Northern California health care leaders reveal challenges, local heroes of the coronavirus pandemic

The pandemic year of 2020 challenged the industry like no other. Things changed, some likely in a permanent way.

The Journal asked some leaders to recall those shifts and who rose to the occasion within their organizations. Answers were edited for clarity and brevity.

Richard Carvolth, M.D.

Regional Chief Medical Officer, Northern California

Providence (formerly St. Joseph Health)

1111 Sonoma Ave., Santa Rosa 95405

877-449-3627

www.providence.org

Biography

Before joining St. Joseph Health, Dr. Carvolth was the chief physician executive for Dignity Health, Sacramento Division. Previously, he held leadership roles at several respected health care organizations, including chief medical officer for St. Joseph Health in Sonoma County; senior medical director for Stanford University Healthcare Association; CEO for TeamHealth West; medical director Marin County EMS Agency; facility medical director at Santa Rosa Memorial Hospital; and cofounder and COO MedStream Telecommunications.

Dr. Carvolth holds a master’s degree in medical management from the Heinz School of Business at Carnegie Mellon University, trained in general surgery at the University of California San Francisco, and earned his Doctor of Medicine degree at Cornell University. He is a Diplomat of the American Board of Emergency Medicine and a Fellow of the American College of Emergency Physicians.

What memories stand out most as you recall the impact of the coronavirus on your institution?

What stands out most to me is the heroism demonstrated by so many so often. Coming on the heels of three years of devastating wildfires, our caregivers, like all members of our communities, have faced challenges day in and day out, at work, at home, at school, and around town.

Despite these extraordinary demands, our caregivers never let our hospitals, clinics, and other services down. Often, caregivers had to make difficult choices to fill schedules and to ensure that patient care always came first. Many sacrifices were made.

And, especially in the early days of the disease, we all dealt with uncertainty and fear. Despite this, and perhaps in part because of it, so many people stepped up, locked arms, and provided support to so many others in need. It is a truism that healthcare folks are devoted to others, but I am especially proud of the caring, devotion, self-sacrifice, and leadership I saw day in and day out in our organization.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

There will be many lasting impacts, positive and negative. I think the two most positive impacts we will see are, on one hand, a willingness to more rapidly adopt technologies, such as telemedicine and safe genetic engineering, and, on the other a recognition of a need to return to basics like sanitation and hygiene as well as concern for the public good in the form of public health measures and social support resources and structures. The negative impacts we must work to correct include distrust of science, ineffective government, and inequities in health care access.

Because of the pandemic, what permanent changes has your health care operation made or is in the process of making?

Permanent changes in our operations will include a focus on improving timely and efficient access to care for our patients. This will certainly mean increasing telemedicine and other technologic methods, but will also mean more focus on mental and behavioral health services, assistance in navigating patients through the often-confusing and disjointed care system, and building new alternatives to sites of care such as “hospital at home” programs.

In what ways have the experiences of last year changed the way you approach your work?

While much of my work has shifted to remote systems which will persist to some extent, I am anxious to return to in-person, on-site, collaborative work, especially on new projects. The impact of the pandemic has been so profound and wide-ranging, that I have more sense of urgency to make progress in better integrating our systems of care – a recognition that our health care systems can never be perfect, but we can do more and do it better.

Tell us about one person in your organization/hospital who inspired you in the past year and why it was so memorable.

In the early phases of the Pandemic, the biggest challenge for all health care organizations had to do with the very limited and ever-changing supply of COVID-19 testing materials. Our organization’s Regional Executive Director of Laboratory Services, Karen Varner, did a spectacular job managing our program. Working tirelessly for long hours, she advocated for our allocations with the suppliers, managed the entire handling, distribution, testing, and reporting processes and interpreted results. Her approach was data-driven and equitable, and her guidance was calm and effective. I’m certain we would not have succeeded as we did without her leadership.

What are two of your organization/hospital’s biggest goals for 2021?

The impact of the pandemic has been profound on our caregivers and on the financial health of our institution. Our goals then are clear. First and foremost, we will support our caregivers in their healing and return to normalcy at work and at home. Second, we will redesign our systems to ensure the on-going viability of our services, with greater effectiveness and efficiency.

James DeVore, M.D.

Chief Medical Officer, Northern California

St. Joseph Health Medical Group (soon to be Providence Medical Group)

1111 Sonoma Ave., Santa Rosa 95405

800-627-8106

www.psjhmedgroups.org/Northern-California

Biography

James DeVore has practiced family medicine in Santa Rosa since 1980. He joined St. Joseph Health Medical Group (formerly Annadel Medical Group) in 2010 and accepted a role as the medical director in 2012. St. Joseph Health Medical Group has more than 75 clinic locations, primarily serving Sonoma, Napa, and Humboldt counties.

What memories stand out most as you recall the impact of the coronavirus on your institution?

There was a moment very early in the pandemic when I was sitting with a physician colleague reviewing the explosion of COVID-19 cases on the West Coast. Almost simultaneously we both recognized the size and destructive power of the runaway train that was coming at us. I remember that chilling realization that our lives and work was about to be turned upside down and changed forever.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

As an old-school family doctor, I have always valued personal relationships with patients above all else. My entire career was invested in pulling up a chair, looking a patient in the eye, performing a physical exam and making that direct connection. And now, COVID-19 has changed everything!

It has been difficult to admit that even that foundational principle about personally connecting with patients has changed. The pandemic has taught us that it is quite possible to provide high-quality medical care virtually with telehealth technology or even a cell phone. There’s no doubt that a new era of health care has arrived, and telemedicine is here to stay.

In what ways have the experiences of last year changed the way you approach your work?

With something as massive and complex as the COVID-19 crisis, I am all the more appreciative of the value and importance of being part of a larger health system (St. Joseph Health and Providence joined in 2016, and the entire system is in the process of uniting under the Providence name). From day 1 of the pandemic, when the very first COVID-19 patient was admitted to one of our hospitals, Providence has not only been a leader on the national stage but has supported our operations in Northern California with expertise, data, clinical guidance, supplies, and an unwavering commitment to financial stability. We are no longer an independent medical community but rather an integral part of a very high-performing, multi-state health care organization.

