CEOs honored for response
Harvard Business School Club of Wisconsin gives award to multiple health system leaders
Developing protocols for emergency departments, setting up COVID-19 units, finding personal protective equipment, moving to remote work for administrative staff, expanding intensive care units, shifting clinics to telehealth, redeploying and training staff, setting up testing sites — health systems' checklists were long and complicated as they prepared for the pandemic last year.
No one knew what to expect. “Everyone,” said Chris Woleske, CEO of Bellin Health Systems, “was facing the same uncertainty.”
But the CEOs of health systems knew they had to be prepared for the worst. The physicians and nurses at their hospitals would have the task of keeping people alive. And the CEOs had seen what was happening in New York City, where hospitals were overflowing and physicians feared that they would have to ration ventilators.
The state's response to the pandemic would hinge on how well the health systems were prepared.
Few people outside of health care are aware of the work — the hundreds and hundreds of tasks — that went into preparing for the pandemic.
“Many, many emails late into the night,” said Cathy Jacobson, CEO of Froedtert Health. “Phone calls late into the night with different things coming up.”
Many of those emails and calls asked, “Did we think about this?”
“You were awake in the middle of the night thinking of things,” Jacobson said.
There were the inevitable glitches — and, at times, the equally inevitable complaints and criticisms — but health systems throughout the state responded to the challenges.
Harvard Club extends 2021 honor
The Harvard Business School Club of Wisconsin wanted to recognize that.
This year the organization is honoring the CEOs of five health systems for their leadership during the pandemic that has hospitalized more than 35,000 people and killed more than 7,500 in the state.
It is the first time that the Harvard Business School Club has given its award for Wisconsin Business Leader of the Year to more than one person. The award will be given to:
Alan Kaplan, a physician and CEO of UW Health.
Cathy Jacobson, president and CEO of Froedtert Health.
Bernie Sherry, who oversees Ascension Wisconsin.
Jim Skogsbergh, president and CEO of Advocate Aurora Health.
Chris Woleske, president and CEO of Bellin Health Systems.
The top executives of the five health systems, who were selected by a committee, oversee many of the state's largest and most complex health systems.
Every health system in state, though, faced the same challenges.
“We could have had a very long list,” said Lisa Wright, a member of the board of the Harvard Business School Club of Wisconsin and vice president of the Wisconsin Business Leader of the Year Program.
The CEOs will be honored at an event sponsored by the Harvard Business School Club of Wisconsin and the Milwaukee Journal Sentinel. The event, which raises money for leaders of nonprofit organizations to attend a program at Harvard Business School, was originally scheduled for Sept. 8, but has been postponed to a later date.
Kevin Steiner, president and CEO of West Bend Mutual Insurance Co., who was the Wisconsin Business Leader of the Year last year, also will be honored at this year’s event.
The annual event was not held last year because of the pandemic.
Thousands involved in response
Without question, the response to the pandemic was the work of tens of thousands of people in health care as well as the staff of state, county and city public health departments.
“The willingness of individuals to do whatever was needed really was remarkable,” said Sherry of Ascension Wisconsin.
But the health systems would have the task of providing care to highly contagious patients while continuing to care for other patients. And they would have to do that while keeping their staff and patients safe.
That little was known about COVID-19 when the pandemic first hit was yet another complication.
The pandemic reached Wisconsin later than other parts of the country and that helped.
The chief medical officer at Froedtert Health, for instance, put together a group in February to begin preparing.
The health system even ordered additional beds that month as a precaution.
By early March, the health systems had set up their incident commands — the plans they have in place to prepare and respond to emergencies, such as natural disasters.
Then the real work began. Ascension Wisconsin’s incident command was making decisions “by the minute, by the hour and by the day,” Sherry said.
Ascension Health, its parent organization, also set up a national incident command.
“We were able to really learn quickly what was happening across other markets,” he said.
Froedtert Health’s incident command met every single day for six to eight weeks, Jacobson said.
At the same time, the health systems moved physicians and clinics to virtual visits, or telehealth — while also moving administrative staff to working remotely — within days.
They also redeployed thousands of workers.
Advocate Aurora Health, the largest health system in Wisconsin and Illinois, reassigned more than 5,000 clinical workers to meet or prepare for surges in its emergency departments and intensive care units.
The health system developed virtual tools to assess where to place people based on their experience, skills and training. And it developed online learning modules to prepare nurses and others for new roles.
Twice a day it held calls for its entire system to address immediate or anticipated staffing needs.
Complicating all this was their own people were coming down with COVID-19 or had to be quarantined because they had been exposed to someone who had.
Unique levels of cooperation
Throughout the pandemic, the health systems worked together — perhaps to an unprecedented degree.
The CEOs of the health systems in southeastern Wisconsin, for instance, scheduled weekly calls. Their chief medical officers also were meeting weekly or as needed.
The leaders of four health systems in Green Bay were talking almost daily at one point, Woleske said.
They coordinated the change in the policies on visitors to their hospitals, preventing people from wondering why one health system was limiting visitors when another wasn’t. They notified each other when they moved or set up new testing sites. And each day they shared how many COVID-19 patients they had.
