Tag: Eric Swensen

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Stretched thin: Still short-staffed, UVA hospital workers hold out for reinforcements

Though UVA Health System’s furloughs ended over the summer, the hospital is still understaffed. PC: Skyclad Aerial

In May, the University of Virginia Health System sparked public outcry when it placed over 500 employees on furlough, citing millions of dollars in pandemic-related financial losses. Affected staff were out of work for up to three months, and were not paid.

Though some feared the staffing cuts would be extended, furloughs—along with pay reductions—finally came to an end on July 25 for the UVA Medical Center, and on August 16 for the School of Medicine.

“Everyone is back,” says Chief Operating Officer Wendy Horton. “Actually, because there was a pent-up…demand, now we’re really busy…we’re actually hiring.”

Hospital staff, which has been stretched thin for months, desperately await those new hires, say multiple employees.

“The whole time of COVID has been a time of staffing crisis at the hospital, because it took such a financial hit when they canceled elective surgeries,” says a nurse aide who works in various units. “Every unit at the hospital is short staffed, more often than not…[We] do not have enough nursing and support staff.”

“Everybody is really experiencing some type of staffing stressor,” says another nurse, who works in the COVID intensive care unit. In recent months, employees have been constantly shuffled around, and even after the shuffling, some units don’t have enough employees with the specific skills required to make things run smoothly.

As the pandemic rages on, even the hospital’s COVID unit has suffered from staffing shortages. At the beginning of the pandemic, employees from units with low patient count were brought into the coronavirus unit as support staff, explains the ICU nurse.

“But when the furlough ended in July, they had to send all of those people back, so that left a lot of holes for where we were having support staff,” the COVID ICU nurse says.

The COVID unit has also seen some staff leave for different posts, due to months of pandemic burnout. “The first three months of, ‘I hope my equipment works. I can’t see my family. The world is shutting down. My patients are dying alone’…That took a huge toll,” says the COVID ICU nurse.

The potential for internal coronavirus outbreaks at the hospital has only exacer­bated staffing fears.

Around two weeks ago, a patient with complex medical problems from another facility came into the UVA hospital without any COVID-19 symptoms, but developed them within a few days and tested positive soon after. About a dozen employees who had come in contact with the patient were put into quarantine.

The “unit basically had to shut down,” says the nurse aide. “It wasn’t that patient’s fault. It was that staff had on inadequate PPE because it was not known that they were COVID positive.”

The employees completed their two-week quarantine at the beginning of this week. They were paid during their absence.

“As far as we know, no one has developed symptoms,” Chief Medical Officer Dr. Reid Adams told C-VILLE on November 5. “People are at home finishing their quarantine, and we expect all or most of them will be back over the weekend.”

According to the nurse aide, there’s also been at least one coronavirus outbreak in the hospital that started with a staff member, who contracted it from the community.

“I was alarmed…I hadn’t heard anything about this outbreak among staff from any of the official university communications,” says the nurse aide. “I didn’t learn about it until I was there.”

“We do know that some employees have been exposed at home, and have developed symptoms and tested positive through the community,” says Adams. “The vast majority of our workforce that has tested positive are due to community exposures…not from care in the hospital.”

According to hospital spokesperson Eric Swensen, less than 7 percent of employees who’ve tested positive for COVID contracted it from the hospital.

Though these internal outbreaks have been more or less contained thus far, the constant threat is difficult for employees. They are also worried about the possibility of a dramatic spike in cases during the winter, putting an additional burden on the hospital’s limited staff.

“There’s definitely great anxiety among staff that it could get worse pretty soon,” says the nurse aide. “Our colleagues in Lynchburg are seeing [their] hospital fill up, and things are pretty bad down in Bristol too.”

And while UVA hospital is currently hiring, training new employees puts an additional burden on the current staff, explains the COVID ICU nurse. “That’s kind of a stressor there.”

To both recruit and retain staff, the nurse aide believes the administration needs to pay all of its employees more, and give them more authority.