Tell us about one person in your organization/hospital who inspired you in the past year and why it was so memorable.

In every crisis, there are opportunities to step up and make a difference. Certain individuals seem more immune to the chaos and turmoil and are able to provide steady, expert and reliable leadership. In our organization, I would recognize Brandi Lazorek, MSN, director of Clinical Operations, for her exceptional leadership throughout this crisis. She not only has the experience and clinical knowledge necessary to manage the rapidly changing coronavirus landscape, she has led our team with a roll-up-your-sleeves style of hard work, compassion and dedication. (She’s also not shy about putting a certain CMO in his place from time to time…!)

Do you have growth plans for your organization/hospital this year, such as adding services or increasing staff?

Yes. In 2021, we aim to continue to grow St Joseph Health (soon to be Providence) Medical Group, which already includes an array of primary care and specialty physicians. In Sonoma and Napa counties, this includes adding doctors across all specialties to meet the needs of our community

Abhishek Dosi

CEO

Sutter Solano Medical Center

300 Hospital Drive

Vallejo 94589

707- 554-4444

www.sutterhealth.org/ssmc

Biography

Abhishek Dosi has been CEO of Sutter Solano Medical Center since 2017, after several years in other leadership roles within Sutter Health. He holds a master’s degree in health administration.

What memories stand out most as you recall the impact of the coronavirus on your institution?

Here at Sutter Solano Medical Center, the patients we serve are our neighbors, friends and family. While our team stepped up to face this unprecedented crisis head on, our community also stepped up in support.

At the height of the pandemic last summer, our local fire department organized a clap-in to recognize our frontline team as they walked into work – such a simple way to say thank you.

Not long after, the Sacramento River Cats handed out goodie bags to our frontline workers with healthy snacks, fresh fruit, juice boxes and toilet paper. Even Dinger, the River Cats mascot, joined the event in front of Sutter Solano’s North Entrance bright and early at 6:45 a.m. to catch the night shift leaving for the day.

Our team also received a generous donation of 150 free vehicle sanitizing services earlier this year, which was a welcome treat. We received so many drawings from children and cards from the community, we dedicated an entire wall in the hospital to display them. These are just a few of the many ways our community has shown its support for our team throughout the pandemic. Despite the challenges we have, and continue, to face, we are incredibly humbled by the appreciation our community has shown and will forever be grateful.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

The two most impactful changes I have seen come hand-in-hand: telehealth and an increased focus on health equity.

If there is a silver lining to glean from this pandemic, it is the rapid adoption of innovative approaches to providing and receiving virtual care – solutions that many of us might not have expected at the beginning of this year. Over the course of six weeks, Sutter Health put into motion a dramatically expanded network of virtual care – training and supplying technology to nearly 5,000 clinicians to conduct video visits. As a result, Sutter’s video visits increased by 32,000 percent over a two-month period. And often, change can be good – in fact, satisfaction rates for telehealth are on par with in-person visits.

Our Vallejo community is home to a beautifully diverse population. This same community, like many others across our nation, is fighting for health equity. Before necessity fueled the expansion of telehealth, many patients would have had to travel much further to see a specialist – something not everyone can do.

Virtual care has allowed our hospitals to also expand access to specialty services like teleneurology and telepsychiatry. At Sutter Solano Medical Center, we have used telehealth within the inpatient setting to help provide access to specialty services, allowing many patients to receive care closer to home.

Now, more than ever, it is imperative that our communities continue to receive the safe, high quality care they need locally now, and into the future – and telehealth is a critical component in the fight for improving broad public health. I truly don’t see this impactful service going away any time soon.

In what ways have the experiences of last year changed the way you approach your work?

This pandemic has been transformative in many ways. Our entire integrated network acted quickly to adapt our “normal” operations to care for patients with COVID-19 and those with other clinical needs. It has been imperative to not only continue making sustainable operational decisions, but to do so swiftly and nimbly – especially in the midst of COVID-19 surges. Shifting my mindset toward more efficient decision making has helped to maintain the integrity of our care.

There are some days I feel emotional about the world we live in – and I have discovered that this emotional connection to my work can be a good thing. The more adversity our teams face, the harder I work – not just for positive outcomes, but also for the people that are providing care on our teams. This kind of work requires a human connection, and I must say that, for me, it has never been stronger.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

I’m going to break the rules a little bit here, because I truly cannot name just one person. Our frontline team has been navigating the COVID-19 pandemic from day one. Every person within this hospital – our nurses, technicians, clinicians, administrative team, pharmacists, social workers, dieticians, EVS – have navigated this difficult puzzle to ensure our patients are getting the optimal care in every single area. This multidisciplinary team is key to making sure the needs of our community are met.

And every day, this team chooses to keep walking through these doors. They choose to be here – for our patients, our colleagues and our community. The decision they make to fight on the frontlines of this virus is not the easy choice to make – and yet, they continue to make it, day in and day out. They continue to serve as the backbone for everything Sutter Health stands for – compassion, integrity, safety, quality and teamwork. Their unwavering courage and dedication inspire me, and I have been so proud to stand with them in this fight.

What are two of your organization’s biggest goals for 2021?

First and foremost, I’d like to continue to operationally scale up our vaccination efforts in collaboration with our county. COVID-19 vaccination will be an important tool to help stop the pandemic.

While COVID-19 will continue to be top of mind, we will also continue to invest in our community and address major issues that have worsened due to the pandemic. Specifically, we have a number of initiatives that we hope can address homelessness and behavioral health. Our longstanding partnerships will be key in filling those gaps moving forward.

Ramona Faith, M.S.N., R.N.

CEO

Petaluma Health Care District

1425 N. McDowell Blvd. STE 103, Petaluma 94954

707-766-4799

phcd.org

Biography

Since 2011, Ramona Faith has been CEO of the Petaluma Health Care District (PHCD), which serves the evolving health and wellness needs of Southern Sonoma County residents.

What memories stand out most as you recall the impact of the coronavirus on your institution?

