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Strengthening Pandemic Preparedness · The SHEA Podcast

• 0:07
  SPEAKER_01: Welcome everyone to the Ches 2026 podcast.
• 0:11
  SPEAKER_01: My name is Rob Sitrenberg.
• 0:13
  SPEAKER_01: I am the chair of Ches this year, and I am an infectious disease doctor.
• 0:18
  SPEAKER_01: I work for Advocate Health in Illinois and Wisconsin.
• 0:22
  SPEAKER_01: Ches is a special interest group of Shea that addresses issues pertinent to community associated healthcare epidemiology and stewardship.
• 0:32
  SPEAKER_01: And anyone and everyone with interest is welcome to join.
• 0:36
  SPEAKER_01: And I'm joined by Dr.
• 0:37
  SPEAKER_01: Vidia Moni.
• 0:38
  SPEAKER_01: Videa, take it away.
• 0:40
  SPEAKER_02: Hi, everybody.
• 0:42
  SPEAKER_02: My name is Vidya Moni.
• 0:44
  SPEAKER_02: I am also a member of Chess, and I am a pediatric infectious disease physician and epidemiologist over at Santa Clara Valley Healthcare in San Jose, California.
• 0:56
  SPEAKER_02: I am very, very excited for today's podcast and hopefully to have multiple more as part of the chess series.
• 1:06
  SPEAKER_02: Today we have a very, very amazing guest with us today.
• 1:10
  SPEAKER_02: His name is Dr.
• 1:12
  SPEAKER_02: Vincent Su.
• 1:14
  SPEAKER_02: I think many of you guys out there listening to this podcast have probably met him before, have talked to him, love chatting with him.
• 1:21
  SPEAKER_02: He is a wealth of knowledge and just like an all-around very cool guy.
• 1:26
  SPEAKER_02: We will be speaking about pandemic preparedness today with Dr.
• 1:30
  SPEAKER_02: Vincent Su.
• 1:31
  SPEAKER_02: Dr.
• 1:31
  SPEAKER_02: Sue, would you like to introduce yourself a little bit?
• 1:34
  SPEAKER_00: Yes, thank you, Videa and Rob.
• 1:36
  SPEAKER_00: It's a pleasure to be here, and you're too kind, Videa.
• 1:40
  SPEAKER_00: But uh we um I should say I am an infectious disease adult-trained, uh overseeing epidemiology and infection control for my organization, which is Advent Health.
• 1:54
  SPEAKER_00: We are based in Central Florida, but we've got close to 60 acute care facilities across nine states.
• 2:03
  SPEAKER_00: And so it's um it's a it's a joy and pleasure to be with you here and happy to help answer any questions and to be a resource to anyone that might have questions about healthcare epidemiology on a larger scale.
• 2:16
  SPEAKER_01: Great.
• 2:16
  SPEAKER_01: Well, welcome, Vince.
• 2:18
  SPEAKER_01: Thank you, uh Vidia.
• 2:20
  SPEAKER_01: So today's topic is pandemic preparedness.
• 2:23
  SPEAKER_01: Now I'm sure over the last few months you've heard a lot and seen a lot on pandemic preparedness.
• 2:27
  SPEAKER_01: We wanted to take a slightly different angle here and ask the question are we really prepared for the next pandemic?
• 2:34
  SPEAKER_01: Many of us have spent hundreds of hours preparing for Ebola virus or the next high-consequence infectious disease, but I want to get a sense of if we're really prepared.
• 2:45
  SPEAKER_01: I think a lot of us thought we were prepared for COVID, but it turns out we probably were not really well prepared for it.
• 2:51
  SPEAKER_01: So, with that, let's get into some of our questions for Dr.
• 2:56
  SPEAKER_01: Sue.
• 2:57
  SPEAKER_01: So, first Vince, what signals matter most now?
• 3:01
  SPEAKER_01: If you could only monitor three early indicators of a brewing outbreak or up to three, which ones would you choose and why?
• 3:08
  SPEAKER_00: You know, I think we need to make sure that our signals are a combination of good, trusted data.
