MDAdvisor Spring 2020

ADUBATO: Kurt, when we were planning for this podcast, we became aware that you had had a very personal experience with COVID-19 as the first Connecticut hospital CEO to test positive. Tell us how you’re doing right now and what that experience has taught you about this pandemic.

“…I still feel like people are looking at me, which has helped me to put myself in the place of someone who has a condition that is more permanent and how that might feel.”

BARWIS: I feel absolutely great, and thank you for asking. I’ve gotten a lot of well wishes from so many people. I think that one of the key takeaways for me was the stigma associated with having it, as my COVID-19 diagnosis was very public. I’m finally going out now to the store and things, with a mask on, of course, and I am well past recovery. However, I still feel like people are looking at me, which has helped me to put myself in the place of someone who has a condition that is more permanent and how that might feel. That was one of the key takeaways for me.

The second takeaway was facing the reality that although I had a milder version of COVID-19, there were times when I found myself thinking, “What if it goes the other way?” I had read about people who were younger than me who were seemingly healthy who contracted COVID-19 and then passed. So you can’t help but have those feelings. There were points when I questioned whether I had everything in order, or whether I should write notes to my wife and kids, and that kind of thing.

ADUBATO: Your ability to empathize with, connect to and appreciate the experience of patients dealing with COVID-19 is clearly much greater because of your experience.

BARWIS: Absolutely, Steve, no question. Again, it’s not just COVID-19 but any kind of condition. I have family members who are nurses who have had the experience of being in a store wearing their nursing uniforms and had people look at them and say inappropriate things. My sister-in-law had to announce that she was going to work, rather than just coming from work, when someone gave her a hard time about being there after taking care of patients. This overall awareness is very important for me in my role.

ADUBATO: When it comes to your physicians, nurses and others on the frontline, talk to us about not only the experience of caring for patients with COVID-19 but also how providers are taking care of themselves and what they need at this challenging time.

BARWIS: Taking care of patients with COVID-19 presents a really different situation than we are used to. There are no family members visiting these patients. I think the vast majority of healthcare workers are so empathetic. They are not just the caregiver, but they are also the person who is interacting with this patient. We’ve set up iPads and things like that for patients to do FaceTime, but not all of them can do it. So, there’s this natural kind of higher level of responsibility to deal with the whole person and to understand that the person who would normally be there to help them, and support them and hold their hand isn’t there anymore. In our long-term care facility, we have a place where the residents can actually stand or sit in front of a window and at least talk to their family on the other side of the window out of harm’s way. I think that’s one of the big differences that I see, and it’s this increased responsibility that’s unique about this pandemic.

In terms of taking care of each other, it’s really sad to hear that some providers on the frontline have done things to themselves as a response to the emotional and overwhelming sight of seeing so many people die and so many people sick. It’s really a hard thing. Internally in our organization, we have a peer support program that we call SOS. We had physicians, psychiatrists and behavioral health staff volunteer to be trained as peer-support individuals. Any person in the organization who feels overwhelmed or feels like they can’t cope can call at any time and ask for peer support. Again, these are individuals who have volunteered, have gone through extensive training and are there to respond to and help others. I know that our organization is not unique in this. I know that across this country so many healthcare organizations, including ambulatory organizations, are doing the same thing, and that’s creating a pathway for individuals who need help to get it and get it very quickly.

ADUBATO: I’m a student of leadership. I’ve been teaching, coaching, writing and more importantly, trying to be the best leader I can be. As a leader, what specifically do you do on a regular basis to not just support but to inspire your team, particularly those who are physicians dealing with the COVID-19 crisis?

“There’s a pulse to an organization, and you have to respect that pulse, even if that means that sometimes, you’re not going to make a perfect decision.”

BARWIS: I wouldn’t profess to have all the answers, but I would say this: For me, personally, I interact with my medical staff members. They literally can text me or talk to me 24 hours a day. I’m very transparent and open. I do rounds on the units and talk to the physicians and the staff. Typically, in my role, as is the case with many other leaders, I’m eating breakfast, lunch and dinner in the organization. If I go to the cafeteria, I make sure that I sit down with different people at different times. It’s so vitally important to be present, to be transparent and to talk through issues and concerns. I think leaders make much better decisions when they’re very transparent and open, and they’re willing to debate and really think through critical decisions with the folks they lead. For me, personally, that’s my style, that’s my approach. There’s a pulse to an organization, and you have to respect that pulse, even if that means that sometimes, you’re not going to make a perfect decision. However, making no decision is just not an option. That doesn’t mean that you’re ever going to have perfect consensus on anything, but you are called to make decisions and keep moving forward. And to do that, you have to have trust. That’s the whole aspect of engaging with people, talking to people, building those trust credits. So, when you make a decision that not necessarily everybody agrees with, they understand that you came to a conclusion based on exploring everything you could, and that you believe in your heart that it’s the right thing for the organization to do.

