At the height of the pandemic, New Jersey-based RWJBarnabas Health had an estimated 1,800 COVID-19 inpatient cases.
Now that the surge has subsided to the point that the network is managing less than 100 inpatients with the virus, president and CEO Barry Ostrowsky believes his team is not only set up to recover from the past surge of cases, but also positioned for future growth.
"We were lucky we never had to make serious choices between and among patients," Ostrowsky said. "And while it was a struggle to ensure that we had sufficient equipment, and sufficient PPE, and sufficient drugs, we were, in fact, able to get through it. But I wouldn't be candid if I told you there weren't nights and weekends and days where we came dangerously close to saying 'We don't have what we need.'"
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The system's endurance through the pandemic can be attributed to three main sources: the leadership's management philosophy, the hard work of the clinicians and a strong financial setting prior to the outbreak.
RWJBarnabas has been fortunate enough not to have furloughed or laid off staff members during or after the pandemic, Ostrowsky said.
"The policy that I established is that our communities have suffered enough and I am not going to create more unemployment for the very communities that are suffering," he said. "To the extent we have to defer some projects, perhaps that's what we'll have to do. But I'm not in a position to recommend a reduction in workforce just to make the financials look that much better."
Beyond ensuring job security for its employees, RWJBarnabas relied on its healthcare staff to get through the toughest times.
If one hospital in the network was facing greater volumes and demand, employees from other facilities switched locations to help. Team members cross-trained in new positions to ease some of the burden. Clinicians stepped into leadership roles and formed care teams to manage the increased workload.
"From a management standpoint, sometimes the best management is to get out of the way and let the clinicians do the work," Ostrowsky said.
|RWJBarnabas CEO and President Barry Ostrowsky|
The network is even leaning on its staff to help formulate plans for the possibility of a second wave.
At the onset of the initial surge, Ostrowsky asked everybody to keep a diary of their experiences working during the pandemic. The system is now using the personal stories of its employees to lead the way for its resurgence strategy.
"The resurgence plan we have is a good one, of course. It's informed by the experiences that we were able to codify in real time when it was happening," Ostrowsky said. "I don't want to have to implement it, but if it gets to the point where the demand for inpatient care is such, I'm pretty confident about it."
Like most hospitals and health systems, RWJBarnabas' finances were significantly impacted by the pandemic. The services that generated most of their revenue were halted, and even the federal assistance they received wasn't enough to make up for the lost earnings.
But what has proven to be a key part of the network's recovery is having a strong balance sheet before the pandemic began, according to Ostrowsky.
That, along with having a diversified health system that was able to generate revenue during the lockdown through virtual care, was able to cushion RWJBarnabas' finances during a period of hardship.
"So if you put all that together, it's not as though you come out unscathed. You do, of course, have weaker financial results, but no weaker resolve to pursue the mission," Ostrowsky said. "I think we are lucky enough to have been, as I say, blessed with a balance sheet that allowed us to continue."
ACQUISITION AND INTEGRATION
As the health system begins its next phase after COVID-19, it has begun to seek out new partnerships. In September it signed a definitive agreement to integrate with Saint Peter's Healthcare System.
The two systems will work together to build a 1,000-bed academic medical center across several campuses that Ostrowksy hopes will become a "national destination" for a variety of programs and research.
RWJBarnabas is also preparing to announce a definitive agreement to acquire Trinitas Regional Medical Center after the two signed a letter of intent last year.
Additionally, the network has begun pursuing ambulatory care sites to acquire, knowing that those locations will host a significant amount of care moving forward.
In the end, what Ostrowsky attributes the network's survival to is the "heroic" work that his clinical staff conducted over the course of the pandemic.
"There was no way that we were going to let them down by making decisions that would negatively impact not only their morale, but the energy they brought to treating patients," he said. "So that's how we got through it."
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The Business of Health
This special collection of stories, which will be updated throughout the month, explores how hospitals, health systems and physicians are attempting to not only financially survive, but thrive, under the new normal.