by: Dr. Kent Hu, MD | Associate Medical Director, The Everett Clinic

The COVID-19 pandemic transformed our world, and with it our way of caring for patients. The Everett Clinic seized this crisis to challenge old assumptions and develop new models of care.

When the first COVID-19 positive patient arrived on our doorstep on Feb. 28, The Everett Clinic responded with rapid innovation. In just a matter of weeks, we implemented incredible changes in the way we operate, including moving the site-of-care to where it would be most safe for patients and our teammates. Prior to COVID-19, we (and most of health care) were a “one trick pony” and this was the face-to-face visit. With a pandemic, we needed to answer the question of how to continue providing high quality care and encourage physical distancing. We accomplished this through two strategies: cohorting suspected/confirmed COVID-19 patients, and virtual visits.  

Within a few days, our Walk-In Clinic sites were divided into two environments: respiratory clinics and non-respiratory clinics. The idea is to cohort patients who are suspected to have COVID-19 disease. Patients with symptoms and risk factors of COVID-19 were directed to special “Febrile URI” sites. This accomplished multiple goals. We could concentrate intensive training of infection control procedures on a smaller number of team members. This helped preserve our limited PPE supplies. And it focused COVID-19 expertise on the patients that needed that care the most.  

The physical space of these Febrile URI sites was also carefully designed for physical distancing, from waiting rooms to lab/radiology areas. Parking lots became drive-thru testing sites. Within the first month of COVID-19, The Everett Clinic was testing over a hundred patients and employees each day from the safety of their car.

Another change to keep patients and team members safe was the rapid standup of a digital health virtual platform. Within just two weeks, hundreds of providers at The Everett Clinic were trained and began offering video visits. In a time when WA State was kept in a stay-at-home order, we were still able to provide high quality, safe care to our patients.

Meanwhile, behind the scenes, critical research was taking place. A study led by Dr. Yuan-Po Tu showed that testing for COVID-19 could be effectively done by sampling the anterior nares. This process was so simple and easy that patients could readily do it themselves. This change in practice allowed us to test many more patients. It also reduced the risk of infection for healthcare workers, conserving supplies of PPE, and providing a more comfortable experience for patients.

Our success was dependent on the team coming together with a singular purpose of providing high quality care while ensuring safety. It’s been an incredible journey, from knowing very little about the novel virus to developing a robust strategy combat the disease. While there is still much uncertainty and we continue to learn, we remain committed to our mission of providing the best care to all our patients.

ABOUT THE AUTHOR:

Dr. Kent Hu is the Associate Medical Director of Quality for The Everett Clinic, part of Optum. He joined the Clinic as an internist on the Hospital Team and became the Associate Medical Director of Quality in 2009. He is responsible for the Clinic’s quality improvement program, disease management programs, clinical process improvement, and patient safety.

Dr. Hu is board certified in Internal Medicine. He received his medical degree from Yale University and completed an Internal Medicine residency at the University of Pennsylvania. He also holds a master’s degree in Public Health from the University of Washington.