There was a great deal of fear and anxiety because so much was unknown. We had to respond quickly and be there for our partners. The stay-at-home order obliged us to make major adjustments in the way we delivered services and engaged with the community. We brought together various sectors of the community to support COVID mitigation efforts, such as making masks and providing PPE. COVID has reminded us that health affects every facet of our lives, and that putting strategies in place to keep the community healthy comes before everything else.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

The pandemic has deepened — and made more visible than ever — the existing inequities and inequalities in our community and the country as a whole. I hope we can learn from this experience and create more equitable systems to ensure that all members of our community have access to the care and services they need.

The pandemic is taking a social and emotional toll on everyone. No matter what you do or where you live, COVID has an impact on your life. Distance learning is causing great concern as it’s widening the learning gap and making kids feel isolated, unable to socialize with their friends and peers. Having to manage student learning in an entirely new way, teachers are experiencing unprecedented stress. Parents are becoming teachers’ aides and having to do so while simultaneously working from home. All this is placing immense strain on families. Although we don’t know the lasting impact on social and emotional well-being, it is clear that additional mental health resources need to be made available broadly and equitably to help our community health.

In the past year or so, what specific accomplishment of your organization do you wish to highlight, and why?

Our board and administration worked diligently for the past five years to identify and secure a long-term operator for Petaluma Valley Hospital. After much effort, this past November 85% of the voters supported a ballot measure to sell the hospital to NorCal Health Connect, an affiliate of Providence St. Joseph Health, for $52.6 million. The sale included a commitment from NorCal Health Connect to operate the hospital as an acute care hospital with an emergency department for a minimum of 20 years at a time when community hospitals in California and across the country are having to limit services or even close down. The proceeds from the sale allow us to have an even greater impact on improving the health of our community through long-term strategic investments in programs and services that address South County’s greatest health needs.

What are two of your organization’s biggest goals for 2021?

With the sale of the hospital, the district is working to develop a community-informed process for investing in impact grants that address the community’s greatest health needs. PHCD has also formed a 501(c)3 called the Petaluma Health Foundation — a community foundation that will seek large cross-sector grants and leverage community health investments.

Steven Herber, M.D., FACS

President

Adventist Health St. Helena

10 Woodland Road, St. Helena 94574

707-963-3611

www.adventisthealth.org/st-helena

Biography

Herber, a board-certified plastic surgeon, is also medical director of the St. Helena Institute for Plastic Surgery. He earned a Bachelor of Science degree from Pacific Union College in Angwin and a medical degree from Loma Linda University School of Medicine. He completed a general surgery residency at Loma Linda University Medical Center, a plastic surgery residency at Yale University, and a maxillofacial and pediatric plastic surgery fellowship at Akron Children's Hospital Medical Center in Akron, Ohio.

What memories stand out most as you recall the impact of the coronavirus on your institution?

We voluntarily stopped all non-essential procedures as a result of the initial arrival of COVID-19. We felt it was the right thing to do to ensure the safety for our patients and staff. However, this was a difficult experience.

Describe two things you see as the pandemic’s lasting impact on health care, and why.

1) We’ve been forced to be more creative in how we bring care to our patients. More can be done virtually, whether through online scheduling, enhanced patent portals, and virtual doctor-patient interactions.

2) We are learning by experience that unexpected events can adversely affect our lives. We need to be as flexible and understanding during these times while taking protocols and procedures to heart. We are leading the way in best practices for ourselves and the communities we serve.

In what ways have the experiences of last year changed the way you approach your work?

My work now more than ever is focused on caring for the whole community. As a healthcare leader, I need to look at ways to look beyond our hospital walls.

In the past year or so, what specific accomplishment of your organization do you wish to highlight, and why?

I want to highlight two key accomplishments that are interrelated. First, is commitment to providing COVID-19 testing to our up-valley community through an onsite clinic and mobile outreach. We were able to administer tests to vulnerable sets of our community and stopped numerous potential outbreaks as a result.

Second, the vaccination clinic we established and continue to run here in St. Helena. Through the St. Helena Hospital Foundation and Adventist Health St. Helena's hard work, and in partnership with our Napa County counterparts, we provide an invaluable service. We are proud to play our part in securing the safety of the community we serve.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

Last year we closed our doors for the first time in our 172-year history. The Glass Fire exploded in the town of Angwin and areas surrounding the hospital. Our emergency manager and incident command (IC) team lead, Kimberly Baldwin, dealt with all logistics 24/7 for two and a half months. She and the IC team were instrumental in putting the hospital back together and prepare us to open our doors once more. I am humbled and inspired by her example.

What are two of your organization’s biggest goals for 2021?

1) Our first goal is to help our community achieve herd immunity from the COVID-19 virus. We are ensuring the continued vitality of the Napa Valley community.

2) Successfully launching our Blue Zones project to further enhance wellbeing, quality of life and longevity throughout the Napa Valley.

Do you have growth plans for your organization this year, such as adding services or increasing staff?

Throughout this year we are growing our organization and enhancing staff in the following areas:

• Adding a Neurology program led by Dr. Natasha Dragicevic

• Becoming a certified stroke center to better serve our community

• Expanding our behavioral health offerings by bringing this needed service into primary care practices

• Expanding our primary care network throughout Napa County

• Enhancing our care in Orthopedics

• Building upon our women’s services, specifically in the area of breast health

• Continuing to lead the way in compassionate, expert cancer care at our Martin-O’Neil Cancer Center

• Establishing a pain management program led by Dr. Jason Pope

• Launching Blue Zones in Napa County

Amy Herold, M.D.

Chief Medical Officer

Queen of the Valley Medical Center, owned by Providence (formerly St. Joseph Health)

1000 Trancas Street, Napa 94558

707-252-4411

www.providence.org

Biography

Amy Herold earned a joint M.D.–MBA from St. Louis University and completed her residency in obstetrics and gynecology at Kaiser Permanente in Santa Clara, California. She was a private practice physician and high-risk OB hospitalist before joining the administrative team of Providence St. Joseph Health in 2015.

What memories stand out most as you recall the impact of the coronavirus on your institution?

There are the scary or difficult memories such as getting the first patients from the cruise ship transferred to us and the resulting anger in the community. There was a fear of the unknown both from our external neighbors and our internal team tasked with caring for these patients as news stories swirled of the escalation of cases overseas.

