Combating the surge: Gragnolati urges community to use telehealth options before racing to ERs

Atlantic Health CEO says system is ‘actively pursuing’ use of temporary tents, trailers in case continued rush of people doesn’t slow

By Tom Bergeron
Morristown | Mar 13, 2020 at 1:20 pm

There has only been one presumptive case of coronavirus in Morris, Sussex and Warren counties. And it was in Butler, which is hard by the border to Bergen and Passaic counties. But, if you think that has slowed a rush to emergency departments in northwestern New Jersey, think again.

Brian Gragnolati, the CEO of Atlantic Health System — which operates a number of facilities in the region — said Atlantic has seen a definitive surge in visits.

And it’s a case of “better safe than sorry” not being a good reason for the rush. In fact, Gragnolati explains how too many visitors is bad for everyone — the sick, the healthy and the health care workers trying to determine which group people fall in.

“The reality is that we are seeing surges in our emergency department just because of the things that people are reading about,” he told ROI-NJ. “So, an important piece of this is to really educate the public. And we’re doing that in a variety of ways, especially social media.

“What we are doing is encouraging people to call before they come. We encourage people to access our telemedicine sites, to contact their primary care providers, to really think about, how do you use virtual visits? That’s really the first line of trying to manage this process. The second thing that we’ve done is when people do come into our (facilities), we have the same look and feel everywhere that they go in terms of asking them questions at the doorway before they go into the building.

“In (some of emergency departments), for example, we’ve created a partitioned area kind of outside of the doors of the emergency department where we take patients through a series of questions. And not just patients, anybody that walks in. I had to answer all those questions before I could walk into the emergency department (at Overlook Hospital in Union County). So, that helps screen, because then we’re able to say, ‘OK, this patient seems to warrant some special treatment.’ And then our staff members, our team members, that then care for that patient come in with the protective devices on.”

Gragnolati said that, if the surge continues — and there’s little reason to think it won’t — Atlantic may have to take more measures, including the building of temporary structures to screen people.

“There are ways to add additional physical capacity that will help people stay in the right place,” he said. “So, we are now actively pursuing tenting and we are actively pursuing trailers. So, in the event that the numbers really grow, we will have those resources available.”

This is another reason why Gragnolati is pushing for more federal emergency declarations (see story here).

“It helps us bypass a lot of the red tape and the interagency things that typically would need to happen,” he said. “We need to have the ability in an emergency to create alternative sources that are connected into a health system in a hospital, so that the concerns about sterility or appropriate care are met. Ultimately, what we want to do as health care systems is to make sure that, when a patient connects with us, we get that patient to the very best place to give them the very best chance to get well.”

Keeping his own health care workers well is a huge concern, too.

“I always like to preface this,” he said. “Ultimately, this is about taking care of our patients and taking care of our communities. And that’s really how we sort through and approach everything we do. The second element of this is to really make sure that we are focused on the needs of our team members. Because you can have great buildings and great technology, but if you don’t have humans that can take care of your friends and neighbors and families, nothing works.

“What we need to do as leaders, whether we’re leading organizations, we’re leading government agencies or leading community partners, is recognize that what we need to do is to make sure we have the things that these folks need in order to be able to do what they do. And that really is the dilemma that I think we are facing right now as a country. Because, you know, this virus is the type of thing that we see. Now, it’s got different characteristics. And I’m not a scientist or a physician to be able to clearly articulate those differences, but, clearly, it moves quickly and it’s a difficult challenge.”

A system flooded with the “worried well,” as some call them, can be devastating.

“I think that articles in the press where you can educate the public are really important,” he said. “I think about what my old Italian grandmother used to say, ‘Wash your hands, don’t cough in people’s faces, don’t go someplace when you’re sick.’

“All those common-sense things really hold true today. And I think that we lose sight of that.”

Gragnolati said he hopes the events of the week are helping to change perceptions and bring understanding.

“You saw the NBA (shut down its season), followed on by the NHL, followed on by the NCAA,” he said. “Those are things that I think are really reinforcing to the public that people need to take basic hygiene and common sense seriously. And that needs to be reiterated.

“When that fails, or you’re anxious about it, if you’ve got a doctor, call the doctor, don’t show up at the doctor’s office, call the doctor. If you’ve got a concern, call us, go onto our website, figure out if you need a telemedicine visit. We’re there for folks to do that.

“What people ought to resist is just heading to the emergency department until they make that first call. And I think that that will help make sure that we’ve got those resources available where people need it, because the principle here is the right care at the right time, at the right place. And I think there’s nothing that makes that more vivid than the situation we’re in today.”

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