A multidisciplinary approach to a pandemic

June 2, 2020
Command Center team (before physical distancing was shown to be effective in preventing the spread of COVID-19).

When COVID-19 hit, Dr. Sarah Tevis, assistant professor of surgery in the division of surgical oncology at University of Colorado School of Medicine and physician advisor, turned to working in the UCH command center. She choose to end her maternity leave a few weeks early to support the COVID-19 response. Those first few frantic days reminded her of life as an intern.

“The learning curve was incredibly steep,” said Tevis who helped field questions about testing, precautions, bed placement, logistics and complex medical scenarios that no one had ever seen.

“I was really pleased that I could contribute in a meaningful way and it was such a rare opportunity to collaborate with teams from other disciplines,” said Tevis.

Similarly, hundreds of providers shifted onto multidisciplinary teams to treat COVID-19 patients in the ICUs and on the floors. The COVID-19 teams included intensivists, anesthesiologists, surgeons, hospitalists , ED and family medicine doctors, and a wide array of residents and fellows from multiple specialities. Providers from the outpatient arena also jumped in, caring for hospitalized non-COVID-19 patients and rapidly switching from in-person to virtual health visits.

“It was an amazing effort particularly because things were changing almost by the hour,” said Dr. Marisha Burden, associate professor of medicine for the CU School of Medicine and head of Division of Hospital Medicine. “The teams were solving problems and taking care of patients safely and collaboratively, which allowed our strengths to shine.”

Dr. Julia Limes, a hospitalist with University of Colorado Hospital and faculty member in the Division of Hospital Medicine and School of Medicine, called it a “great challenge for everyone.”
“We were communicating with leadership in the command center and collaborating in real time,” said Limes. “It was a major shift in operations.”

Cathy Ehrenfeucht, vice president of operations and capacity, said when she and other leaders called the code yellow on March 13, they thought activating the command center would be temporary. UCH’s first patient had already arrived, and the gravity of the situation hit hard a few days later when more patients were admitted. The hospital needed more negative airflow rooms. Units were converted using the new term called “COVID negative.” More staff needed to be retrained. Virtual visits ramped up. The command center, staffed with representatives from departments including emergency management, nursing, facilities, operations and the medical staff was, “pivotal.”

“The providers were able to use their own lingo to communicate, walk each other through a completely new view in Epic, provide feedback and loop closure,” said Ehrenfeucht. Meanwhile, the medical staff continued to raise their hands and offer to help in any way they could.

Dr. David Schwartz and Kasey Bowden, NP.

“We planned for the worst and hoped for the best,” said Burden.

“We were working feverishly because our patients were so very sick and they turned sick quickly,” said Ehrenfeucht. “Everyone was putting their heart and soul into everything.”

Eventually, as guidance on caring for COVID-19 patients matured and best practices were shared widely, the pace slowed in the command center. Rather than fielding questions and issues about medical conundrums, staff focused on procedures, PPE guidance, implementing patient safety and visitor policies and more.

Ehrenfeucht said staff and providers demonstrated “phenomenal attitudes every day.”
Tevis is back to performing more surgeries on cancer patients. She’s thankful she had a window into such a seminal time. Like Limes and Burden, she hopes the new community of peers that’s emerged will continue collaborating long after COVID-19.

She also looks forward to the day when she can hold a patient’s hand and hug them.

“It’s the worst day of their lives and being emotionally supportive of my patients is the best part of my job,” said Tevis.

Indeed. “This event has underscored the reasons we all went into health care,” said Ehrenfeucht.

About the author

Molly Blake is a communications specialist for UCHealth. She joined the team in 2019. Molly spent much of her journalism career freelance writing for various publications including The New York Times, NBC news, alumni magazines and more. She is the proud spouse of a United States Marine Corps veteran, and wrote extensively about their life in the military.