members according to a priority matrix developed by the Virginia Department of Health. Nurses came back from retirement to help operate a daily vaccination clinic in the hospital. Vaccines were distributed to our pediatric practices to administer to our most vulnerable patients who met the current age criteria, and doctors and nurses volunteered to work in special vaccination sessions held in our health centers.

We also vaccinated staff at partner facilities like St. Mary’s Home and Ronald McDonald House.

The challenges of the COVID-19 pandemic, the lessons learned, and the advancements we have made during this time will improve the care that CHKD provides for years to come. “The resilience of the staff is what gets me up every morning,” says Mitchell, who worked 12-hour days, seven days a week, for months. “As challenging as it’s been, we have learned so much that will serve us well in caring for patients in the future.”

As challenging as it’s been, we have learned so much that will serve us well in caring for patients in the future.

– Karen Mitchell, CHKD’s chief nursing officer and vice president of patient care services