“To really create stable staffing at this hospital, we just need to be spending more on labor. Also, decision making in the hospital is extremely top-down. Hospital workers need more power in these decision making processes.”

In light of the hospital’s situation, both employees urge the community to continue to wear masks and practice social distancing, and show appreciation to health care workers.

“If you know someone who works for the hospital system, tell them thank you,” says the COVID ICU nurse.

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Coronavirus News

Cut off: UVA Health furloughs hundreds of employees

Furloughed patient care assistant Erik Hancock says he is shocked that UVA Health is reducing crucial staff “at a time like this.” PC: Eze Amos

COVID-19 has stripped the pockets of businesses all around Charlottesville, including one of the city’s biggest: The University of Virginia Health System. Since the onset of the pandemic, the health system has lost $85 million per month due to a sharp decrease in surgeries and clinic visits. To offset these losses, it announced April 28 that it would furlough some non-patient care staff for up to three months, among other cost-saving measures.

As of May 8, 561 employees have been placed on full-time unpaid furlough, with the option to apply for unemployment or use their paid time off. Everyone will continue to receive insurance benefits.

But contrary to the health system’s initial statement, furloughed employees include those who provide patient care. One nurse practitioner (who asked that we not use her name) says some physician assistants and nurse practitioners, also known as advanced practice providers, have been furloughed for three months, while others have been placed on “rolling furloughs,” meaning they work a reduced number of weeks.

“This means in some areas that still have a lot of patients, like the COVID unit, [or that] were already short [there was already up to a 50 percent shortage of APPs in places]…we have been reduced to an unsafe skeleton crew while trying to provide patient care,” she says.

These staffing cuts put patient safety at risk, she contends, and they could have been entirely avoided.

“Comparable institutions have successfully managed to implement cost-saving measures without compromising patient safety,” she says. “All of my APP colleagues were prepared to help make sacrifices and fully anticipated salary cuts.”

“To be cutting staff providing critically needed care in a time like this when [Executive Vice President for Health Affairs] Craig Kent is still making $570,000 a year— [after] his much-touted 40 percent salary reduction—is shameful,” she adds.

In an email, spokesman Eric Swensen confirmed that UVA has cut hours for “patient-facing staff” in areas with fewer patients, but that the number of such staff with full-time unpaid furloughs for the next three months remains “very low.”

“We are eager to care for our patients, and as our volume increases so will our staffing,” he added. “We have made staffing decisions at the department level so that we can calibrate the necessary staffing levels to ensure the safest patient care. For that reason, almost all of the full-time furloughs were in non-patient care areas.”

The nurse practitioner says she will have to take multiple weeks off within the next two months. She has enough paid time off to cover it, she says, but if it’s extended past July, she will have to apply for unemployment.

Her APP colleagues on furlough without enough (or any) paid time off are not as lucky. Receiving notifications about the furloughs just a few days before they took effect, they had little time to plan, she says. According to Swensen, affected employees were notified the week of April 28—shortly before the furloughs took effect on May 3.

Some employees took to social media to express their worry and frustration over UVA’s decisions—but declined to speak to C-VILLE about their experiences, fearing they would lose their jobs for good.

“It sucks, but I am hopeful that unemployment will come through and make all this doable. I’m a single-income household with 50/50 shared kids, so it’s nerve-wracking,” shared an inpatient nurse on Reddit. “Nine out of about 25 people in my department were furloughed.”

One outpatient care unit employee, who would only speak to C-VILLE anonymously, says they have been furloughed until July 25, and that their supervisor simply told them “to apply for unemployment.”

“It is really stressful and depressing. I have a number of bills to pay on top of mortgage and medical bills,” the employee says. “The unprofessional attitude of my supervisor was hinting for me to seek other jobs.”

Another anonymous UVA employee, who works as a certified nursing assistant, has been on furlough since April 30. She is not scheduled to go back to work until the end of July, and is unsure if she will return.

“My boss told me on 4/30, so I didn’t have a notice. I wish I did. I did not have enough time to file [for unemployment] that week, so it should start this week,” she says.

