Sam H. Wald, MD, is vice president/associate CMO, Perioperative and Interventional Services, Stanford Health Care, Palo Alto, Calif., and clinical professor, anesthesiology, Stanford (Calif.) University. Here, he shares how Stanford University instituted new safety protocols in response to the COVID-19 pandemic.
What was the first month of the pandemic like for you?
The first time we took broad action related to the pandemic was March 12th, the same day that Santa Clara County made multiple recommendations, including the halting of elective surgeries. At Stanford, we took a conservative approach and within 24 hours cancelled and/or rescheduled all elective surgeries on our main campus. Within days, this was extended to all stand-alone outpatient sites. The goal was to provide safety within our health system and for the community in terms of conserving resources and slowing the spread of the virus. This guiding principle continued to be our touchstone and has been maintained to this day.
Over the first few weeks, we set up governance and groups to help with maintaining our supplies and allocation of personal protective equipment, personnel and physical resources. It was a challenge to provide clear communication across the system given that information was so dynamic.
How have you led during the pandemic? What leadership skills did you rely on, and how did you apply them?
During the pandemic, I found I needed to expand my role along with many other leaders in our system. To respond to the pandemic required a blurring of previous “lanes of responsibility.” Whatever collaborative skills I had previously employed required even more attention.
Specifically, the perioperative area was a heavy user of PPE, but any new policy or practice had an enhanced organizationwide effect. All stakeholders truly needed inclusion. Plus, everyone was afraid of the virus spreading, and there was an added presence of strong emotions related to our acute well-being, which required extra patience of leaders.
Additionally, I discovered the need for dexterity in decision-making, especially with large groups of stakeholders. Often, we did not have all the information needed, nor did we have enough time to arrive at a consensus. In many instances, a final decision had to be made even though we were sometimes relying more so on opinion than fact.
What key lessons learned can you share? How will you use them going forward?
Multiple lines of communication are paramount. The communication should be clear, direct and as simple and easy to absorb as possible. The decisions we make as leaders are only as good as our ability to implement them.
How did your experience compare with other crisis situations? Did you use lessons learned from it? How?
The COVID-19 crisis is different from many of crises we have faced in the past because they were limited both in terms of length and scope. The COVID-19 pandemic has extended longer than any event that comes to mind and has affected every aspect of our healthcare delivery system. Long term, I think improvement will hopefully come from this experience. As an example, telehealth has gotten much more attention and will become a broader tool with faster long-term adoption. Keeping an optimistic attitude about what we can learn from this challenge is also important as a leader.
What are you focusing on currently regarding COVID-19? What is most important now?
At this time, our focus is on refining many of the processes related to COVID-19 as a healthcare delivery system. At Stanford we are continuing to maintain our enhanced occupational health program and testing protocols. We are also continually assessing our resources, such as PPE, and we are looking to ensure that our patients have the easiest access possible to care. We are preparing to leverage what we have learned about testing and PPE use to prepare for another surge and to minimize the impact of the seasonal flu. The institution has proactively formed a task force related to implementation of a vaccine for when it becomes available.