Inspire 2020 FALL

HPH: Caring for our Community

Hawaii Pacific Health Command Center Hawaii Pacific Health Command Center .
The teamwork involved in sourcing PPE, UV disinfection of N95s, responding to questions and adjusting as appropriate has all been great to see and be a part of.
Dr. Melinda Ashton, HPH Executive Vice President

One virus can change the world, that’s the reality of COVID-19. Our way of life and our approach to health care has forever been altered. The pandemic has been a daily dose of constant change and uncertainty for medical teams across the globe. For Hawaii Pacific Health (HPH) the primary focus was the safety of patients and staff while serving the community in its greatest time of need. This effort would take everyone at HPH to address everything from treating COVID-19 patients to helping families learn how to connect virtually with their doctors.

“We have approached the pandemic with a determination to have the same approach to needed changes as one system; not as four hospitals with a lot of clinics,” said Dr. Melinda Ashton, executive vice president and chief quality officer of Hawaii Pacific Health.  “Most important to me has been gathering the best information about PPE (personal protective equipment) and then working hard to make sure that all our staff who need to know how to use it, do know. The teamwork involved in sourcing PPE, UV disinfection of N95s, responding to questions and adjusting as appropriate has all been great to see and be a part of.”

Infection prevention at HPH was a collaborative effort that included state and city leaders, health care industry competitors and multiple other groups. And the best way to learn was to listen. “Having the humility to know that not everything is known and that we need to adapt to evolving information meant listening to the front lines as they often see things that can help,” said Dr. Leslie Chun, CEO of the Hawaii Pacific Health Medical Group.

The respiratory evaluation clinics were complemented by testing sites at all HPH medical centers. Again, the process would utilize tented outdoor spaces for the initial contactless connection with patients. “We decided early on that we needed to set up a way to protect the patients and staff within our clinics. The drive-through specimen collection was a way to centralize that activity and make it safer for all. It turns out that for a period of time, other hospitals, outside of HPH, were sending their patients to our drive-up systems because they didn't have their own.” The long-term testing sites, which were open seven days a week, were completely funded by HPH for months as a service to the community.

The Employer Hotline, another free resource, connected employers and business owners to physician experts for guidance on addressing and reducing COVID-19 workplace exposures. This call-in initiative was inspired by public confusion stemming from conflicting information. Dr. Chun took a few calls and described some who dialed in as “panicked.” “People worry about themselves. They worry about the employees. They worry about their business. We need to know what to do because we're reading things that we don't understand.”

Translating community fears and internalizing a responsibility to make a difference resonated in every corner of HPH and with every employee. Primary care physicians and urgent care doctors were volunteering to be hospitalists at Straub; innovative medical teams engineered a model to expand the use of one ventilator to support four patients at once; and information technology specialists designed 3D printed face shields and then recruited local schools to help provide additional materials. For many, it’s brought the best out of their expertise and humanity.

Lifesaving Treatment

COVID-19 survivor George Ma credits Straub Medical Center for saving his life. The 46-year-old fitness trainer still can’t comprehend how he went from multiple workouts a day to barely being able to take a breath. “It feels like you’re drowning,” George said. Nine days after his diagnosis, George's hours-long coughing fits left him struggling to breathe; he was rushed to Straub's Emergency Department. A chest x-ray confirmed that his lungs were filled with lacy white streaks, a sign of COVID-19 pneumonia that causes severe breathing problems.

“I thought about throwing in the towel because the pain was unbearable,” George said. “During my recovery, the staff was very patient with me. Straub’s team showed true compassion.” George spent 12 days at Straub undergoing multiple treatments for the new coronavirus including convalescent plasma therapy. It’s the transfusion of blood donated by people who have recovered from COVID-19 that helps others with the virus to recover.  

Since returning home, he’s made a lot of progress but George still deals with lingering symptoms including fatigue, hiccups while breathing, insomnia and, at times, the inability to concentrate. But his determination to help those who cared for him continues on. From his hospital bed, he asked his friends and family to donate to Straub and his story still inspires gifts in his honor. “The main reason why I wanted to donate is that many nurses in the COVID unit volunteer to work there,” George said. “It takes a great amount of courage to fight on the front lines, caring for patients and putting your own life at risk. Mahalo to the staff at Straub for your brave work.”

Answering the Call

For some local physicians, the desperate need in other Mainland cities called them to serve. Dr. Andrew Summersgill felt compelled to go to New York City to support colleagues and friends who he had trained with at Lincoln Medical Center. “It was good to be there to help shoulder some of the burden that they were experiencing,” Dr. Summersgill said. “That's what our career asks of us and people really stepped up to take care of our community.”

The Pali Momi Medical Center emergency doctor volunteered to treat coronavirus patients for three weeks at the Bronx hospital. Although he had worked in Pali Momi’s Command Center, he found that his 12-hour work days in New York gave him a different perspective unlike anything he had experienced before.

“It really hit home to me how real the disease was,” Dr. Summersgill said. “People were dying and people were really sick but it was helpful to see that we were able to care for these patients and we could do so safely.

Giving for COVID-19 Relief Efforts

Dr. Priscilla Chan and Mark Zuckerberg, both part-time residents of Kīlauea, made a generous gift to Wilcox Medical Center as part of a $1 million donation toward COVID-19 relief on Kauai for health care, food security, rent assistance, education and other essential needs.

"People and organizations are stepping up in extraordinary ways to prevent the spread of this virus and support one another,” Dr. Chan said. We’re grateful for all that our partners are doing, and we’re glad to support their work on Kauai."

“This donation to Wilcox for COVID-19 relief efforts will significantly impact our work as we fight to protect everyone on Kauai from this virus,” said Jen H. Chahanovich, president and CEO of Wilcox Medical Center and CEO of Kauai Medical Clinic.

Among the donations for COVID-19 relief efforts, a few major gifts benefitted all four HPH facilities. Those Hawaii Pacific Health system supporters include UHA Health Insurance, Harry and Nee Chang Wong Foundation, and Farmers Insurance.

Virtual Visits

Stay-at-home orders didn’t stop regular appointments for Emalia Pietsch Hogan’s young son, Keahi, with the Rehabilitation Department at Kapiolani Medical Center for Women & Children. “Even when COVID hit, restricting in-person access at Kapiolani, we never missed a beat because we were then able to connect virtually,” Emalia said.

Consistent speech therapy is necessary for Keahi to maintain his progress. His family found the virtual visits also created a new window of opportunity for experts to gain even more insight into other ways to help toddlers at home. “When our 3-year-old was about done with his portion of the visit his therapist would observe him playing in the room and give my husband and me more ideas on what we do to help him at home.”

The experience has changed the family’s approach to medicine for Keahi and his sister, Elia. “If my kid has a fever or my kid has an earache, or whatever it is, I have been able to work with our kids’ doctors and done everything telehealth,” Emalia said. “It’s been phenomenal.”

As the pandemic continues, Hawaii Pacific Health remains open to this shift to serve even more people in the future. Telemedicine is here to stay and will continue to evolve so video visits, phone conversations and online scheduling can connect even more patients with those who provide care. The public is even more interested in seeking information and answers about various infectious diseases. The long-term psychological impact of COVID-19 remains to be seen. “While we are physically distanced, hopefully we’re socially connected so we can stay healthier together,” Dr. Ashton said. We may now have a masked view of the world but the fight against COVID-19 is all of ours. No matter what comes next.