I will never forget what I was doing that Monday night Feb. 17, 2020 when we got the call from the government asking if we could take those patients that needed our help. I remember those first patients were sad and scared, being separated from their loved ones and not knowing what was going to happen to them.

Our team took time to talk to them and find out what brought them joy. It was as simple as good coffee, so we made coffee runs for them to bring them something they would like. It was also a difficult time this January when our peak surge hit and we needed to call on the state for more ventilators, nurses, and supplies and we were scared that the cases would become more than we could handle.

We will remember those stark moments, but the best memories I have are of the local restaurants and community members donating meals to the hospital for months to feed front-line workers. I will remember the family that came out to hold up signs in front of the hospital every Wednesday for passing cars to honk for the heroes inside. We used to go out to the parking lot when they were there just for the joy of what they were doing for us.

Recently the city council and private donors sent scoops of Ben & Jerry’s ice cream to the staff for a sweet treat that everyone loved. It’s those moments I will remember forever as our Napa community rallied to take care of us while we were working so hard to take care of them.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

COVID-19 has made digital technology and delivery a priority in many facets of our lives and health care is no exception. As we are social distancing we are ordering services remotely and learning to provide health care remotely. Many visits can be scheduled using smart devices connected to physicians on the other end and I believe virtual visits will become a permanent, convenient part of health care. It will increase access to specialty care even for those who live in rural or remote settings without requiring hours of travel.

The pandemic has exposed harsh inequality in the health system. It has also made us more aware of the long history of inequality of care access and the mistrust many residents, especially in the BIPOC community, have of the health care system for various reasons. It gave us, as health care providers, a chance to take a hard look at some of our processes and systems and have some difficult conversations with community leaders about how we could have, and can do better. I see the pandemic as an extraordinarily challenging period in our history but a spark for us to make real changes in how we deliver care in the future.

This is a third thing, but I hope our attention to hand washing and infection prevention stay as we move back to “normal.” It is great to see so many people aware of basic infection prevention practices.

In what ways have the experiences of last year changed the way you approach your work?

We have been in an atmosphere of “crisis management” for a year now. It is exhausting emotionally and physically.

The last year has been a reminder that we all need to take some time for self-care to try to avoid burnout. We also recognize that all of us are going through this together, so if tempers are occasionally short or someone has hit their limit for the day, we can respond with grace as a team. I’ve never seen such sustained teamwork as I have in the past year. It has really taught us to recognize and rely on the talents of our colleagues. We would not be able to get through this without the army of talent we have at the hospital.

Tell us about one person in your organization/hospital who inspired you in the past year and why it was so memorable.

This is not one person, but it is one team. After we received our COVID-19 passengers from the Diamond Princess last February we were worried about how our staff would feel about taking care of patients with this new infectious disease.

We have always maintained current education in infection prevention and appropriate protection to manage other respiratory diseases such as tuberculosis or measles, but this was a new disease and very scary. We had a team of three nurses who volunteered to take care of those first patients, Jen Payne, Chris Rivera, and Kellie Owens, and they really set the standard for our care teams.

I find their willingness to step up and provide compassionate hands-on care in the face of the unknown to be incredibly brave and the definition of what we do in health care. We have gotten much more comfortable with caring for COVID-19 patients as we face it daily, but I’m humbled by how these first three stepped up to care for the people who needed them the most.

What are two of your organization/hospital’s biggest goals for 2021?

Our biggest goal for 2021 is to continue expanding our vaccination program as fast as we can get our hands on more vaccine. We have been working with our health care partners in Napa County to coordinate our efforts to get vaccinations distributed as quickly as possible. I’m hopeful that as our supply grows and we can hold more mass vaccination clinics we can see a return to normal through 2021.

We would like to see a return of our surgical volume and preventive care services, such as mammograms and colonoscopies, that people may have put off during the pandemic. We want to ensure that everyone feels comfortable and safe with receiving preventive services so we can avoid serious illnesses in our patients.

Chad Hickerson

Regional Chief Executive Officer

Northern California Behavioral Health System (Aurora Santa Rosa Hospital)

1287 Fulton Rd., Santa Rosa 95401

707-800-7700

www.aurorasantarosa.com

Biography

Chad Hickerson served the California State Hospital system, successfully implementing California State Senate Bill 130 (mandated reduction of seclusion and restraint) in some of the most challenging state hospital programs. For 10 years he worked with the California Correctional Health Care Services Agency in the state’s prison system. In 2017, Hickerson joined the Telecare Corporation where he served as vice president of Operations. In 2021, Hickerson began serving on the board of directors for the Hospital Council of Northern and Central California.

He earned a master’s degree in organizational development and leadership from Chapman University and a bachelor’s in healthcare administration from Ashford University. Hickerson is a licensed psychiatric technician nurse and a licensed auditor from the American Correctional Association.

What memories stand out most as you recall the impact of the coronavirus on your institution?

Communication immediately became the most important aspect of leadership. While organizing and implementing CDC and CDPH precautions were obviously critical, communicating to staff, patients and their families about our state and local policy-driven action to protect everyone at the facilities was just as important. Health care professionals are known for being courageous. What many do not know is the added difficulty of working with patients suffering acute mental illness during a widespread emergency. There is a lot of anxiety generated by the pandemic, even in people who do not suffer from clinical anxiety. Reassurance, compassion, communication – those were and are our most potent, healing tools.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

1] Mental health care was legislatively acknowledged as a critical and visible part of health care last year. California passed mental health parity laws [SB 855], to address gaps existing in insurance coverage. Heightened awareness and the need for services, such as suicide prevention, brought mental illness to the forefront of the healthcare conversation and collaborative action was taken.

2] Heightened awareness for the basic public health precautions against the spread of disease. This is a positive impact that I hope will be lasting.

In what ways have the experiences of last year changed the way you approach your work?

Interestingly, we have all become more adept at assessing problems-solutions quicker and reducing the drag time that sometimes accompanies the implementation of new processes.

In the past year or so, what specific accomplishment of your organization do you wish to highlight, and why?

