Emerson Hospital: An Interview with President Christine Schuster

Emerson Hospital is gradually unrolling the welcome mat.

Well, not for everyone just yet, but certainly for residents who have been delaying necessary medical procedures because of fears of contracting the coronavirus.

“The hospital is a safe place to be,” declared Emerson President Christine Schuster in an interview this week. “Our priority during this whole crisis has been to keep our staff safe so we could keep patients safe. The tide is shifting and the recovery planning is underway.”

Emerson, like all Massachusetts hospitals, was directed to clear space for an anticipated surge of patients suffering from Covid-19. But unlike metropolitan hospitals, the surge never came to Concord and most of the other 26 towns in the hospital’s service area, from Bedford and Lexington to Hudson to Pepperell.

According to data from the state clearinghouse for Covid-19 information, on Wednesday there were 51 patients with the virus hospitalized at Emerson but only seven in intensive care. Four weeks earlier, the numbers were 20 and four, respectively.

“We had 32 ventilators, but we never used more than four or five at a time,” Schuster reported. Through our own funds and some donors’ funds, we opened a second intensive care unit with a capacity of 32. We had to prepare for a surge that never came.” On some Monday mornings, the emergency room was nearly empty.

But that doesn’t mean the virus isn’t a constant presence.

“As we start to open for necessary surgery, we have a separate, dedicated entrance for surgical patients so they do not cross paths with Covid patients,” said Schuster, who is a registered nurse. “We isolate coronavirus patients in a separate in-patient wing.”

“We have enough personal protective equipment (PPE) and the staff is regularly checked for symptoms. We follow CDC guidelines for cleaning. Everyone wears a mask. And here are no visitors unless someone is dying.”

“For weeks now, people have been putting off care,” Schuster said, whether a painful shoulder, a biopsy, whatever. “So now, with a doctor’s recommendation, we are bringing back urgent cases that may have gotten worse.  Call your doctor if you are not feeling well. Most Emerson doctors are using telehealth for care that does not require an office visit.”

Elective surgery will resume after state officials give the go-ahead, she added.

The hospital, Schuster said, “has totally changed the way we operate to create a safe environment. Staff never bring anything in from their homes; the get a clean change of scrubs here every day.

Schuster acknowledged that the hospital leadership has a plan if down the road there is an increase in Covid cases. “We’re worried people won’t follow the guidelines,” she said.

She is also concerned that Emerson “will be competing with every other industry for PPE when things reopen. We are the ones who keep people safe and keep people alive. You can never balance health and wellness with the economy.”

Schuster said Emerson’s senior management team is working closely with the Massachusetts Health and Hospitals Association and the Partners HealthCare network, with which the hospital is clinically associated.

“I’m on calls three times a week with my peers,” Schuster said. “We very much try to work together and have a coordinated approach. Our open line of communication with [State Health and Human Services Director] Marylou Scudders has been fabulous.”

This pandemic has gutted the financial stability of all hospitals, including Emerson. “We’re trying to figure out how to get back on our feet,” said Schuster, whose annual financial statements consistently have been in the black.

“We did everything we were asked to do” by state government, and as a result the hospital had a dearth of in-patients. “We’ve lost millions in revenue.”

The wellness center around the corner on Baker Avenue is basically shut down because of social distancing requirements, Shuster said. The rehabilitation center is closed because there are no surgery patients referred there. Some exercise classes are being streamed to subscribers, she noted.

Before the crisis, Schuster said, “75 percent of our revenue came from ambulatory outpatients.” Indeed, that was the business plan. “For years, everything was pushed to the lowest cost settings And it’s almost like it backfired because we don’t have the in-patient volume. We’ve been so successful for so long with that strategy.”

The Emerson president said she is disappointed so far in the federal and state financial response to the hospital’s needs. “We have done everything we’ve been asked to do.”

She lauded the Emerson workforce. “Our first priority has been keeping the staff safe, and we did everything we could. The Auxiliary made special face masks so they could be role models in the community.”

And the community has shown its appreciation, the president pointed out, including food deliveries A cavalcade of first-responders in their emergency vehicles came from all over the service area to assemble along Route 2. “Our staff was so touched.”

Schuster said a number of staff members were placed on “standby status,” which means that they continue to qualify for benefits and will be recalled as soon as the demand returns. Meanwhile, they are eligible to collect unemployment. “When there are no patients, there’s nothing for them to do,” the president said. “I love our staff, and we are committed to bringing them back.”

There was also a more impromptu “pots and pans parade” and a flurry of notes attached to a tackboard at the entrance. “The community has been here for us, and our vision is caring for the community,” Schuster said. “At the height of this, those little acts and gestures meant so much to our staff.”

Meanwhile, doctors and nurses and others find respite in one if the hospital conference rooms, which has been converted into a sort of spa, with anti-gravity chairs, soothing music, and refreshments.

Schuster also noted that Emerson’s weekly community newsletters includes resources for mental health, substance abuse and domestic violence services.

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