How is Sinai-Grace Hospital in the Detroit COVID-19 epicenter holding up?

Stephen Henderson talks with DMC Sinai-Grace Hospital CEO Daniel Jackson to find out how prepared Detroit hospitals were, can medical staff maintain the work load, and much more.


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Stephen Henderson Daniel Jackson, CEO of Sinai Grace Hospital, welcome to One Detroit.

Daniel Jackson, CEO, Sinai Grace Hospital Thank you very much. Thank you for having me.

Stephen Henderson Thanks for sitting down with us. So, your hospital sits right in the middle of the 48235 zip code, which we’ve learned over the last few weeks, is really the epicenter of the coronavirus outbreak here in the city of Detroit. That zip code has more cases, and it has a higher rate of infection than in other parts of the city and of course, there are more deaths. I just want you to spend a little time talking to our viewers about what that has meant for your hospital. What things have been like in this hospital over the last seven or eight weeks?

Daniel Jackson, CEO, Sinai Grace Hospital Right. For a hospital it has meant multiple things, I think first and foremost, it’s the continuation of our commitment to taking care of the community pre and post-COVID, Sinai Grace Hospital has been here for over 100 years serving this community.

So, part of it is continuing to serve in that capacity in terms of specifically how we have been impacted by the surge associated with COVID-19, It has at times been overwhelming in terms of the volume of patients that we’ve seen and the number of challenges that we’ve had to work to remain steadfast in that commitment to the community. And there’s a myriad of things on a regular basis that goes into a hospital functioning well. All of those particular functions are stressed when you have as much capacity and such a protracted amount of time as we have seen and experienced.

Stephen Henderson There have been stories about the extraordinary lengths that you’ve had to go to because capacity wise, this just overwhelmed, is just overwhelmed the hospital. Talk about some of the things you’ve had to do in terms of just meeting the needs as they come through your doors every day.

Daniel Jackson, CEO, Sinai Grace Hospital I think there are two components that are very significant. One is trying to be as proactive as possible in terms of planning, given the experience of other locations, whether it be in Asia, in New York, in Washington state and trying to apply those things.

And then you have the real-world experience of what happens when it is actually your place where it’s taking place at that moment. And so, a combination of planning, preparing and then being able to pivot in the moment and as we saw things evolve and change quite literally, sometimes from hour to hour in terms of best practices or recommendations, we’ve had to try to remain nimble to do that.

So, whether it is supplies, the availability of supplies or commandeering human capital resources, you’ve had other parts of the country that have had similar instances. And those resources are drawn and then become scarce. If you’re not in a place where that first wave takes place.

So, for example, here in the US, New York was a hotspot, remains a hotspot. So there’s a drawing of resources that goes to New York that then also creates a more difficult opportunity for other locations such as Detroit or California or Washington State. So you have to work through those things. We’ve also benefited, though, however, from our sister hospitals here in Detroit who were able to reallocate resources that were able to support us as well. Then also being a part of Tenet Healthcare, having resources come from other parts of the country where there are hospitals and people available that may not have been going through the same thing. So, we’re very thankful. In both instances to be able to partner with others.

Stephen Henderson Give us a sense of place there and 48235. It’s in northwest Detroit. It is not the poorest part of the city by far. It’s one of the densely, more densely populated parts of the city though. The population there, talk about why, in your view, the effects of the coronavirus are so profound for those folks. And those are the folks who I think are showing up in in such large numbers at your doors.

Daniel Jackson, CEO, Sinai Grace Hospital Right. One of the things is the density of population in our primary zip codes, but also the starting point, if you will, in terms of health status. We have a number of people that have pre and preexisting conditions, whether it be high blood pressure. Kidney disease. Obesity. Some of these pre-existing conditions exacerbate the impact of COVID-19. And there’s a high prevalence of some of those conditions in our community. That coupled with also we have a high concentration of nursing homes in our community as well.

The significance of that is that those patients, while convalescent, do not move much, but also, they may be compromised in terms of dementia or other maladies that prevent them from communicating where they are, their status.

So, in most of those instances when those patients present here at the hospital, their disease process is further along, they are much more critical. And because of just the sheer volume, there’s a higher concentration of those patients that we were able to treat.

But I would also say in the context of that, a lot of success as well in terms of treating. Through Thursday, we’ve discharged over 650 patients home. So, while it’s very tragic and some outcomes, there’s been a lot of healing that has taken place as well.

Stephen Henderson I wonder if you can talk a little about how prepared you feel like we were in Detroit and Detroit hospitals to deal with this this this pandemic and the profound needs that have cropped up. Sinai-Grace is part of the Detroit Medical Center and connected to the other hospitals and the DMC, obviously. Was the overwhelming part of this partially about lack of supplies, lack of resources that existed long before this?

Daniel Jackson, CEO, Sinai Grace Hospital I don’t think so. My experience would be that we were prepared and preparing. However, I think. Not I think, I know, we are a generation, this is the first pandemic in over 100 years. So, I don’t think that’s the type of thing that you can fathom. There are lessons you learn in the midst of and we are no different than other entities. And having learned those lessons as you progressed through the crisis, you become more adept at how to do that.