The past year, 2020, was challenging in many ways. The specific accomplishment was not one person’s doing. It was the collaboration of many in this county. Keeping the Santa Rosa hospital open and available for our acute patients during yet another wildfire during a pandemic is hard to describe. It took a serious toll on those involved, who looked at potential disaster in the eye, put one foot in front of the other and became healthcare heroes for the community.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

There is not one person in particular, but many. Through the truly unique paradigm that we’ve all experienced together throughout the past year with the COVID-19 pandemic, I’ve been inspired on a daily basis by the countless health care workers who have remained dedicated and steadfast in coming to work every day to deliver the care, treatment, and services that our community so desperately needs.

In fact, the demand for access to behavioral health care has dramatically escalated over the past 12 months. In dramatic fashion, our workforce has responded to that challenge with passion and vigor, and I have continuously found myself inspired by their response to constant challenges.

What are two of your organization’s biggest goals for 2021?

1. Open the 49-bed expansion and new outpatient services spaces at Aurora Santa Rosa.
2. Open the Sacramento Behavioral Health Hospital and begin seeing patients.

B. Konard Jones

President and CEO

NorthBay Healthcare

4500 Business Center Drive, Fairfield

707-646-3116

www.northbay.org

Biography

B. Konard Jones joined NorthBay Healthcare in April 2017 after holding other senior leadership positions there and with UCSF Benioff Children's Hospital.

What memories stand out most as you recall the impact of the coronavirus on your institution?

Without doubt, it has been the resolve and incredible collaboration across our organization from the day the first patient arrived. As a small and independent system, we’ve always been nimble, but never have we faced such an incessant array of challenges.

In late January, we became the primary hospital to care for civilian personnel arriving at Travis Air Force Base under quarantine from China, as well as quarantined cruise ship passengers. Even before the Centers from Disease Control team arrived, our nursing and senior leadership team had already gathered with state public health and county officials to quickly establish infection prevention protocols for this new and virulent virus.

We knew very little about it, had no treatment regimens. But we developed protocols that were adopted throughout the country.

Memorable? The facilities team created COVID-specific units from scratch, in record time. When our Cardiac Rehabilitation team was sidelined due to pandemic-induced cancellation of services, they joined our Call Center staff, connecting with 5,000 homebound patients, ages 65 and older, to assure their safety while on lockdown.

As a result, they made 174 home deliveries of medications, medical equipment and supplies, food and produce, masks and even pet medications to grateful patients.

As we experienced an unrelenting COVID “super surge” over the holidays, the surge response was inspirational. Employees across the organization filled in when and where necessary, even creating “strike teams” to do the arduous task of repositioning proned COVID patients. Despite exhaustion, economic uncertainty, the stress of stay-at-home orders and children out of school – and yes, the California wildfires – our staff seem to say, “Where am I needed next? What more can I do?”

What are two of your organization’s biggest goals for 2021?

To ensure we achieve our mission we are focused on several initiatives in 2021 and beyond to strengthen our organization:

· Develop a three-year strategic plan to ensure we are positioned for a “new normal,” whatever it may be in a post-pandemic world;

· Continue our economic recovery efforts to ensure we have the financial stability to fight the battle ahead; and

· Solidify the brand of NorthBay by more effectively telling our story of advanced medicine and driving the excellence that our community says it wants.

Chad Krilich, M.D.

Chief Medical Officer, Sonoma County

Providence (formerly St. Joseph Health)

1165 Montgomery Drive, Santa Rosa 95405

707-525-5300

www.providence.org

Biography

Chad Krilich earned an M.D. and MBA from the Tufts University School of Medicine in Boston, after simultaneously majoring in biology and economics at the University of Washington in Seattle.

Providence in Sonoma County is a network of hospitals, ambulatory care centers and a medical group.

Prior to serving in Sonoma County, Dr. Krilich worked for MultiCare Health System.

What memories stand out most as you recall the impact of the coronavirus on your institution?

Looking back on the last year, what stands out are the faces of our physicians and caregivers. I think of those who show up every day, whether they provide direct patient care, process labs, or clean our facility. Some have families. Some have been infected by the coronavirus. And some have experienced family members who have passed from COVID-19 or been hospitalized. I am eternally grateful how each of these faces, albeit behind masks with a face shields, are reflections in my mind of the grit our team has displayed and continues to display during the pandemic.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

Two lasting impacts of this pandemic are disaster preparedness and technology.

In Sonoma County, we are all too familiar with disaster preparedness, which gave us a leg up. Having responded to our annual wildfire epidemic for the last four years was very good preparation for the pandemic. Through the use of the Hospital Incident Command Structure (HICS) the organization became adept at acquiring the necessary resources to achieve objectives during any disaster. The pandemic showed that investment in preparedness paid off whether it be through securing adequate supplies or staffing, or creatively solving surge problems.

Patients routinely accessing health care through technology is another lasting impact. One of the greatest barriers for this to occur effectively in the past was payment. There was limited reimbursement for outpatient visits via video conference platforms. Now that this barrier and others are removed, the ease with which patients can be cared for through an internet connection is relatively smooth. It does not discount the value of a doctor patient interaction in person, but it does amplify access for patients to health care, and it is not going away.

Because of the pandemic, what permanent changes has your health care operation made or is in the process of making?

More patient connections via technology will be the norm. This includes office visits and the ability to have patients leave the hospital early with home health care and electronic monitoring.

In addition, being a part of a world class organization (Providence) we can call large meetings in matter of hours. We did this over the course of the pandemic, whether it related to safely resuming elective surgery or responding to caregivers testing positive for the coronavirus. We will continue to leverage this technology to bring world class care to our patients related to coronavirus or other diseases which may impact our communities.

In what ways have the experiences of last year changed the way you approach your work?

The pandemic has further highlighted the importance of living a life in health care as a marathon, not a sprint. In health care, we are taught to run into the fire. Whether it is a patient having a heart attack or a mom who is having a baby, we are trained to drop everything and respond for the betterment of our patients.

A pandemic and a life in health care cannot always be a “code” or the proverbial sprint as described above. Doing so leads to further burnout, behavioral health disorders, and increased risk of suicide for our health care workers. Observing this throughout our country and hospital during the pandemic has highlighted the importance of remembering that a life in health care should be managed as running a marathon, not a sprint.