Patient care assistant Erik Hancock was also furloughed with just a few days notice, and he’s now applied for unemployment.

“We were expecting furloughs, but we didn’t know how many, or when, or what department,” he says. “Things had been thrown up in the air left and right.”

While Hancock still plans to return to his job part-time after the furlough, he is shocked that UVA is reducing crucial staff “at a time like this.” And with the way it’s handled the situation, the nurse practitioner predicts some workers may decide to not come back at all.

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Coronavirus News

Ground zero: Local hospitals, health department prepare for coronavirus spike

UVA hospital has been providing medical screening for a variety of diseases as a precaution for the ongoing COVID-19 epidemic. PC: Zack Wajsgras

In just a matter of days, the number of confirmed cases of the novel coronavirus in the Thomas Jefferson Health District has jumped from one to 16, including four in the City of Charlottesville and six in Albemarle County. While the first case was initially thought to be travel-related, it’s now unclear how the individual, a staff member at the UVA women’s center, came in contact with COVID-19, according to the health department. The department is also investigating how the remaining ten individuals contracted the virus, and who else they could have exposed to it. 

With the number of coronavirus cases in Charlottesville only expected to grow, local hospitals are taking extensive measures to prepare for an influx of patients, as well as to assist those currently seeking testing and treatment. In some parts of Italy and, most recently, New York City, an exponential spike in cases has overwhelmed local health care systems, leading to critical shortages of beds and ventilators. 

According to spokesman Eric Swensen, UVA Health System is postponing most clinical visits and surgeries scheduled between now and April 6, with the exception of urgent care, in order to “conserve our resources” and “build capacity to be able to care for folks when they need it.” To minimize the potential spread of the virus, patients at UVA hospital are no longer able to have visitors (with some exceptions). 

UVA staff is also screening everyone before allowing them to enter any facilities, he adds. “If you’re a visitor and are showing any kind of respiratory symptoms or possible exposure to coronavirus, we’re not going to allow you into our clinic or medical center.”

Swensen says there’s been a significant number of people calling UVA health care providers, as well as the UVA health call center, with questions and concerns about coronavirus. In order to prevent the virus from spreading, he urges those who think they may have the virus to call their primary care provider (or, if they don’t have one, the Virginia Department of Health hotline), and not rush to the emergency room. A doctor will then screen them over the phone for common symptoms of the coronavirus—fever, cough, and difficulty breathing—and ask about their travel history and potential exposure to the virus. If they meet the CDC criteria for testing, a doctor can send them to UVA’s referral-only coronavirus clinic. 

In light of the severe national shortages of coronavirus tests, UVA health is now one of the few institutions across the country that has created its own tests, with a goal to have results within one to two days, Swensen says. Due to this increase in testing capacity, it expects to see a spike in local confirmed cases of the virus in the upcoming days. 

“Depending on the severity of their symptoms…not everyone necessarily who gets coronavirus will need hospital care,” Swensen adds. “The first case in Charlottesville is an example of this, where that person is being evaluated and cared for from home.”

According to a news release, one of the other local residents diagnosed with the virus, a UVA student living off-Grounds in Albemarle County who may have contracted it while traveling, is also currently in isolation.

Sentara Martha Jefferson Hospital has taken similar steps to prevent the spread of COVID-19 within its facilities. The hospital has a “fair amount” of ventilators and isolation rooms available, says Vice President of Medical Affairs Paul Tesoriere, and is working with the government to get more testing kits. 

“We’ve identified different areas that we will expand into if we get into a situation where we get a significant influx in patients,” says Tesoriere, “areas that are not being as utilized because the virus has cut down on some procedures or visits.”

A task force meets several times a day to address daily needs and long-term plans.

The TJHD is working closely with both UVA and Sentara, as well as other community partners, to oversee the area’s pandemic response effort and investigate the cases in Charlottesville. But it generally does not supply testing kits or personal protective gear, including masks, goggles, and gloves. Due to the mass shortage of such gear, local doctors and nurses are currently hosting an Equip Cville emergency supply drive (see page 9), collecting donations from businesses, labs, and schools, in partnership with Support Cville. 