“It was amazing the collaboration that occurred immediately among the health care CEOs,” Woleske said.
At the same time, the health systems were working with cities, counties and the state as well as with the seven regional Healthcare Emergency Readiness Coalitions in the state. Everyone did their part.
UW Health participated in two clinical trials for COVID-19 vaccines.
The health system also made its physicians, epidemiologists and other experts, who were on the faculty of the University of Wisconsin School of Medicine and Public Health, readily available to reporters to help people understand the pandemic as it evolved.
Froedtert Health’s Wisconsin Diagnostic Laboratories moved quickly to expand its capacity to do COVID-19 tests, ordering additional equipment before the pandemic hit. It also put in place the ability to do COVID-19 tests that required different mixes of chemicals, so that it was not reliant on one supplier. That was all-important when supplies were scarce.
Wisconsin Diagnostic Laboratories has done roughly one in four of the COVID-19
tests in the state, Jacobson said.
Ascension Wisconsin took the lead in helping staff the so-called alternative care facility, or field hospital, at State Fair Park in West Allis on the chance that hospitals would be overwhelmed by COVID-19 patients.
Sherry reached out to two retired executives from Ascension Wisconsin who agreed to oversee the field hospital.
The health systems throughout the state, though, also knew this would be a test.
“We wanted to be remembered for three things — for taking good care of our team members, our patients and our community,” Skogsbergh, president and CEO of Advocate Aurora, said in an email. “We wanted to look back on Advocate Aurora Health’s response and know that our system did right by those we serve.”
Large financial losses
The initial response took place as the health systems were incurring large losses.
Their revenue plummeted when they stopped doing elective procedures — which account for roughly half of all procedures done at hospitals — to conserve equipment and resources.
The temporary halt in elective procedures and the move to virtual visits, or telehealth, at clinics resulted in some health systems to reduce some employees’ hours or require them to take leaves of absences while keeping benefits, such as health insurance.
Froedtert Health temporarily reduced the salaries of executives and supervisors as well as physician compensation. Bellin Health did the same.
Most of the health systems lost money in the second quarter of last year.
Money from the federal CARES Act — the economic stimulus bill in response to the pandemic — helped offset those losses and kept health systems profitable for the year.
Bellin Health and its affiliates received $32.1 million from the CARES Act and state dollars. Froedtert Health received $90 million. Ascension Wisconsin received $217.6 million through the Cares Act. Advocate Aurora received $786.7 million from the CARES Act and $14.5 million in funding from Wisconsin and Illinois. UW Health received $92.9 million from the CARES Act.
The pandemic made clear health systems’ essential role — a shift from the focus on the steady increase and wide variation in hospital prices. But the pandemic also drew attention to longstanding and entrenched disparities in health care.
Froedtert Health, Ascension Wisconsin and Aurora Health Care, before the merger that created Advocate Aurora Health, have focused on expanding in suburbs rather than low-income neighborhoods in Milwaukee.
Elective surgery pause short-lived
The halt in elective procedures was brief. It also may have been unnecessary — though that wasn’t known at the time. The pandemic initially hit Wisconsin with less force, partially checked by the lockdown in the spring.
Froedtert Health, for instance, was projected to have more than 500 COVID-19 patients in the spring of 2020. The number of patients peaked at 83 at the time. The surge didn’t hit until November, when it had more than 200 COVID-19 patients.
In late October, the state was on track to run out of beds in intensive care units and the nurses to staff them in as little as two weeks. The surge in the fall hit northwestern Wisconsin particularly hard.
That pattern is worrisome as the Delta variant spreads throughout the state. The number of hospitalizations already is rising and could jumped when the weather gets colder and people spend more time indoors.
More than half of the state’s population is vaccinated, and that will lessen the number of people who need to be hospitalized. Physicians also know more about how to treat COVID-19 patients. But the Delta variant remains a concern.
Physicians and nurses have seen thousands of people die from the disease. And providing care for patients with COVID-19, which requires regularly putting on and taking off protective gear, is exhausting.
“People are tired,” said Woleske of Bellin Health. “They have been through a lot.”
Other patients also will continue to need care during any surge in COVID-19 patients.
Many of the state’s health systems have given bonuses to employee to thank employees for their work — though Ascension Wisconsin excluded the nurses and other workers at Ascension St. Francis Hospital who belong to a union.
They also have taken other steps to support their employees.
Froedtert Health, for instance, has continued to provide free meals at its hospital cafeterias for its employees and allows them to take a meal home, an initiative put in place because people often were working long shifts and didn’t have time to shop or prepare meals.
The CEOs of the health systems — those being honored by the Harvard Business School Club of Wisconsin and those who oversee other health systems — had an important role in the state’s response to the pandemic.
But the same goes for the thousands of people who provide care to patients The CEOs know that.
Bellin Health, which employees 5,000 people, has the motto “Team is we get things done.”
“It’s in our DNA. We say it all the time,” Woleske said. “I learned just how true that is in this organization, and that applies all the way from my office to the front line.”
“It truly was an incredible team effort,” she said.