Specifically, that means taking the time to care for one’s self including a healthy lifestyle such as diet, exercise, sleep, and taking time away from work to decompress. Doing so, will ensure longer, happier, and hopefully healthier careers.

Tell us about one person in your organization/hospital who inspired you in the past year and why it was so memorable.

Amy Compton-Phillips is our chief clinical officer for Providence. She is a great physician leader. Over the course of the pandemic, she has chaired our 30-minute check-ins, sometimes seven days a week. She facilitates discussions on clinical care. Even more important, she speaks truth about equity, racial injustice, and the need for better leadership. She routinely shares these messages on a national level, including on news outlets such as CNN. I am grateful that we have a leader such as Dr. Compton-Phillips guiding us through the pandemic.

What are two of your organization/hospital’s biggest goals for 2021?

Areas which are a big focus for 2021, and which position us to improve patient outcomes, include reducing sepsis mortality and improving efficiencies for our patients who are hospitalized. Our aim is to save more lives while not holding on to patients in the hospital for any longer than they need to be in an inpatient bed. This will require the use of evidence-based practices, technology, and community partnerships in helping us achieve our mission, which includes caring for the poor and vulnerable.

Gary M. LeKander, M.D., FCCP

Chief of Staff, Pulmonary and Critical Care Medicine

Healdsburg Hospital

1375 University Ave., Healdsburg 95448

707-431-6500

www.healdsburghospital.org

Biography

Gary LeKander is the chief of staff at Healdsburg Hospital and chairperson of the Medical Executive Committee overseeing the medical care at the hospital.

He also is the medical director of the Intensive Care Unit and Respiratory Therapy Department at Healdsburg Hospital. LeKander’s other accomplishments include opening the Patricia and Raymond Chambers ICU and providing support to the hospital’s Northern California Wound Care Program.

In addition, LeKander provides outpatient pulmonary medicine care as a member of the St. Joseph Health Medical staff in both Santa Rosa and Petaluma.

What memories stand out most as you recall the impact of the coronavirus on your institution?

I think back on early March we were concerned about the virus but maintained a fairly normal hospital working schedule seeing patients and performing surgeries. As COVID-19 spread, we saw a rapid decline in patient care and that resulted in a nearly empty hospital with no outpatient visits, minimal emergency and surgical visits, and only a few inpatients after the first day of the shelter in place orders. It was unlike anything we had witnessed before and we worried for the health of our patients and community.

Describe two things you see as the pandemic’s lasting impact on health care, and why.

The response to COVID-19 broadened our sense of responsibility and preparedness as the hospital abruptly switched direction to prevention and treatment of the virus. We mobilized staff and resources and prepared for a battle not fully aware of what was coming. This ability to respond quickly to disasters has been a skill we have developed over many fire seasons and it was encouraging to see the how both our community and hospital responded swiftly to this new crisis.

Secondly, communication technology took on a new and elevated role and we installed platforms that allowed for internal communication (virtual meetings and secure texting) as well as patient-facing technology (telehealth visits) allowing everyone to continue their work while remaining socially-distanced.

In what ways have the experiences of last year changed the way you approach your work?

I personally have a renewed sense of prioritization of some of the basic fundamentals in health care. This includes hand hygiene practices, appropriate use of protective devices, strict adherence to infection control practices and educating others when reminders of these practices are helpful. As an industry, we have renewed our awareness to the infection prevention guidelines that minimalizes preventable harm and maximizes patient recovery chances.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

I would like to recognize one pillar of our COVID-19 response team, Kristin Lytle, RN-BSN, who works as our hospital educator and director of Staff Development. Kristin is an instrumental member or our hospital’s COVID-19 preparation and response team, but it is her work in our COVID-19 testing program that shines.

Kristin has personally performed thousands of COVID-19 swab test on all of our staff and providers at our hospital. She has been deemed the “top-swabber” having performed weekly testing on all 300+ staff for months. She has been a lead coordinator in the testing, reporting, and record keeping of thousands of COVID-19 screening tests, which is a huge task that is very time consuming with no room for error. Currently, she holds an integral role as a member of the COVID-19 vaccination effort. In this crazy time of COVID-19, Kristin has been an outstanding member of our COVID-19 response team.

What are two of your organization’s biggest goals for 2021?

First, as in progress throughout our country, our biggest goal at Healdsburg Hospital for 2021 is to vaccinate as many of our staff, patients, and local community members as possible - hoping that everyone will step up and get vaccinated.

Secondly, 2021 will be a transition year as we join forces with Providence St. Joseph Health to develop our community plan to provide excellent inpatient and outpatient care to our local community into the future.

Marie Mulligan, M.D.

Chief Medical Officer

Santa Rosa Community Health

3569 Round Barn Circle, Santa Rosa 95403

707-303-3600 x3678

srhealth.org

Biography

As a child of immigrant parents, Marie Mulligan, who uses the pronouns they/them, is driven to provide patient-centered care to underserved, marginalized populations. They have over 35 years of experience in culturally responsive family medicine and managing chronic pain through integrated healthcare, and are board certified in family medicine as well as addiction medicine.

What memories stand out most as you recall the impact of the coronavirus on your institution?

What stands out is not a memory but a feeling of awe and pride at the resilience of my staff and the team of leaders I work with. Before COVID, SRCH lost our Vista Campus in the 2017 Tubbs fire that devastated Santa Rosa. What was remarkable was how we adapted: we shared space at our Lombardi Campus, rented exam rooms, and opened the temporary Fiesta Campus made of “clinics in a can”. We operated full clinics, even though we were down about 20 exam rooms.

Throughout COVID, I’ve seen the same resiliency in our team. We share a mission to serve the underserved and to address health disparities. It’s our commitment to this mission that ultimately motivates us to cultivate resilience and work together to anticipate and meet challenges like the pandemic.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

Ultimately, I think we’re going to see telehealth become a lasting, key part of delivering care. Hopefully, this also means FQHCs will get permanently approved for telehealth reimbursement since the current waiver from CMS is temporary. 70% of our patients are Medi-Cal members who benefit from the ability to see us remotely and the continued option of telehealth can make their medical visits more accessible even after the pandemic.

