Leadership | 09.03.20
A COVID-19 Call to Action
Never could I have imagined life to be what it is today as a result of COVID-19. Never would I have thought my city, New York City, would come to a grinding halt, shut down, and be the nation’s epicenter of a pandemic, quarantined for nearly three months. I can’t help but sit back and reﬂect on all that has happened here in the city that can no longer say it never sleeps.
It seems like so very long ago that I had a brief conversation with my senior executive leader. His ask was rushed and had a different-than-normal sense of urgency. It was late February, and I was told to take the week to assess all that the MSO team would need to ensure they could function remotely and prepare them to expect to begin to work from home in the not-too-distant future. Beyond laptops, I had to think of everything that was essential for day-to-day work for a team of 28 credentialing analysts (coordinators) not typically called to remote work, especially on a long-term basis. He directed me to also reach out to my counterparts at our regional hospitals and deliver the same message. He ended that conversation by telling me that I should personally take steps to stock up on nonperishables at home. Half of my mind was racing and feeding off his sense of urgency while the other half remained skeptical and in disbelief that this virus, COVID-19, would impact New York, New York Presbyterian, my team, and my family, in the way he was preparing me for.
Over 20 years as an MSP, countless hours of CE credits, certifications, conferences, and all the valuable connections made through MSP networking were about to be hauled out front and center to answer the call to action that was about to take place to navigate credentialing through COVID-19. Although it took some time to realize the enormity of what New York and the rest of the nation were beginning to experience as the virus spread, we were quickly laser-focused on what was needed. This was so very different from any disaster New York faced in the last 20 years. This was vastly different from 9/11 and Hurricane Sandy.
It was serendipitous that a small group of my MSP colleagues went to dinner right before the critical climb of COVID-19. A group of local New York counterparts at neighboring facilities got together to welcome a new member to our group. This group of individuals had no idea that we would be in touch sooner and more frequently than we thought via email, comparing notes on
the governor’s latest executive orders, and shortly after having a Zoom cocktail hour where we decompressed, processed, and chatted about the events of the last few weeks, how we were handling the volume of credentialing, and what method our facilities would be using. Having a connection to a local MSP network and peers like these is invaluable!
At New York Presbyterian, we chose to implement temporary emergency privileges (TEP), to meet urgent patient care needs. It seemed to fit best, as this pandemic is forecasted to last far beyond what we would use disaster privileges for. Most of the practitioners coming to assist were expecting to be here for several weeks or, in some cases, months. They were prescreened by either the chief medical officer, chief of service, or recruitment for needs assessment and would typically have arrangements made prior to their arrival. To have 24–48 hours to run all web-based sanctions, in addition to the required NPDB, and obtain a primary sourced attestation to competence was critical to keeping our gates well-guarded.
We assembled the TEP team to work exclusively on processing TEP. We quickly realized we needed a short form (application) and a streamlined approval process to turn requests around within 24–48 hours. In the beginning, this team of six worked 10-hour days, seven days a week. We prepared credentials reports daily for the approval calls every evening. I can’t thank this team enough for their willingness to push through and their commitment to doing their part to keep patients safe and seen! Unlike any other surge, our frontline staff and clinical leadership were so very vulnerable and susceptible to this pandemic. We needed to add relief and replacement medical staff at an incredibly high rate. At the time I wrote this article, the number of TEPs that were processed and granted during COVID-19 topped off over 1,000. We welcomed help from multiple facilities across the country, including retired medical military personnel. The sacrifice of so many traveling to us, coupled with the need our medical staff had for relief, was what kept our spirits up and filled us with purpose to keep going.
We had our teams settled and functioning completely remote by mid-March. The initial, re-cred, GME, operations, and our newly formed TEP teams all had put together their home offices and were actively engaged via Webex teams. Although being remote at first seemed to be the desired choice for many, after a few weeks, the isolation seemed to be taking its toll. I cannot stress the importance of human connection and the need to consciously maintain it. I learned quickly that a direct phone call, video chat, and handwritten note went a long way to keeping spirits up during this time — mine as well as theirs!
As we look to reopen to the “new normal” and truly see how MSPs have adapted during this pandemic, I cannot help but be extremely grateful and blessed for the opportunities NAMSS has afforded our MSP community. The call to action by the Education Committee that put together the COVID-19 webinar series was one of many examples of educational support we are very fortunate to have. MSPs are COVID-19 warriors, and we have a lot of lessons learned to share to further the future of our profession. This pandemic will accelerate all of the speaking points we have had, relating specifically to technology use and best practices, tele/virtual health, and leadership skills for virtual teams. In light of all of the various governors’ orders related to credentialing during COVID-19, I expect there to be room for us to advocate with regulatory bodies to modernize and streamline credentialing standards. I have no doubt that all that has been, and can be, learned is being prepared for webinar series, podcasts, and Synergy articles really soon! Now is truly an opportune time to advance our profession.
There is so much to be said where it concerns the emotional toll this has taken on our teams, our community, our families, and ourselves. Although I can step back and be proud of all we accomplished during this incredibly challenging time, my heart still aches for the people lost, known and unknown to me personally, milestone celebrations canceled, and the increased disconnection of human contact. The anxiety, depression, and other mental health issues need attention now more than ever. We all need to pause, reﬂect, and give space for our emotional health and recovery. For me, that process begins with gratitude. I am truly grateful to my MSP peers, my network, both fellow New Yorkers and non-New Yorkers, and those who were there as a group or individually throughout, just checking in. A tremendous thank you to Mark, Donna, Anne, Jackie, Aimee, Di, Sally, Jenny, Sara, Susan, Diane, Chris, Erin, Melissa, and others for all of your help, support, check-in calls, texts, and words of encouragement. It truly meant more than you will ever know. Thank you — MSPs are essential! Let’s keep going.
Susan Diaz, CPCS, CPMSM, is the director, medical staff, at New York Presbyterian. She is the NAMSS Immediate Past President.