Innovations, Operations & Crisis Management Heroes

Heroes Behind the Scenes

For two years, countless key staff worked tirelessly to propel critical innovations, uphold our standards of quality and safety, and keep BIDMC operational.

Shifting into Overdrive

Giving Matters: Heroes Behind the ScenesAt the start of the pandemic, Chris Minette, Vice President of Support Services, was struck by all the unknowns. “We didn't know how this virus was transmitted,” he says. “We didn't know who would or would not be infected.” It was an unsettling time for his team members, who manage Food Services, Environmental Services, Radiation Safety, Hospitality, and Materials Logistics. “It was very, very scary, but everyone stepped up,” says Minette. “I don't know if there's a way to adequately thank them.”

Each day brought new challenges, as longstanding procedures were upended to ensure patient and staff safety. “Despite the immense tragedy, everyone came together and put their own needs aside to conquer the hurdles each new day brought,” says Kristine Viale, Operations Manager of Environmental Services, whose team adjusted to new cleaning protocols and worked side-by-side with the Materials Logistics group to ensure supplies were fully stocked. Former Food Services Manager Shana Sporman could always count on her devoted staff. “Nobody ever hesitated to step in when needed,” says Sporman. “There's so much pride in the kitchen. Our staff will walk through blizzards—they do whatever it takes to ensure that our patients and staff are fed.”

Seeing so many people with different backgrounds coming together to drive one mission was astounding and humbling.
Chris Minette
Vice President of Support Services

Throughout the pandemic, the Infection Control and Hospital Epidemiology team, led by Senior Medical Director Preeti Mehrotra, MD, MPH, worked closely with Minette and his team. Each day, they visited employees on COVID-19 units to provide instruction and reassurance; with information from state and federal agencies rapidly evolving, their guidance was particularly important. “It was nonstop,” says Mehrotra. “Something you thought to be true in the morning was different by the afternoon, but our priority was to do everything in our power to protect patients and staff from this terrifying virus.”

Declan Carbery, Director of Emergency Management, shares similar sentiments. “We weren't experts in pandemics, but we provided support and information to help staff best support their patients.” The Emergency Management team steps in whenever the hospital’s normal operations are disrupted, whether from a utility failure or a mass casualty event. With the pandemic hitting harder and lasting longer than anyone could have foreseen, Carbery and Project Manager Mo Ortega worked around the clock—remaining on-call 24/7 for months at a time. “One of our primary goals was to help staff across BIDMC think about how to utilize resources in new ways,” says Carbery.

Developing Innovative Solutions

As time went on, staff continuously generated creative ideas and solutions—all of which became indispensable to BIDMC’s pandemic response. “No one ever said, 'we can't do this' or 'this won't work,'” says Carbery.

Underpinning many of the medical center's key decisions and preparations was a custom forecasting model developed by the Center for Healthcare Delivery Science (CHDS) team. “There was a tsunami coming and we needed to understand it,” says CHDS Director Jennifer Stevens, MD, MPH. “Among other things, our staff needed critical information about what to expect in terms of hospitalizations as well as ICU bed and ventilator needs.” At the outset, national models were based on limited information from China and Italy—and the CHDS team wanted deeper insight. Stevens, together with emergency department physician and clinical lead for machine learning Steven Horng, MD, biostatistician Tenzin Dechen, MPH, and economist Ashley O'Donoghue, PhD, developed a predictive model especially for BIDMC, at BIDMC. “We built this model from scratch overnight,” says Stevens. “With the collaboration of Information Systems, we were able to build our own data-driven tools based on social mobility data and specialized machine learning,” says Stevens. The unique model has continued to forecast the timing and magnitude of clinical demands, helping to optimize hospital-wide operations and ultimately, to better serve patients.