Another important change is a shift not just in awareness of how inherently inequitable our health care system is, but actual practices and policies to address those inequities.

Because of the pandemic, what permanent changes has your health care operation made or is in the process of making?

What’s permanent these days?! In all seriousness, I think the biggest change is more of a re-commitment. COVID confirms how important equitable, culturally responsive health care is. It can mean life or death, sickness or health. For us, that means more motivation to continue our hard, important work - whatever it takes.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

I am fortunate to work with a wonderful team of leaders who share a mission that’s heartfelt and important. I am especially inspired by our COO, Gabriela Bernal Leroi. She truly understands what it means to be a team and meet the needs of our community. Gaby is wholly committed to operational excellence and that she is also bilingual and bicultural helps her connect to patients and staff alike.

What are two of your organization’s biggest goals for 2021?

We have two major priorities for 2021. First, we want to protect our community from COVID-19. It’s a massive undertaking, which we’re definitely seeing as different states roll out their vaccination plans and will involve collaborating with external partners in ways and at a level that we haven’t so far to be able to deliver mass vaccination.

Our second priority is always our priority: to continue to aggressively pursue quality improvement as part of our commitment to eradicating health disparities, particularly in hypertension, diabetes, child health care, and women’s health for our 40,000 plus low-income and ethnically diverse patients.

Dan Peterson

CEO

Sutter Santa Rosa Regional Hospital

30 Mark West Springs Road, Santa Rosa 95403

707-576-4000

www.sutterhealth.org

What memories stand out most as you recall the impact of the coronavirus on your institution?

My strongest memories of this time will be twofold: First, is a mental picture of our frontline caregivers carrying the weight of the world on their shoulders. These hospital staff have worked so incredibly hard, under relentless stress over the past year never knowing what the next day would bring, but they have always shown up, and they have always been strong enough to keep going despite it all.

Next, is the mental picture of the staff vaccine clinics we implemented at the end of the year. I will always remember walking into that clinic and feeling the sense of contrasting hope and optimism amongst our staff like a ray of hope shining through a cloudy sky when we needed it most.

Describe two things you see as the pandemic’s lasting impact on health care, and why.

I think it has brought about an acceleration in the much-needed shift to telehealth. Video visits had been growing slowly prior to COVID, but this has really forced the adoption to happen faster than it otherwise would have. I view this as a fantastic development that will make healthcare significantly more accessible and convenient going forward.

The pandemic has also made the world much more aware of the basic principles of cleanliness and infection control that we have practiced in hospitals for years. I believe we will see reductions in many transmissible illnesses in the years to come similar to what we have seen with a decrease in seasonal flu transmission this year.

In what ways have the experiences of last year changed the way you approach your work?

I have come to even further appreciate the value of a strong team. Trying times always expose your weaknesses and gives you clarity on your strengths, and so I think it has accentuated the importance of making sure we are always doing the work of holding our teams accountable and expecting excellence from them because I don’t think you could survive a time like this without having laid that foundation ahead of time.

Karin Reese, M.S., R.N.

Chief Nursing and Administrative Officer

MarinHealth

250 Bon Air Road, Greenbrae 94904

415-925-7000

www.mymarinhealth.org

Biography

Reese has over 35 years of clinical, teaching and administrative experience in acute outpatient and home care settings. She has held nursing management positions in hospitals across Northern California and Washington. She received her B.S.N. from Humboldt State University and her M.S. in nursing from the UC San Francisco.

What memories stand out most as you recall the impact of the coronavirus on your institution?

The opening of MarinHealth Medical Center’s Oak Pavilion in September 2020 stands out as my most significant memory since COVID-19 impacted our community. For perspective, MarinHealth’s original hospital was built in 1952 to serve 50,000 people. The local population has since soared to 250,000 and medical science has advanced dramatically.

The new five-story, 260,000-square-foot building houses 114 private patient rooms; an expanded emergency department and trauma center with separate entrances and treatment areas for trauma, psychiatric and high-security patients; and six operating rooms, three of which are equipped with state-of-the-art Interventional Radiology equipment.

It was built from the ground up to support an all-inclusive approach to healing the whole patient. The hospital leverages its natural surroundings, as well as best practices in modern healthcare building and design. Each patient room contains floor-to-ceiling windows with views of either Mount Tamalpais or the hospital’s gardens that maximize natural light. Designated zones allow staff the space to seamlessly maneuver equipment, as well as room to unfold a cot for overnight visitors. The absence of nurse station columns, commonly found in hospital layouts, provides clear sight lines for monitoring patients.

I also appreciate that the building reflects our county’s sustainability values. As I write this, the new Oak Pavilion is positioned for LEED Gold certification, an internationally recognized green building certification system that provides third-party verification that a building or community was designed and built using strategies aimed at improving performance across all the metrics that matter most. This includes energy savings, water efficiency, CO2 emissions reduction, improved indoor environmental quality, and stewardship of resources and sensitivity to their impacts.

Now, describe two things you see as the pandemic’s lasting impact on health care, and why.

One way the pandemic will have a lasting impact on healthcare is the way organizations prepare for future surges and health crises. To take care of the future needs of their communities, organizations will prepare by stockpiling personal protective equipment (PPE), make improvements to their consumer platforms, and have strategic plans in place to maintain strong financial security. Another lasting impact is that hospitals and clinics will continue to make investments in technology and design that make it ideal for operating during future health crises.

At the beginning of the pandemic, when the county issued stay-at-home orders, we mobilized quickly to provide our hospital with virtual care services. This included upgrading medical equipment and laptops that would support high-quality video interactions with patients. The telehealth program has been so successful to date, that I believe virtual doctor visits could become the new norm for many.

Because of the pandemic, what permanent changes has your health care operation made or is in the process of making?

We plan to always be prepared for the next health crisis that hits our community, whenever that may be. We’re making it a priority for our staff to be better prepared for the future. This includes stockpiled PPE, maintaining strong financial security, and working on increasing the testing of innovative healthcare platforms by our patients, staff and providers.