ADUBATO: The leaders of each of the three states in the tri-state area—New York, New Jersey and Connecticut—have been making decisions independently but also collaboratively. In that regard, given that Connecticut is part of this tri-state area at the forefront of the COVID-19 epidemic, what specific collaboration is there between you and some of the other hospital CEOs, and how has that helped you lead in this pandemic?

BARWIS: In the state of Connecticut, through the hospital association, the CEOs initially were meeting by phone, by teleconference twice a week, debating and talking about really key and central issues related to preparedness. Then, ultimately, we were learning from each other about how we were going to address and improve the treatment and care of these patients and improve safety. It’s just been an incredible kind of sharing. Competitiveness just vaporized. Even the closest competitors are talking to each other and learning from each other about how they can improve and do better at what they’re doing. The initial period of the elimination of elective surgeries involved tremendous collaboration and conversation about how that would be implemented across the state and as an organization. We wanted to be careful that we are all on the same page, so nobody is all of a sudden left behind because they weren’t aware of what everybody else was doing.

ADUBATO: There are some in the media who ask, “Couldn’t we have anticipated this pandemic hitting our area, the region, particularly Connecticut, so hard?” What do you say to that?

BARWIS: There’s always opportunity to improve. I think in hindsight we can talk about a lot of different things that we could have done to be more prepared. There’s no question that we have to address our personal protective equipment (PPE) situation and reexamine how we stock and maintain inventory. I think that the hot spot in New York City and the influx through Fairfield County into Connecticut was fast, and those hospitals became overwhelmed very quickly. Hartford County is a little bit off of any main highway. We’re not on 95, we’re not on 84, and so, there was a theory about how we were somewhat sheltered. However, we’ve had a pretty steady census. I’m sure that in the future we will look back and identify the opportunities to be much better at being prepared, being aware and being reactive more quickly.

Testing is a major area where we can improve. In Connecticut, for example, 50 percent of the deaths are in long-term care facilities, and yet today, there’s still rationing of swabs for the testing. It’s not that the testing equipment isn’t here. The swabs are the issue. We quickly acquired the testing equipment, and then relied on the State to help us with the swabs. That wasn’t a reliable way to do it. We just secured a pathway for swabs, and so I’ve been working with the health district to identify hotspots like nursing homes that are unable to test their patients and isolate patients who have COVID-19. Having this knowledge makes me think a lot differently about relying on outsourced platforms and lab tests going forward. If I send out a test, it’s going to take me 48 hours to get the results. If I do it internally, I can have the results within two to three hours. That saves lives.

ADUBATO: I recently heard that leading in the age of COVID-19 is like flying a plane as you’re building it. In that regard, how prepared will you and your team be if the second wave that everyone is talking about happens in the fall?

BARWIS: I know people are very concerned about how we get back to normal. That is one of the benefits of having gone through this, having your incident command set up, meeting every day and talking about the steps you’re going to take. That’s a great example about building the plane as you’re flying. That feeling won’t be as prevalent in a second wave. We’ll know exactly what to do and how to respond. When training the staff, before I got sick, there was tremendous fear about simply donning and doffing PPE. We hadn’t had our first patient yet, and we weren’t sure how we were going to deal with it. When I got back to this hospital, and I rounded on the floors, all I heard was, “We got this. We know what we’re doing.” That’s what’s going to be different in a second wave.

ADUBATO: Do you believe that we will get back to this thing called normal? Or do you believe there is going to be some other way of life that we’re just going to have to adapt to?

BARWIS: I believe that there’s going to be a new normal. There has to be a new normal. I think that people’s awareness of how COVID-19 spread, of what they have to do to protect themselves and of the fear and the anxiety that people have will change us. People are putting off screening procedures and putting off needed healthcare. They are so afraid. I think that is going to continue, and it’s going to define a new normal for us. I think as a community, as a society, we are going to be better for it.

ADUBATO: We want to thank Kurt Barwis, who is the President and the CEO of Bristol Health in Connecticut. Kurt, most importantly, to you, to your family, to your team at Bristol Health, on behalf of Patricia Costante and the MDAdvantage team, we wish you all the best. Thank you for joining us and sharing your wisdom and your insight.

BARWIS: Steve, thank you so much and thanks to MDAdvantage for doing this. I really appreciate all that you do to make our communities healthier and safer.