“We are working on compiling a list of those in the community that need PPE, and any extra we have we will make sure to get to the appropriate individuals in appropriate health care settings,” says TJHD’s Public Information Officer Kathryn Goodman. “[However,] the demand for [PPE] is unprecedented, and suppliers do not have the inventory to keep up with demand. Local health care providers trying to purchase critical supplies are competing with all providers across the county…efforts like [Equip Cville] are essential to the long-term success of what will be a lengthy response.”

But tests, investigations, and supplies alone will not bring an end to the coronavirus pandemic, Goodman adds. Social distancing, or self-quarantining, is equally as important. 

“We know that there will be cases in this community, and so we’re asking people to stay home as much as possible so that we can prevent and lower the number of cases we see in the area,” she says. “If people do have to go out in public, stay six feet away from one another. [But] if people can just stay home, that’s the best thing we’re going to be able to do to prevent the spread of this.”

When to call your doctor

Symptoms of COVID-19 can range from very mild to severe (or, in some cases, may not occur at all), and usually appear within two to 14 days after being exposed to the virus. They include:

  • Fever
  • Tiredness
  • Cough
  • Shortness of breath
  • Difficulty breathing

If you are experiencing these symptoms, and know or suspect that you’ve been in contact with a person who has COVID-19, or have traveled to an area with a COVID-19 outbreak, you should call your primary care doctor. If you don’t have one, you can also call your local emergency room, urgent care clinic, or a coronavirus hotline:

Contact your doctor early if you’re 60 or older, or have underlying chronic medical conditions, even if your symptoms are mild. Seek medical attention immediately if you’re experiencing any of these emergency warning signs of COVID-19:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Updated 3/25 to reflect accurate number of local coronavirus cases

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Coronavirus News

Be prepared: Is Charlottesville ready for the coronavirus?

It’s been nearly three weeks since most of Virginia moved into Phase 2 of the state’s coronavirus reopening plan. Some restrictions were loosened on businesses and social gatherings, but the pandemic is far from over, warns Ryan McKay, deputy incident coordinator for the Thomas Jefferson Health District. PC: Robert Llewellyn

Since last week, when health officials warned that Americans should prepare for the inevitable spread of the coronavirus here in the U.S., at least 12 Americans have died and new cases have been emerging almost daily. 

The Centers for Disease Control and Prevention has warned that Americans should be prepared for the spread of the virus in local communities, as well as the possible disruptions to daily life it could cause, such as school and daycare closings.

So how is Charlottesville preparing? 

While the risk in Virginia “is still low” (there have not yet been any confirmed cases in the state), the Thomas Jefferson Health District is monitoring the situation and is prepared for any potential outbreak, says Jessica Salah, TJHD’s health emergency coordinator.

“We have been working with our central office since 2004 for pandemic influenza. We regularly meet with our community partners, local service providers, and health care partners to plan how we handle pandemic flu,” Salah says. “If you take pandemic flu out of the equation and insert a different communicable disease, the planning process and preparedness is very similar.” 

At UVA Health System, spokesman Eric Swensen says the system also “has a team in place that meets regularly…and makes updates to our plan as we need to,” based on guidance from the CDC and Virginia Department of Health.

According to Dr. William Petri, chief of UVA’s Infectious Diseases and International Health division, UVA hospital has numerous isolation rooms available for those infected with contagious diseases like COVID-19 (the disease caused by the new coronavirus). It also has plenty of face masks on hand, since the virus is primarily spread by coughing and sneezing (or by touching a contaminated surface). 

“And if a physician needs to go into isolation for 14 days because they potentially may have COVID-19 or are being treated for COVID-19…we are establishing a backup system, so that there’s another physician that can take their place, and we don’t get shorthanded,” Petri says. 