As I mentioned earlier, the switch to telehealth for us was transformational. We’ve found that virtual care visits not only increase care access, but it also offers incredible convenience. An individual no longer has to take time off work, get in their car, drive to their provider’s location, find parking, sit in a waiting room etc. To give you an example of telehealth’s popularity, we’re currently seeing a 60-40 ratio split between people using telehealth versus in-person physician visits. I think telehealth is going to continue to be a major way we engage with new and existing patients.

In what ways have the experiences of last year changed the way you approach your work?

This pandemic has really helped us to better prepare and respond to potential future health crises. It’s taught us to think and react quickly and efficiently, allowing all of us to focus on what we should be doing and what we do well. I’ve also learned how to be a better strategic partner with Marin County’s Health and Human Services. By working in lockstep, we’re able to quickly get our share of vaccines, better communicate with our community and get more needles into people’s arms.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

The person who inspired me the most over the past year is our new CEO, Dr. David Klein. Unlike other hospital senior leaders, David spent 14 years as a general surgeon, so he has a grounded perspective as to what’s required to keep the staff inspired and happy. In addition to ensuring the hospital consistently maintains the highest quality and safety, he bases his decisions on keeping the patient at the center of everything we do. Dr. Klein came into the position in the midst of the pandemic, firmly took the reins and guided the hospital through a turbulent time, which I think is at least partly due to his being able to relate to people on both a patient and physician level.

Do you have growth plans for your organization this year, such as adding services or increasing staff?

In addition to opening our first urgent care clinic, our growth plan includes expanding our relationship with UCSF, which was formed in 2018 with the goal of improving patient care and strengthen physician practices for the Marin County. As nonprofit entities, both MarinHealth and UCSF Health share a core value and mission of offering high-quality care for the entire Marin community. We plan to leverage this partnership much more in 2021 to increase our physician recruitment and provide our community with more access to care.

Shannon Thomas

Chief Administrative and Nursing Officer

Sutter Health’s Novato Community Hospital

180 Rowland Way, Novato 94945

www.sutterhealth.org

What memories stand out most as you recall the impact of the coronavirus on your institution?

The teamwork and flexibility this team demonstrated during the early stages of COVID continues to be my fondest memory. Information was coming so fast and changes occurring so frequently, the team could have easily gotten overwhelmed. Instead, they embraced the situation with empathy, compassion and patience. Those same characteristics have carried us throughout the pandemic.

Describe two things you see as the pandemic’s lasting impact on health care, and why.

The pandemic forced many health care organizations to deliver care in a different way. We have seen Emergency Department (ED) volumes drop significantly. At the same time, we have seen virtual visits with physicians increase substantially. I think we will continue to see a demand from patients to have virtual visit options with their physicians.

In what ways have the experiences of last year changed the way you approach your work?

I’ve had to slow down and take each day hour by hour. There was so much to learn, so much information coming all at once, and constantly changing. My two most important roles during the pandemic were disseminating important information in a timely manner and rounding to ensure that information was understood by those receiving it. There was fear involved, but I found by getting out and rounding with my teams and answering their questions the fear subsided and was replaced with confidence and determination that we were all in this together and we would overcome it together.

Tell us about one person in your organization who inspired you in the past year and why it was so memorable.

This past year was truly a team effort. The collaboration I have witnessed between departments has been inspiring. Everyone, from admitting, environmental services, food & nutrition, lab, pharmacy, care coordination, administration and of course our front-line clinical team, has my eternal gratitude for giving so much of themselves professionally and emotionally in what was a very memorable year.

—

Norair Jemjemian

Senior Vice President and Napa-Solano Area Manager, Kaiser Permanente Area

Norair Jemjemian is responsible for health plan services, hospital operations, and services provided to members outside of the hospital setting, including continuing care, pharmacy, and health plan regulatory services. He has more than 25 years of hospital, health plan, and medical group management experience. This includes 25 years with Kaiser Permanente and 2 years with HCA Healthcare. His experience includes positions such as chief operating officer and CFO.

Jemjemian holds a master’s degree in business administration in management and leadership from the University of LaVerne and a Bachelor of Science degree in finance from the California State University, Northridge.

Naveen Kumar, M.D.

Physician in Chief, Kaiser Permanente San Rafael Medical Center

Naveen Kumar, MD joined TPMG as an Interventional Radiologist (IR) in 2007 and has served in multiple leadership roles including Chief of IR, Regional Chair of IR, and Elected Director to the TPMG Board. Prior to that, Dr. Kumar attended medical school at the University of California, San Francisco where he stayed for radiology residency and IR fellowship after doing a year of an internal medicine residency at the Kaiser Permanente Oakland Medical Center.

Tarek Salaway, M.H.A., M.P.H., M.A.

Senior Vice President and Marin-Sonoma Area Manager, Kaiser Permanente

Salaway has 25 years of leadership experience across multiple health care systems, including CEO for Providence St. Joseph Health Mission Hospitals; COO for USC’s Keck Medical Center and Norris Cancer Hospital; and executive director of Cardiovascular and Neurosciences for Stanford Health Care. He holds master’s degrees of health care administration (M.H.A.), of public health (M.P.H.) with an emphasis in epidemiology and health services, and of arts in international relations (M.A.) from the University of Washington. He also has bachelor’s degrees in political science and French literature from the UC San Diego.

Michael J. Shulman, M.D.

Physician in Chief, Kaiser Permanente Santa Rosa Medical Center

Shulman graduated from Occidental College with a degree in chemistry and received his master's degree in chemistry from Harvard University and the Swiss Federal Institute of Technology in Zurich, Switzerland. After medical school, he completed an Internship in general surgery and residency in urology at the University of Texas Southwestern Medical Center in Dallas, Texas. In 2006 Dr. Shulman joined The Permanente Medical Group. He served as Santa Rosa's Chief of Urology for over nine years before being appointed Physician-in-Chief for the Santa Rosa Medical Center in 2017

Christopher Walker, M.D.

Physician in Chief, Napa-Solano Area, Kaiser Permanente

Walker leads approximately 700 physicians, and over 3,000 medical personnel across two medical centers and three clinics. Originally from Southern California, he graduated from the University of California, Santa Barbara before joining the United States Air Force to pursue his medical degree. He completed his family medicine residency at David Grant Medical Center at Travis Ari Force Base and served in many clinical roles overseas before his separation from the military.