Adding to the urgency was a desperate need for personal protective equipment (PPE), which was nearly difficult to procure due to supply chain issues. “There were points when I worried that we were going to run out of PPE,” says Minette. David Flanagan, Senior Director of Capital Facilities, Engineering, and Research Laboratory Planning, shared this fear. “When N95 masks were running low, it was alarming,” says Flanagan, who joined forces with Beth Israel Lahey Health (BILH) Chief Infection Prevention Officer Sharon Wright, MD, MPH, and the Infection Control team. Together, they laid out a bold, complex plan: they would develop a novel, onsite vaporized hydrogen peroxide (VHP) chamber to disinfect N95 masks so that they could be safely reused within 48 hours.

“We needed the very specific engineering skills of my team, the infection control expertise of our clinicians, and of course, buy-in from leadership,” says Flanagan. “It was ambitious and there were a lot of hurdles along the way, but we knew we could do it.” Adds Mehrotra: “We decided to shoot for the moon.” They brought together a multidisciplinary group from Facilities, Environmental Health and Safety, Infection Control, Materials Management, Pathology, and Central Processing, along with redeployed staff. Thanks to this team’s ingenuity and collaboration, BIDMC became the first medical center in Massachusetts to have VHP technology available onsite—and soon shared this innovation across the BILH system.

“Many teams, including nursing leadership and the Improvement and Innovation team, were essential to support the clinical staff as they were introduced to the VHP process,” says Flanagan. The VHP chamber remained in use for more than ten months, successfully disinfecting as many as 6,000 N95 masks per day, and greatly extending PPE supply.

Creative solutions weren't confined to the BIDMC campus. During the statewide lockdown, a team from Hospitality, Real Estate, Legal, Human Resources, and Information Services secured accommodations and made temporary housing arrangements for BIDMC and BILH staff who needed to quarantine or who were worried about keeping loved ones safe at home. “More than 300 staff members utilized our hoteling program,” says S. Nicholas Kriketos, Manager of the Service Ambassador Program, whose team helped arrange everything from security to toiletries. “Our colleagues were relieved and thankful to have this option available during this worrisome period.”

Continuing Vital Patient Care

Telehealth came to the rescue during the pandemic—and successfully carries on today. “The launch of the BIDMC VirtualVisit platform enabled us to support our physicians, maintain social distancing and continue to provide uninterrupted access to healthcare for our patients during the lockdown and throughout the pandemic,” says Oren Mechanic, MD, MPH, Director of Telehealth, who oversaw the development of this novel system. Developed right here at BIDMC, the comprehensive and user-friendly web-based platform is one of few such applications in the country to provide consent forms, screen sharing for images, and text message reminders for visits and symptom checking.

Because the vast majority of clinicians had never used telehealth previously, the launch of VirtualVisit required extensive physician training. Mechanic worked closely with patient advocates, clinician champions, interpreters under the leadership of Alexa Kimball, MD, MPH, CEO of Harvard Medical Faculty Physicians, Chief Information Officer Leanne Harvey, and Chief Technology Officer Venkat Jegadeeson, and their teams, to refine the platform and train users. “It was a multidisciplinary team effort through and through,” says Mechanic. “I'm so proud of the innovative work we've done.” At a time when the workforce was stretched thin, medical students also stepped in to lead the COVID-19 Outpatient Pulse Oximetry Protocol, led by Alon Dagan, MD, which enabled many patients to be safely discharged and monitored from their homes via telehealth. In total, more than 500,000 virtual visits have taken place since the pandemic’s start.

Today, the VirtualVisit platform continues to provide patients with an important option that enables social distancing and enhances access. “Our goal with telehealth is to provide accessible, convenient care to all,” says Mechanic. “It helps address disparities and is particularly helpful for people who have difficulty traveling or who cannot miss a day of work.”

From developing a PPE disinfection system to predicting hospitalization volume to working in the kitchen to creating detailed inventory of supplies, so many staff persevered behind the scenes. “I have an amazing, dedicated team,” says Patty Caldwell, Manager of Supply Chain Operations. “They are truly super heroes.” Adds Minette: “Seeing so many people with different backgrounds coming together to drive one mission was astounding and humbling.”

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