Dr Cacchione Shares Ascension’s Lessons From the Pandemic’s Challenging Early Days

Joseph Cacchione, MD, FACC, executive vice president of Clinical & Network Services at Ascension, described some of the lessons he learned from operating in states that were hit hard during the early days of the COVID-19 pandemic.

Michigan was one of the hard-hit early states; Ascension, which operates 15 hospitals in the state, was able to quickly learn about treating COVID-19 and share those lessons across the system, said Joseph Cacchione, MD, FACC, executive vice president, Clinical & Network Services, who recently sat down for an interview with Chief Healthcare Executive™.

CHE: Some states where you operate are among those that were hit very hard in the early days of the pandemic. What lessons has Ascension learned that you can share across the health system and across other health systems?

Cacchione: Michigan was hit very hard very early, and it's actually just getting over its third wave of a surge. And, I would say, for us, it was about from the vaccine standpoint, I think we treated Michigan just the way we treat everybody else. And that was get as many people vaccinated as we possibly could. From an overall standpoint, though, we, as a health system, were able to leverage our size and scale to assist Michigan when it was peaking. And then vice versa, when other markets were peaking. We could shift resources to other markets. So, we learned a lot about how to treat patients, how many patients were going to [become ill] when Michigan peaked early. We learned a lot about the treatment, and we saw a reduction in mortality over the course of the pandemic, from about 35% in patient mortality, now down to less than 10% of inpatient mortality. So, it's come down quite a bit. And it's because of our learnings through the pandemic, and, and learning so those markets that peaked at different times, and then redeploying resources was an important part of our approach to the pandemic.

CHE: Are there specific advantages that having a multi-state health system offers during a pandemic?

Cacchione: Specifically, what we're able to do is create a critical staffing pool of nurses from other states that would be able to go to Michigan or wherever we were peaking. We actually paid them a premium to go there to support their colleagues. That was the first thing.

There are videos from the Kansas market that was sent as a video “card” to Michigan—saying, “We're coming to help,” that was a real tear jerker, because they saw the Michigan people under stress, and it was just a great way for the health system to come together.

The second thing we did was as a health system, with PPE—and our supply chain group really did a phenomenal job of procuring PPE during this. We never once had any PPE that was not real or counterfeit PPE. We never once ran out of anything--gowns, gloves, masks, eye shields—and we’ve helped other health systems with masking and gowns when we could, and so we felt very blessed.

We had the resources to purchase and overpurchase when everything and anything came available, and that at one point we actually had direct shipments coming from China—to our docks—to supply our health system, and candidly, other health systems. Similarly, with ventilators, we created a virtual ventilator stockpile. So, when a market was surging, we would send additional ventilators to that market. We had a pool of ventilators that were sitting on the sidelines, waiting to see where they were needed. And we would ship ventilators off. As a health system, we were redeploying the resources, and those were specific examples of how we redeployed those resources in a way that made us made it made it much more tolerable.