On the front end, I would say some of the things I will refer to as the way–so you had other places that were already drawing resources, whether it be supplies of people that again, you tried to pivot and anticipate where that would take place. I think we like other hospital systems in Detroit, experienced that in a fashion that was unpredictable. And so, in the moment, you do the best you can and you learn as you go. And I cannot speak highly enough of our practitioners and healthcare providers who had the courage and the dedication to do just that.

Stephen Henderson So, I want to ask you about your staff as well. We’ve seen and heard lots of stories about nurses and doctors and other staff there and what they’ve experienced during the pandemic. Are you worried, I guess, about the toll this is taking on that staff, not just physically, but the mental strain, you know, of so much treatment, of so much illness and death, all compacted into such a tight timeframe? You know, I wonder if nurses, for instance, will be able to keep doing the job that they’re doing at Sinai Grace into the future.

Daniel Jackson, CEO, Sinai Grace Hospital Right. I would not use the word worry, but I would use the word we acknowledge the impact that humans will face and understandably so, put measures in place to try to minimize that. Can you eliminate it? Absolutely not. Just the sheer impact of doing this and going to this day after day would impact anyone. And so, again, I referenced the courage and dedication that the staff members have had. And then we had the organization try to make sure we make every possible step and resource available to support them in that. And sometimes, that includes saying you need to step away. It is prudent to step away so that you can recharge and come back again, ready to take care of other communities.

Stephen Henderson And do you feel like the support systems, I guess, from that staff are in place to be able to keep them, you know, keep them going through all this and then, of course, on the backside of this to keep them treating the population?

Daniel Jackson, CEO, Sinai Grace Hospital I do think the support system is in place, but also, we acknowledge that there are varying degrees of support that’s required and so understanding the scale ability of that, how you support that and again, being very much aware and acknowledge that in tune and create a forum where people can voice where they are. And sometimes, it may be unbeknownst to a provider where they are. So, you have to try to have some eye to discernment around evaluating that. Having support available, then also having multiple layers of support for available so that we can we are a step away and at the same time understanding that it is a contained stretch of being extended beyond normal capacity. It’s taxing.

Stephen Henderson Right. I want to come back to this question of the effect, not just on your staff, but on that community. You said you said earlier that you’ve had more than 600 people discharged after being greeted with COVD. But the numbers, the death numbers. I wonder if you can talk about what those have been and then talk about the emotional impact of this in that hospital and in this community. This is not something we’re accustomed to dealing with. It is so intense, and it happened so fast. I wonder if you can give us a sense again of what this has been like.

Daniel Jackson, CEO, Sinai Grace Hospital What I would say is a magnitude in terms of we know that death is a part of the life cycle and we take pride in the fact that we, at our very best, are a place of healing. And so, in every instance, there is a component that is somewhat disheartening in that continuum. And so in a pandemic, you feel and experience that component more often than you desire. So the resilience of working through that, the joy of seeing the next patient come off the ventilator. Those things are the drivers in terms of what keeps people motivated. There’s nothing remotely more intrinsic in terms of what happens for the staff that goes go through that day after day. Again, that for an extended amount of time. There’s a lot of joy and growth that comes from the team making a difference, if you will. And that is evident when you see how people care for the patients and the impact of what it means to them personally as well, because outside of the people that you take care of, this also can extend into your personal life as well. So, it’s a multi-factorial perspective. But again, you cannot praise our providers enough in having the fortitude to work through that again.

Stephen Henderson Can you compare the numbers of the least patients to the number of deaths just and you get a sense of what you’re dealing with?

Daniel Jackson, CEO, Sinai Grace Hospital What I would say is we average about two patients a day that come off of the ventilator that are survivors and I believe the numbers are over 100 that have come off the ventilator since the end of March, which is astounding. I don’t have the exact numbers on those patients who have succumb to COVID-19, but they are more than you would rather have happen.

Stephen Henderson What about going forward? What should change? What could change? Not just at Sinai, Grace, but in the wider health system, in the city and in the country as a result of having had to manage something like this.

Daniel Jackson, CEO, Sinai Grace Hospital As a health care system, we’re still learning. As a world, we’re still learning. There are a lot of unknowns about COVID-19, and a lot of modeling that’s taking place about what the appropriate protocol to treat.

What are the long-term effects? As we tried to find solutions to battle this, I think there are some things that are very important of what we know now. The value of social distancing. We know that now. The value of hand-hygiene. We know that now. The idea of trying in communities and beyond to make sure that we make testing available so we know the status of those around us and the effectiveness of other efforts in that fight on COVID.

So, I think continuing to educate ourselves to be vigilant about those standards and having those standards being compliant and that dialog continuing for the good of the community and others. I’m being very cautious as we try to evaluate what are the next steps. I think what things is most important is we enter this next phase, if you will, of things that people experience that are not COVID-related, that still need to be treated.

We have an inordinate amount of people out of fear or concern choose not to seek health care and are not being treated as they could or should when those resources are available. So, helping people to know to reach out to your primary care physician, if there is an emergent need that you know how to access health care and understand that it is safe to do so.

Stephen Henderson Daniel Jackson, CEO of Sinai Grace here in Detroit. Thanks very much for being with us.

Daniel Jackson, CEO, Sinai Grace Hospital Thank you very much. I appreciate your time.