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5 Years Later: What CMOs Learned from COVID-19

Analysis  |  By Christopher Cheney  
   January 16, 2025

Top clinical officers at NYU Langone Health and Scripps Health share what their organizations learned from the coronavirus pandemic.

It has been five years since the first case of COVID-19 was diagnosed in the United States, and a pair of top clinical officers says there are a dozen lessons learned from the pandemic.

On Jan. 20, 2020, the first case of COVID-19 in the United States was diagnosed in Snohomish County, just north of Seattle, Washington. The ensuing pandemic exacted a heavy price on the country, with more than 111 million cases and 1,219,487 deaths reported through April 2024, according to worldometer.

At NYU Langone Health, one of the lessons learned from the pandemic was the value of preparation, according to Fritz François, MD, executive vice president, vice dean, and chief of hospital operations at the health system.

NYU Langone Health has been holding tabletop exercises for disaster scenarios once or twice a year since Superstorm Sandy in 2012.

"On Jan. 8, 2020, we held a tabletop exercise for an outbreak of a respiratory virus," François says. "The question was, what would we do? The entire organization came together to think about what we would do for an outbreak. Just a few weeks later, there was an incredible outbreak worldwide and a pandemic would be declared. We had lead time to prepare."

Several aspects of that tabletop exercise were applied during the pandemic, François says.

The health system talked about having a core group of individuals who were trained to take care of respiratory virus patients. They dedicated the ICUs as areas to care for the sickest patients, and intensivists who could take care of these patients. They talked about making sure they had the right equipment and supplies, and talked about having the right protocols to support the patients.

Lessons learned at NYU Langone Health

NYU Langone Health learned six primary lessons from the pandemic, according to François.

First, health system leaders need to think about where patients are going to go during a respiratory virus outbreak. They need to think about where respiratory virus patients are going to be placed in emergency rooms and hospital inpatient units.

Health system leaders also need to think about load-balancing patients at multiple hospitals.

"You need to consider hospitals that are being overwhelmed versus hospitals that are not overwhelmed," François says. "You have to coordinate where patients are sent."

Second, health system leaders need to think about personnel. They must determine whether they have the right personnel, not only in terms of specialists who can care for individuals with respiratory illnesses but also nurses and technicians.

"You need to think about the group of individuals who need to come together to provide care for patients," François says.

Third, health system leaders need to acquire adequate supplies of personal protective equipment (PPE) for staff members.

"We had thought about it in advance, and we ensured that all of our staff had the appropriate PPE," François says.

Fourth, health system leaders need to provide the necessary products and equipment in their supply chain. In the case of the pandemic, this included respirators and monitors.

Fifth, health system leaders must implement the proper processes and protocols. For example, there should be processes for moving patients from one area to another. Treatment protocols were a challenge during the pandemic because COVID-19 was a novel virus.

"You need to have evidence-based protocols to ensure that care is being provided effectively," François says. "Our protocols were reviewed by subject matter experts. When new data came out, we updated the protocols."

Sixth, health system leaders should focus on performance. At NYU Langone Health, this meant developing a plan to respond to the pandemic and measuring how the health system performed.

"We developed a dashboard that allowed us to understand how many patients were coming through the emergency departments, how many patients were being admitted, how many patients were in the ICU, how many patients were on ventilators, and how many patients did not survive," François says.

Standardizing care is essential to achieve a high level of performance, according to François.

"By standardizing care, we wanted to make sure that anyone who came to our health system—whether it was Manhattan, Brooklyn, or Long Island—received the same quality of care," François says. "From a health equity perspective, this was critical."

Lessons learned at Scripps Health

Scripps Health also learned six primary lessons from the pandemic, according to Ghazala Sharieff, MD, MBA, corporate senior vice president as well as chief medical and operations officer for acute care at the health system.

First, Scripps learned that the health system could ramp up telehealth services.

"Before COVID hit, we saw 188 patients through telehealth in a six-month period in 2019," Sharieff says. "In the peak of COVID, we were seeing 3,000 patients a day through telemedicine."

Second, Scripps learned the value of virtual meetings for staff members.

"We have become much more efficient in our meetings," Sharieff says. "There is value to in-person meetings, but for things that are routine such as operations meetings and updates, we are doing that effectively through virtual meetings."

Third, from a CMO perspective, Sharieff learned the value of having a regional CMO group meeting regularly during the pandemic.

"We realized early on during the pandemic that there was conflicting information from the Centers for Disease Control and Prevention, state authorities, and county officials," Sharieff says. "CMOs from across our region needed to get together, so we could have a consistent message going out to our staff."

The regional CMO group was able to join forces on advocacy during the pandemic. As a group, they were able to send a letter to the state saying that weekly staff testing was not feasible.

"There was a point in time when the state wanted us to test every staff member for COVID every week," Sharieff says. "It was not practical. We didn't have enough tests for the patients who were sick."

Fourth, Scripps understood that working as a health system rather than a collection of five individual hospitals is important during a crisis. Like NYU Langone Health, Scripps used load balancing to make sure that none of its hospitals were overwhelmed during the pandemic.

"We are much more proactive now," Sharieff says. "We learned how to pivot and move quickly."

Fifth, as a CMO, Sharieff discovered the value of working closely with the health system's supply chain.

"I recommend that CMOs across the country get more involved in their supply chains," Sharieff says.

Sixth, Sharieff learned that a CMO must be intimately involved in crisis management during a pandemic.

"A CMO should be present in the command center and not delegate that work," Sharieff says. "You need to roll up your sleeves and do the work."

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

NYU Langone Health benefited from holding an exercise on responding to a respiratory virus outbreak a few weeks before the coronavirus pandemic began.

For health systems with multiple hospitals, load balancing patients between hospitals can ensure that a hospital is not overwhelmed during a pandemic.

CMOs should be involved in their organization's supply chain.


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