Petri, along with UVA virologist Peter Kasson, is currently applying for a research grant from the National Institutes of Health to develop a vaccine for COVID-19. Though the grant could take months to be awarded, he believes that, with support from UVA, they should be able to start working on the vaccine soon. And with pharmaceutical companies like Gilead Sciences already conducting clinical trials for COVID-19 vaccines, there could be a treatment available within a year, Petri predicts.

Dr. William Petri PC: Sanjay Suchak/UVA

Meanwhile, the university itself is also making plans. Since January, “a UVA team has been meeting regularly to prepare for the potential impacts of [COVID-19] on the university,” according to an update issued to parents by Patricia Lampkin, vice president and chief student affairs officer. The university has made arrangements to quarantine potentially infected students, if necessary. 

UVA has not canceled any of its study abroad programs, but says it will do so if any countries where it is hosting programs receive Level 3 warnings or higher from the State Department. (Currently, China, South Korea, Iran, and Italy have such warnings, and UVA is not hosting any programs there this semester.) The university also strongly recommends students not travel to these countries during the upcoming spring break.

According to UVA spokesman Brian Coy, there is a small group of students studying abroad in Italy with a non-UVA program. The university has advised those students to return to the United States, where they may undergo screening for the virus.

Student travel organization WorldStrides, which has its headquarters in Charlottesville, has canceled or relocated programs scheduled for China, South Korea, and Italy this spring, but there are currently no students in those countries, according to Beth Campbell, vice president of content and communications.

Though TJHD recommends Charlottesville residents stay updated on the COVID-19 outbreak, it ultimately encourages them not to panic, and take simple precautions to keep themselves (and others) healthy, Salah says.

“Monitor CDC travel recommendations and avoid nonessential travel to [Level 3 countries],” Salah says. “We are also recommending that folks older than 65 get the pneumonia vaccine, and that everybody over the age of 6 months get the flu vaccine.”

TJHD does not recommend buying a face mask, but, as with every cold and flu season, advises people to wash their hands regularly, minimize touching their face and commonly used surfaces (like railings and door knobs), and stay home when sick. 

“And if you suspect you might have [COVID-19]—and the biggest reason to suspect that is that you have been to a country where COVID-19 is spreading person-to-person, and now have a fever, cough, and shortness of breath—call in first,” Petri adds. “Don’t just walk into the emergency room or doctor’s office, because then you run the risk of spreading the infection to other people.”

Charlottesville City Schools’ page on coronavirus: charlottesvilleschools.org/coronavirus/

Updates from UVA Health: uvahealth.com/services/infectious-disease/coronavirus-faqs

 

Updated 3/4 and 3/5 to reflect the increasing number of American deaths. As of 3/10 there are now five confirmed cases in Virginia, more than 720 in the U.S., and 26 deaths. 

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Secret services: Why is it so hard to find out what your doctor’s visit will cost?

It’s not that easy to find out what a doctor’s visit will cost, especially at the appointment. Photo by SKYCLAD Aerial

When you buy a house or a car, you know how much it’s going to cost. That’s not necessarily the case when you go see a doctor, especially if you don’t have insurance, a local woman discovered on recent visits to a UVA clinic.

Sara Ensey is a self-pay patient, and when she went to UVA Primary Care Riverside December 12, she asked twice what the cost would be before she saw a healthcare professional, and was told, “We cannot give you that information,” she says. One person added, “You don’t have to pay all at once.”

“This is an outrage and a disgrace, and it should not be legal,” says Ensey.

Too many people have to choose between medical care and other necessities, and UVA Health System should be transparent about costs, she says.

She had a similar encounter in June, and later received a $385 bill for a 10-minute primary care visit that involved no labs, blood work, or x-rays. Worse, she says, the bill had none of the codes that categorize the services she received.

“We do provide price estimates upon request,” says UVA Health System spokesperson Eric Swensen. Patients need to call or visit uvahealth.com for an estimate, which can take up to two days, according to the website.

Ensey questions why the burden is placed on a patient to log onto a website or place a phone call to obtain the information. “If they are so forthcoming with pricing information, why the hurdles? I asked in person and was denied—twice.”

