As it has for some months, discussions around COVID-19 dominated the North Shore Health’s (NSH) most recent board meeting.
With the number of cases rapidly increasing in Cook County, NSH Administrator/CEO Kimber Wraalstad said COVID-19 continues to be the primary focus for NSH, Sawtooth Mountain Clinic, and Cook County Public Health and Human Services. In October, the positivity rate for Cook County increased from 0.2 percent to 5.7 percent, and then 11.1 percent. Those results were published by the Centers for Medicare and Medicaid Services (CMS) and are updated each Wednesday.
“An increasing positivity rate indicates that testing is generally performed on the sickest patients while missing milder or asymptomatic cases,” Wraalstad said, adding, “Essentially there are more cases in the community than are being identified.”
Minnesota Department of Health Commissioner Jan Malcolm sent a letter to Cook County elected officials on November 9, noting the county has a COVID positivity rate above five percent.
“Having a positivity rate above five percent means the spread of the virus in your county has reached a concerning level,” wrote Malcolm.
In her letter, Malcolm further stated that one in four long-term care residents who develop COVID-19 would be hospitalized, and one in five will die from the disease. “In addition, community and workplace-related exposure and infection of staff can lead to staffing shortages, jeopardizing care for all residents,” she said in her email.
With the higher rates of positive coronavirus cases in the county, NSH has started to test employees, volunteers, and essential caregivers twice a week. If the positive (county) test rate falls below five percent, NSH will continue to test twice a week for two weeks and then drop back to testing once a month.
“This level of testing takes a tremendous amount of commitment from all involved, from those being tested to those collecting and processing the specimens,” Wraalstad said.
As a result of the coronavirus’s rapid spread in the county, visitation at NSH was temporarily suspended. Essential Caregivers continue to have access to their residents/patients as they participate in routine testing and compassionate visits in both the hospital and North Shore living will be allowed in specific circumstances by prior arrangements. Emergency patients will be allowed one individual to visit with them if medical staff approves it. These policies will be reviewed on a weekly basis, noted Wraalstad.
Patient movement
With St. Luke’s and Essentia Health in Duluth and other regional medical facilities at or above capacity, the Northeast Regional Healthcare Coalition and Wilderness Health continue to meet to discuss patient movement. With the pandemic hitting the entire state like a sledgehammer, hospitals in the Twin Cities have been moving patients to Duluth and North Dakota. Elective surgeries and outpatient procedures have been scaled back at many facilities during this crisis, said Wraalstad. She added that plans are being made for lateral transfers to try to maintain capacity for critical patients in tertiary facilities.
Drug pricing program
Some good news came from the Health Resources and Services Administration (HRSA), which approved North Shore Health to participate in the 340B Drug Pricing Program, effective January 1, 2020. SUNRx and NSH pharmacist Deidre LaRock-Muggley have already begun working with the hospital’s wholesaler, McKesson.
“In addition to the work with McKesson, data fields and download processes need to be coordinated with Meditech, our electronic records vendor. SUNRx, McKesson and Meditech have experience with this program and have been helpful as we begin implementation,” Wraalstad said.
Telemedicine PT and OT
Sharon Berglund and Patrick O’Neil updated the board on how the physical therapy department is providing physical and occupational therapy using telemedicine. This technology allowed patients to be seen by therapists in their own home. The initial assessment must be completed in-person, but then patients can have their follow-up appointments using the remote technology. It was commented that following the pandemic, this technology could be used by patients who don’t want to travel, either because of weather or distance. Testimonials from patients were shared.
Hospital Conference
Coming soon is the 2021 Minnesota Hospital Association Trustee Conference, which will be held on-line for the first time.
New trustees will attend four sessions on health system finance, board governance, advocacy and quality improvement. Held January 14-15, trustees will also receive information from community experts on the impacts of social factors and how they contribute to individuals and families’ overall health. Topics covered in this session include housing, transportation, educational attainment, food security, and economic resources access.
ECHO Collaborative
Wraalstad said North Shore Living has enrolled in the Upper Midwest Nursing Home COVID-19 ECHO Collaborative. This collaborative will involve 16 weeks of sessions where expert faculty and attendees will share best practices, challenges, and solutions related to infection prevention and staff and resident protection from COVID-19.
Information Coordinator
The hospital board approved a plan for NSH and Cook County to share the cost of a Public Information Coordinator position. The charges, including salary and benefits, would be split equally. A Public Health Coordinator’s job description has already been developed and agreed to, and the estimated cost to NSH would be $27,800 through June 30, 2021. Wraalstad said the price of this position should be reimbursed using Provider Relief Funds.
The Cook County Board of Commissioners voted to accept the agreement on Tuesday, November 24.
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