It was the spring of 2020, and Dr. Christian Bergman – like so many physicians specializing in the care of patients in the senior population – was concerned. Reports that COVID-19 was spreading quickly in Washington State and then New York, especially among older Americans, had him fearing a worst-case scenario.
“If the virus gets into the Richmond metro area, how many millions of people do we have? How many people are susceptible?” he wondered. “If you have a major outbreak in a facility with 200 patients, within 48 hours, you could have a mass casualty event.”
Protecting Virginia’s most vulnerable
Dr. Bergman’s patients, in particular, were potentially at risk. He is the medical director of a physician group that practices in 12 area nursing homes, providing direct patient care as well as clinical care. While members of his team at the time were connected to the Governor’s Task Force on COVID-19, giving them access to up-to-date information, they recognized that sharing information and best practices among practitioners throughout Virginia would be critical if they were going to be able to suppress the spread of the disease and ultimately save lives.
As spring turned into summer, alliances began to form, and Dr. Bergman and his group forged a partnership with the Virginia Center on Aging, which was seeking federal grant funding to support the COVID Action Network. They were creating a hub-and-spoke model for educating the geriatric community on how to best address the issues that everyone was confronting.
“We focused on what we found were the exemplary nursing homes, and from their work, create and fine tune a quality curriculum,” said Dr. Bert Waters, associate director for the Virginia Center on Aging.
VCU ECHO Nursing Home COVID Action Network
The centerpiece of the educational efforts was Project ECHO, a program at the University of New Mexico that creates what it calls a “virtual community of practice,” enabling the medical community to share information and best practices with one another, creating a ripple effect of medical knowledge farther and wider. The advent and growing popularity of telehealth is helping propel its success.
Dr. Waters reports that they were able to recruit more than half of Virginia’s 273 eligible nursing homes to participate in the network. The participating nursing homes were grouped into four cohorts and in coordination with a quality improvement expert from the Institute for Healthcare Improvement, the program developed and implemented 16 weekly 90-minute ECHO sessions for each of the cohorts. The sessions promoted collaboration, sharing success stories and following up on quality improvement projects. Important topics, such as vaccine distribution and strategies for vaccine acceptance, cohort practices, testing and visitor policies were reviewed with the facilities.
By November, the numbers began to come down, even with concerns about the upcoming holidays having the potential to fuel another wave.
“When we recruited, we highlighted that this is to share best practices to share some of the success stories of other facilities – it was kind of a peer networking community where you could talk to others who were going through the same issue,” said Dr. Bergman.
“I think the best part about it was the sharing best practices among the different nursing homes and the communication between them because that is something new for them; they had never experienced it before,” added Dr. Waters.
While the program has initiated new collaborations with nursing homes across many healthcare disciplines, it also will help to foster innovative ways to collaborate virtually in a post-COVID-19 and virtually connected world.
The team hopes to build on its success. Earlier this spring, they began to undertake a Continuation Phase of the grant, giving the network the opportunity to continue to learn from one another.