COVID Chronicles

COVID Chronicles: A view inside the Emergency Department

Welcome to the COVID Chronicles. These are the behind the scenes stories from Kittitas Valley Healthcare staff at various points in time during the COVID-19 pandemic.

Dede’s COVID Chronicles interview is from May 21, 2020

When Kittitas County received its first positive case of COVID-19, Dede Utley, Director of Emergency Services, felt helpless. Dede was across the country in Washington D.C. for a conference on the opioid crisis and all she wanted was to be here with her staff to help relieve some of the stress.

“I’m so proud of what we have done,” Dede said. “The hospital and Incident Command did a great job with surge planning. It was a huge adaptation with all the information changing rapidly, especially when we were getting conflicting messaging. Our Quality Department and Incident Command was able to get the right information out to our staff.”

Dede explained that her staff embraced and engaged with the planning, they all had input and worked through problem solving solutions. There was a lot of preparation done planning for the Triage Tent which was put up in front of the hospital for weeks. The tent was set up as a screening point for patients where it would help dictate which path they were able to take inside the hospital for treatment, based on their symptoms and possible exposure. Thankfully the tent has yet to be used and has been taken down, but it can quickly be put back up if needed.

The Emergency Department has to plan for the unexpected; they have patients from birth to 100-years-old, acute care patients, and chronic illnesses. Every day is different. She wants patients to know that KVH is still here for them.

“We are going to continue to take care of you,” Dede said. “We don’t want people to ignore symptoms of a stroke or a heart attack.”

Sarah Anderson, a charge nurse in the Emergency Department agrees. “The most rewarding part of my job is being available in a time of need,” she said. “There’s beauty in the equal access to care in the Emergency Department. We are available to people no matter how major or minor the emergency. And, that holds true during a pandemic; we’re here for you.”

Early on KVH had to make the decision to restrict visitors at the hospital for the safety of their patients and staff. Which has been really hard on patients not being able to have their loved ones with them while in the Emergency Department and the staff recognizes it. They’ve been calling patients’ family members and even going outside to the parking lot to give family and friends updates.

Dede explained, “I think it’s just really important that the community know we understand, if you can’t be at the bedside, we’re going to do the best to provide the care and let your loved one know that they’re not alone.”

She says relationships between the staff have strengthened throughout the pandemic. And she’s very thankful in her current role that she can take care of her staff, so they can take care of our community.

Dede has had this quote taped on her computer for 15 years, as reminder of why she is a nurse. “No matter how far away from the bedside my management duties take me, I am centered by knowing that my work ultimately is for the patients in our emergency department, and for the people in our community.”

“Our community is amazingly strong and everyone has really come together,” Dede said. “I am proud and lucky to have found Ellensburg. I’m thankful for the path that lead me here.”

COVID Chronicles: A view inside of the COVID Clinic phone calls

Brandee’s COVID Chronicles interview is from May 14, 2020.

Welcome to the COVID Chronicles. These are the behind the scenes stories from Kittitas Valley Healthcare staff at various points in time during the COVID-19 pandemic.

On a normal day Brandee Coates, Care and Service Coordinator, can be found in the Kittitas Valley Healthcare (KVH) Quality office responding to patient complaints, staff reporting or following up on patient falls. However, for the first seven weeks of the KVH Coronavirus Clinic being open, she only spent one day at her own desk.

The Coronavirus clinic has received more than 2,000 phone calls since it opened on March 7, where staff have talked to patients about symptoms, precautions and social distancing. Brandee has been on the phone with concerned patients for countless hours. “I’ve spent a lot of time just giving them reassurance. They want to know if they’re doing the right thing, ‘am I being cautious enough?’” she said.

What Brandee didn’t expect, was how emotional people would be when she called with their negative results. “People are so scared, especially the high risk patients,” Brandee said.

She had to take some extra time off to recharge, after so many phone calls to patients with their results. The patients would cry because “They’re so relieved to hear they don’t have this potentially life threatening illness, like I told them they aren’t going to die, or get their loved ones sick,” and she would cry with them. This has been a much more emotional process than Brandee expected, yet rewarding at the same time.

She’s also been grateful for the support from local businesses. “There have been so many community members feeding the clinic staff when we know they’re having a hard time keeping their doors opened,” Brandee explained. “We live in such a caring community.”

Brandee is excited to rebook her family’s spring break trip to California with her best friend, when things return to semi-normal life. It’s been tough to work full time and help homeschool her two children but as she told them, “This is hard for everyone, no one wanted this.” But we can do it.

COVID Chronicles: A view inside of the COVID Clinic

Welcome to the COVID Chronicles. These are the behind the scenes stories from Kittitas Valley Healthcare staff at various points in time during the COVID-19 pandemic.

Photo: Toni answering patient questions at the KVH COVID Clinic May 19, 2020.

When Toni Clayton accepted her new position in the Quality Department in April 2020 as the Clinic Quality Service Coordinator, she was excited for a new challenge and workload. What she didn’t know was that due to a SARS CoV-2 pandemic she would be fully immersed in a new Kittitas Valley Healthcare (KVH) COVID Clinic for the next month. 

On March 5, 2020, Toni and other KVH employees went to work planning how the new clinic would function, creating standard work and determining when they would be ready to open the clinic. Luckily, KVH Family Medicine Ellensburg had moved two weeks earlier into the new KVH Medical Arts Center, leaving the old “Valley Clinic” space available and virtually ready to go.

