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Dayton General grappling with supply shortages; Gov. Inslee authorizes $2 million for rural hospitals


April 2, 2020

-File photo

DAYTON–The Columbia County Health System (CCHS) has implemented tele-medicine so patients can reach healthcare providers and Gov. Jay Inslee authorized $2 million for rural hospitals.

Columbia County Health System CEO Shane McGuire expressed need for better state and federal funding during this crisis because CCHS is already overtaxed financially. Governor Jay Inslee has since announced $2 million funding for rural hospitals already over-burdened by COVID-19 preparedness and the shutdown of regular patient care in the physical therapy and out-patient clinic departments.

The stress on the CCHS is, in part, because of reducing nonessential visits to combat the spread of the virus for physical therapy, imaging and clinic visits. The staff is "looking at each patient and determining whether the risk of exposure outweighs the risk of not performing their treatment," McGuire said. But this reduces the revenue by $1.2 million gross per month and this is while there has been increased spending to prepare for a potential COVID-19 outbreak in the area.

The CCHS has received aid from the Healthcare Authority and McGuire reported contacting State Rep. Skyler Rude, who plans to communicate with fellow representatives Eileen L. Cody, D-34 and Joe Schmick, R-9–two senior members of the House who are influential in regards to healthcare legislation. McGuire also has had contact with Congresswoman Cathy McMorris-Rodgers and Senator Maria Cantwell's offices.

McGuire spoke of other help received, locally and elsewhere from his report. "We've had a tremendous outpouring from our community, but from people everywhere really," said McGuire. "Seneca donated two boxes of N-95 from their stock, Public Health has produced procedure masks, we've had several donations from various places including Pennsylvania and Maryland. Our community has seamstresses standing by to sew masks for us, if needed. It is mind-blowingly humbling and I can barely type this without emotion."

CCHS is applying a new approach to care for residents in Booker Home, while at the same time preserving the supply of protective gear. This approach is through tele-medicine.

Chief of Staff Kyle Terry, M.D., and other care providers, if they should become sick, are now able to remotely visit with patients. The tele-medicine is also set up to check-in on patients through a mobile computer that goes from room to room. This limits risk of possible transmission, as well as the need to use fresh protective gear required to visit with each patient.

McGuire says the hospital has made changes "to accommodate more isolation patients in a negative air environment. We've also made changes to our screening and triage spaces. We are working closely with our regional partners to communicate our place and readiness to respond by taking acute and swing patients. We are also communicating our limitations regarding vented patients or ICU level of care patients." Visitor policy has been changed for inpatients and is not allowed with current patients except for a few instances.

This is just one of the many adaptations the CCHS has made which was discussed at the most recent board meeting. Staff is now screened at any sign of symptoms and are then quarantined.

Currently, there are two staff members who are isolating at home because of contact with a patient who was tested for COVID-19 in Walla Walla, and who didn't have results back when he came to visit the CCHS clinic. Another staff member is self-isolating due to a cough and is awaiting results of the test.

When staff is out, it can tax the system and McGuire has requested an emergency staffing plan, should the need arise. More generally for preparedness, the staff has adopted a chain of command. Staff are also being trained on the use of two new respirators.

"I really do appreciate all the support I have been receiving from Dr. Terry, as the new Chief of Staff and the medical staff, in general, said McGuire. "There were a lot of elements to this crisis that were simply beyond my capacity to make executive decisions on, and they have been providing fantastic advice and guidance to me. I think it's to the credit of the team here, and definitely to the benefit of the community."

Publication of a recent front-page piece about CCHS in the Washington Post (see accompanying article) and possible other stories in the Post, ABC Nightline and local papers, McGuire hopes to bring the need of rural healthcare funding greater attention.


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