LVEDC Q&A: Carol Kuplen of St. Luke’s & Ed Dougherty of LVHN
By Colin McEvoy on June 15, 2020
The Lehigh Valley Economic Development Corporation (LVEDC) is led by a Board of Directors with expertise that represents a broad cross-section of the regional economy, including representatives from the Lehigh Valley’s two high-quality health networks.
Carol Kuplen, President of St. Luke’s University Hospital Bethlehem & Chief Nursing Officer at St. Luke’s University Health Network, and Ed Dougherty, Senior Vice President & Chief Business Development Officer at Lehigh Valley Health Network, both serve on the board. They share their perspectives on the coronavirus outbreak below.
Can you give me an update on the number of coronavirus-related cases your health networks have seen, and how those numbers have changed over time?
Kuplen: To date, St. Luke’s has provided care to over 1,500 inpatients. The numbers have declined drastically over the past seven weeks from a high of approximately 400 inpatients per day to 30 cases in the network as of today.
Dougherty: LVHN’s laboratory subsidiary, HNL Lab Medicine, has performed more than 39,000 COVID-19 tests and reported more than 6,500 positive results. We have cared for more than 1,200 COVID-19 positive patients in LVHN hospitals. We are clearly over our peak. We have been seeing generally steady declines in our cases across LVHN since April 20, when we hit our highest total of COVID-19 cases. Though encouraging, we need to remain ever vigilant and cautious – recently we have seen an uptick in COVID-19 admissions starting a little over two weeks following Memorial Day.
The health networks did not overrun during the peak of the pandemic here in Lehigh Valley. How much of that do you attribute to the social distancing and self-quarantining efforts undertaken by the community?
Dougherty: The community’s work to stay home kept many more people from becoming ill and gave health systems the ability to help people who needed to be admitted for care. Cell phone movement and traffic count data showed approximately 35% to 40% reduced movement in the region. As basic as it sounds, this reduced community transmissions. As we saw in other regions, health systems would have been challenged if this social distancing did not happen. Health systems also made changes designed to increase capacity throughout their networks. This gave us the ability to provide more ICU-level care to more people by utilizing clinical space that is typically used for other services. The combination of community members being diligent about social distancing and health systems surging or increasing capacity was a successful formula during this initial wave of cases.
As the region starts to reopen, are people starting to come back to St. Luke’s for elective surgeries, non-emergency issues, and other visits they may have been delaying before?
Kuplen: Yes, we are thrilled to have our patients returning for surgery, testing and office visits. Emergency department visits are returning, but at a slower pace, and we continue to encourage our neighbors to seek care as needed. Delaying care can often lead to more risks, and complex care and therapy being required.
How has the community responded to utilizing virtual care during the pandemic, and do you think its continued use could be a trend moving forward?
Dougherty: The community response to virtual care has been fantastic. LVHN has provided virtual care ranging from critical care physicians and nurses managing ICU cases overnight to more typical video visits for more than 10 years. In that time we provided more than 500,000 virtual encounters. In the first month of COVID-19 we provided more than 150,000 virtual visits, keeping patients and providers safe. Initially, most of the care we were providing in the practices was virtual. Today about 20% of the visits are still virtual. We believe virtual visits are here to stay in some capacity and will be one of the positive legacies of COVID-19.
Can you tell me the effect the coronavirus pandemic has had on staffing, and how St. Luke’s is dealing with its ongoing need to recruit and retain talent in these times?
Kuplen: Certainly this pandemic has resulted in staffing challenges on both ends of the spectrum. Our patients diagnosed with COVID-19 that required hospitalization were acutely and critically ill. Their clinical needs coupled with intense infectious isolation procedures required additional staffing. The network used a variety of creative strategies to assure sufficient, highly-qualified staff were available 24/7. These needs were in contrast to other areas of the network that were experiencing low volumes or work requirements. St. Luke’s instituted a job sharing program which supported our staff through the last three months. Various HR programs were also put in place to provide financial and psychosocial support to our staff.
Can you tell me about the collaboration between LVHN and St. Luke’s in various aspects of the coronavirus response effort (such as the approach to visitation) and why they were beneficial to the region?
Dougherty: The unified message, directed by senior medical leaders Drs. Whalen and Jahre in early March around topics like visitation policies provided a unified direction for our community. This signaled that COVID-19 concerns were real and that the systems were focused on patient care and community need in a way that was calming and reassuring.
Kuplen: Early on our medical staff leaders conferred routinely on volumes, approaches and experiences. The organizations also agreed on a visitation policy so our community members knew there were consistent guidelines across the region. This promotes confidence and comfort to our neighbors by assuring we are working cooperatively to safely meet their needs.
How does Lehigh Valley benefit from having two strong health care networks in LVHN and St. Luke’s?
Kuplen: The Lehigh Valley is very fortunate to have two excellent choices for health care services. Choice is always an important factor as it promotes a healthy competition. At the end of the day, both institutions are committed to quality health care which is the greatest benefit to the communities we serve. Our community is fortunate that between the two networks very few people need to seek care outside of the region. We boast outcomes that rival and surpass New York City and Philadelphia hospitals. We should all be proud of the stellar health care made possible in Lehigh Valley!
Dougherty: Over the years, both networks have had a strong focus on patient safety and quality, and have pushed each other to be collectively better than other areas of the country as manifested by having eight Leapfrog A hospitals combined. This is not typical in communities across the country. As a result, we were better equipped to care for COVID-19 patients because we were able to balance cases throughout the network and provide the most advanced interventions available for patients. One of the things we are most proud of is LVHN’s mortality rate which is about 50% lower than the state’s overall mortality rate. That’s a key benefit from having strong health networks.
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