Kittitas County had its first positive COVID-19 patient on March 7 and the clinic opened to support the community. This new clinic was opened to help keep potential COVID patients out of the KVH Emergency Department and KVH Clinics and to prevent unnecessary exposure to additional people.

The teamwork between KVH’s Quality Department, their administration team, Dr. Kevin Martin, Dr. Mark Larson, the Kittitas County Health Department and many others was inspiring she explained. “This collaborative group came together with a shared goal. Seeing it on paper and planning a clinic is one thing,” Toni said. “Seeing it all work in practice was a great success.”

“You can’t say enough about the community coming together, it takes a village for this all to get done,” she said. “We have people working really hard behind the scenes, hours and hours of work went into making this all work for the community.”

When the clinic first opened, Toni spent much of her time working with Dr. John Asriel testing patients for COVID-19, the flu, and answering patient concerns via a new phone line. As a Medical Assistant for 26 years, Toni has had experience with personal protective equipment and communicable illnesses so the environment was not new to her.

“We were never asked to do something in the clinic that our admin team weren’t doing themselves. I was there in the clinic answering phones, and so was the CEO,” Toni explained. “There’s this quote, ‘if you’re too big to serve, you’re too small to lead,’ it really sums up our leaders here. And it makes you pretty proud.”

What can’t Toni wait to do when she can return to semi-normal life? “I’m a hugger, from a family of huggers! My parents are 84 and I went from being their caregiver to not really seeing them at all, which has been really hard,” she said tearfully. “And I want a haircut!”

Hopefully, Toni and the rest of the community will be able to start doing normal things again soon. But until then Toni and the rest of the KVH staff will continue to serve the community they love.

COVID Chronicles: A view inside of Incident Command

Welcome to the COVID Chronicles. These are the behind the scenes stories from Kittitas Valley Healthcare staff at various points in time during the COVID-19 pandemic.

Photo: Incident Command meeting at KVH Hospital (March 2020)

In February 2020, Kittitas County had its first suspected case of the novel coronavirus disease, COVID-19, and incident command was activated at Kittitas Valley Healthcare. KVH, was able to prepare their response to this possible case, while working with closely with the Kittitas County Public Health Officer, Doctor Mark Larson. At that time, all COVID-19 testing was being done on the east coast and it was taking at least a week to get results back. Thankfully, that first patient was negative.

Four weeks later, the Kittitas Valley Healthcare Incident Command team (IC) was activated a second time for COVID-19 response on March 2, 2020. This was done as leaders realized that virus had likely been circulating the northwest for weeks, and they understood the outbreak would likely change KVH’s day to day operations.

“The Incident Command Team is an assemblage of peers who check their titles at the door,” said Julie Petersen, KVH Chief Executive Officer. “Everyone is there with an expertise to contribute.”

Each of the members is in charge of an essential part of the planning to keep KVH staff, patients, and the community safe. When KVH staff think about the leaders within the organization, they often think of the administration team. This group is part of the IC, however additional members with expertise in supply chain management, environmental services and clinical care were also added to the team. The preparation for, and response, to COVID-19 had to include a larger team.

The IC team quickly went to work gathering information about the inventory and availability of personal protective equipment (PPE), reviewing preparedness procedures, processes and communications. This team collaborates with the Kittitas County Public Health and other local authorities, with the common goal of protecting the people of our county as best as possible. They’ve been tasked with minimizing potential exposure to community and staff by ensuring employees and providers understand disease transmission and utilize proper PPE, among many other duties.

One of the first things the IC team decided was the need for a “pop-up” COVID-19 testing site. Luckily, KVH Family Medicine Ellensburg had recently moved to the new KVH Medical Arts Center, leaving the old “Valley Clinic” space available. The first patients were seen in this walk in clinic on Saturday, March 7, five days after activating incident command. This clinic has proven to be an integral part of Kittitas County’s COVID-19 response plan. As of mid-July, 2020, nearly 4,000 calls have been answered and over 2,000 COVID-19 tests performed.

Kevin Martin, Chief Medical Officer said an untold story is the supply chain issues KVH has had throughout the pandemic.

“What we were promised and what we have actually been given are completely different,” he explained. “There was a lot of urgency for preparation in the beginning and since then it there has been a lot of strain in knowing what we have and what we might need.”

Morgan Anderson and her staff in Materials Management have spent endless hours trying to acquire masks, gowns, sanitizer, and cleaning supplies. As an institution KVH has had to prepare staffing and supply levels for the potential increase of patients, which took a lot of resources and planning.

“This has pushed us to explore capabilities I don’t think we knew we had, fortunately I don’t think we will have to do all of them,” said Kevin. “We have been fortunate, but at some point we will see some of it in practice. Hopefully we have over prepared, it is unlikely we would have hit the bullseye in planning.”

One of the challenges the IC team has faced, especially in the beginning, was how quickly the recommendations coming from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and the Washington State Department of Health were changing. Signage and messaging throughout the hospital and clinics changed often, sometimes more than once a day.

“We’ve got a great team. They’re doing a remarkable job taking care of each other and keeping open lines of communication. The new normal might be, not knowing what normal is,” said Kevin. “We have to be adaptable, flexible and resilient.”

Rest assured KVH has been preparing for and are currently working to do their part to decrease the risk of transmission to their patients, staff, and community.