Swensen says the estimate depends on several factors, including the complexity of care a patient needs and the details of her insurance coverage, and it can take some time to develop an estimate that is as accurate as possible. “The estimate review process is detailed to capture procedures and tests that may be needed together with the patient’s insurance coverage to best determine the patient’s out-of-pocket estimate,” he says.

But Ensey thinks the information should be available at a patient’s appointment. “How is a patient to self-advocate and make a cost-benefit analysis if no one can tell you what the cost will be?” she asks. “That’s ridiculous.”

Ensey recently moved here from Vermont, and she says the University of Vermont is required to provide patients estimates at the time of the visit. And some health systems offer online calculators specifically designed for just this purpose.

“It surprises me UVA doesn’t have something similar,” she says.

Charlottesville’s other main health care provider, Sentara Martha Jefferson, doesn’t seem any different. Spokesperson Jenn Downs says in an email, “Our patient financial service customer service representatives can provide an estimate of total charges.” But as at UVA, that must be done in advance.

Ensey wants to make it clear that the issue is not about pointing fingers. “This is about raising awareness so that the situation can change for the benefit of patients in the greater community and beyond—because it won’t if no one calls attention to it.”

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Fifeville fumes: No parking after 7am

Dawn Woodford says Fifeville parking suffers because of UVA employees. Staff photo

By Mary Jane Gore

Fifeville is a neighborhood of new avenues and narrow side streets. Some curbs are permit parking only; others are open. The well-positioned neighborhood, near West Main Street and adjacent to the UVA Health System and other university buildings, is now fighting to preserve its streets for resident parking.

“It’s getting worse and worse,” laments Dawn Woodford, who’s lived in Fifeville for 20 years. “Someone visiting a resident can’t find parking space. Sometimes someone parks so you can’t even get in the driveway.”

Empty spaces fill up quickly, mainly in the morning between 7 and 8am as people leave their cars and head to work. There is “no place to park,” says Woodford, and in her view, the expansion of the UVA Emergency Department area will lead to worse congestion.

“The issue of parking in our neighborhoods that surround the university and the university hospital is certainly one that is of concern given the impact it has on the quality of life of our residents,” says City Councilor Heather Hill, who recently became one of two councilors representing the city on the Planning and Coordination Council.

UVA Health System does provide parking options, though employees must pay more for nearby garage slots. “All health system team members have options to park in university-owned parking lots or garages,” says Eric Swensen, public information officer for UVA Health System. “Some of those parking areas are within walking distance of the UVA Medical Center.”

Employees also may park at satellite locations, such as U-Hall/John Paul Jones Arena and Scott Stadium, and then ride a bus. The contractor for the hospital expansion project has rented parking spaces for construction workers, Swensen notes.

Related problems also are evident. “As I observed while visiting a neighborhood off of Cherry Avenue, beyond parking is the issue of individuals walking through private property, crossing the railroad line, and then climbing over the fence to get to their place of work,” Hill says of an early April visit.

One solution would be more UVA employee parking in the area. “There are no park-and-ride locations near the hospital, and no new parking areas are planned at this time,” Swensen says.

UVA Health System is making plans that could help to alleviate the crowding. By realigning and relocating its ambulatory care sector by 2024, the footprint of care near the hospital would shrink from a current 413,000 visits to about 200,000 visits annually. The Fontaine Research Center could double its visits—from 182,000 per year now to about 400,000 in the future.

Permit parking is another idea that could keep nonresidents off the Fifeville streets.

“I would encourage those streets that have not implemented zone permit parking to evaluate it with their neighbors and communicate back to the city what hurdles may be preventing alignment,” Hill suggests. “Is it cost, which we can likely work through some options to address? Is it convenience, as permits make it difficult for guests to visit residents depending on the time of day? Other reasons?”

Woodford says the police don’t always come. Hill agrees that “enforcement can be a challenge given the relatively limited resources.”

Woodford’s bottom line is clear: “Why should we pay to fix UVA’s broken parking situation” as rents rise in Fifeville?