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All In for New York: Q&A With Hospital for Special Surgery CEO Lou Shapiro

Analysis  |  By Jim Molpus  
   April 02, 2020

HSS suspended all nonessential surgeries, expanded capacity, and is treating patients from other hospitals in need of emergency orthopedic surgery, medical-surgery and critical care, regardless of COVID status.

Hospital for Special Surgery, based on Manhattan’s East Side, is the largest and most highly rated orthopedic hospital in the United States, annually performing more than 32,000 surgical procedures. This week, HSS became a general acute care hospital as New York City faces the COVID emergency.

HSS has suspended all nonessential surgeries, freeing up most of its 215 licensed beds to act as overflow for non-COVID patients from other Manhattan hospitals, says HSS President and CEO Louis Shapiro.

HSS has also expanded virtual care and created four ortho urgent care facilities to take the volume of patients still needing required orthopedic care. For hospitals across the country, the question that HSS faced may come to them: no matter what your usual mission, what can you do to help?

Shapiro spoke with HealthLeaders editor Jim Molpus about the opportunity to lead right now.

HealthLeaders: Tell us how you started to flip the switch so HSS could provide essential care during the outbreak.

Shapiro: HSS continues to provide essential on-site care and has added a rapidly broadening virtual care offering as well as urgent ortho care options at four locations throughout the tristate area. By proactively suspending all nonessential surgeries on March 17, we made bed capacity, supplies, and staff available to help neighboring hospitals treat their COVID-negative patients who require essential orthopedic surgery, medical-surgery, and critical care. 

As the strain on the New York City healthcare system continues to grow, we recognize the need to do more and are further executing on our surge plan to use all available capacity across our system. We are working closely with neighboring NewYork-Presbyterian to fill an expanded HSS capacity of well over 200 beds by also receiving COVID-positive patients starting today [Wednesday, April 1]. We are now treating patients with emergency orthopedic needs, regardless of COVID status. We will also treat COVID-positive patients who require ventilators or intensive care. We will continue to care for COVID-negative patients on several floors of the hospital as well, including medical-surgical patients and patients who have had other types of surgeries.

HL: Have you calculated the financial impact of that?

Shapiro: March 17 was when we published our own guidelines on what the definition of essential musculoskeletal care was. When we implemented that, we quickly ramped down from 100% to less than 20%. You do the math yourself. We are a $1.8 billion organization. The cost to the enterprise is enormous, but in this environment, united we stand. We are all in, every way you could be in.

HL: We’ve all read the stories of the incredible sacrifice and stress that healthcare professionals in New York are under. How is your team holding up?

Shapiro: They're all heroes, number one. They are all heroes. If you go outside in New York at 7:00 PM, you hear a chorus. That's everyone coming outside going to their balconies applauding healthcare workers. I can only speak for our situation, but the people here are extraordinary. We had more than 900 people volunteer to go to NewYork-Presbyterian to help them. We’ve deployed about 50 of them. The culture is what drives our reputation and our results. You just never, ever cease to be surprised by the commitment and passion for people we have.

HL: How's the supply chain breakdown affecting HSS?

Shapiro: Don’t forget we are in a short tunnel. The peak in New York is in 11 days or more. It's a problem. We have a lot of academic relationships with China, so we have been purchasing supplies through the global supply chain. And there are good people who have been donating PPE. But PPE is still a challenge for the industry, for sure. Ventilators is the major problem, which is, I think, catastrophic for a variety of reasons.

HL: Can you share any crisis management direction you have given your team?

Shapiro: Our leadership team has two goals: Earn your leadership position and make HSS more accessible. For the organization, we have five principles that have been guiding us for the past three weeks: Protect our staff, protect our patients, protect our organization, protect society, and communicate frequently and transparently. As soon as I know something, you'll know something. And literally every decision can be put against those principles.

Editor's note: This story has been updated. 

“How you take care of people in good times is how they take care of you in times of challenge. ”

Jim Molpus is the director of the HealthLeaders Exchange.

Photo credit: Courtesy HSS


In two weeks, HSS flipped its model from orthopedic hospital to a general acute care model to help in the emergency.

900 HSS team members volunteered to help other hospitals.

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