• 3:15
  SPEAKER_00: And from that standpoint, you know, we obviously want to look at things such as hospitalization trends.
• 3:21
  SPEAKER_00: And I think we have to make sure that we look at hospitalizations, for example, on various levels.
• 3:26
  SPEAKER_00: We've got our own facilities, uh, and and then there's probably state data, and then there's federal data as well.
• 3:33
  SPEAKER_00: So, you know, certainly the capacity of a healthcare organization to take care of its hospitalized patients is critically important.
• 3:42
  SPEAKER_00: Another set of data that I think is very important, of course, is laboratory data.
• 3:45
  SPEAKER_00: If we know the organism that we are monitoring, we want to look at those numbers of positive tests.
• 3:51
  SPEAKER_00: Again, we are lucky to have data on our hospital level as well as, and then to monitor state and federal as well.
• 4:01
  SPEAKER_00: And if you don't have the specific laboratory data, maybe you could look at surveillance, uh, clinical syndromic surveillance.
• 4:07
  SPEAKER_00: So are there, is it a respiratory disease, for example, that might be that we're seeing a lot more of?
• 4:14
  SPEAKER_00: And so we would want to monitor that.
• 4:15
  SPEAKER_00: Now, I would also say though, in addition to um to good trusted data and putting it together, we also have to monitor other signals.
• 4:25
  SPEAKER_00: And I I do, I think I get paid to to watch the news or to read the traditional media.
• 4:31
  SPEAKER_00: I think it's important to understand that there's also listserves with ProMed and other um even SIDRAP and and and there are media uh that are can be trusted to um to help identify things.
• 4:46
  SPEAKER_00: And it may not be in your locale, it could be somewhere else, but you got to monitor that.
• 4:50
  SPEAKER_00: Even social media, and I know that social media has its drawbacks, but you we always have to be in tune with what's going on uh with that.
• 4:59
  SPEAKER_00: So I just recently got an Instagram account uh just because I could help monitor certain things um related to my job.
• 5:07
  SPEAKER_00: I I'll I'll call it uh work related.
• 5:09
  SPEAKER_00: The other and the last thing, um Rob, is um really to ask our my fellow epidemiologists.
• 5:16
  SPEAKER_00: So we've got a very active community healthcare epidemiology group here, chess.
• 5:20
  SPEAKER_00: Um, this is a great place to say, hey, what are you seeing?
• 5:24
  SPEAKER_00: You know, what what are you monitoring?
• 5:25
  SPEAKER_00: So there's a combination of good data, there's also other data, media, opinions.
• 5:32
  SPEAKER_00: I think all of that needs to be taken into account.
• 5:34
  SPEAKER_01: That's great.
• 5:36
  SPEAKER_02: I have a question for you.
• 5:37
  SPEAKER_02: So after COVID, we started seeing more and more wastewater data show up.
• 5:42
  SPEAKER_02: And then this past, like early, like late spring, early summer, we started dealing with the hontavirus outbreak that was seen in the cruise ship.
• 5:50
  SPEAKER_02: And there was a lot of chatter about should we be monitoring for hantavirus in the wastewater?
• 5:56
  SPEAKER_02: Do you think wastewater has become necessary for us?
• 5:58
  SPEAKER_02: Like, is that a necessary potential tool for us to use in monitoring these future outbreaks?
• 6:05
  SPEAKER_00: I think in my mind, there's no doubt that there is a definite application to wastewater uh monitoring surveillance.
• 6:12
  SPEAKER_00: Uh, this has been started in small, smaller areas.
• 6:16
  SPEAKER_00: I think the CDC and other agencies, state have now are now using this as a way to monitor things.
• 6:24
  SPEAKER_00: So I think it's absolutely going to be part of our surveillance.
• 6:28
  SPEAKER_00: I wouldn't say it's essential insofar that you know it's necessary to have it, but it is another trusted source of data to help us in it with the addition of other things to help us monitor what's going on.
• 6:42
  SPEAKER_00: So I would say it's a very important adjunct.
• 6:44
  SPEAKER_00: And I think that it is validated now for use on a regular basis.
• 6:48
  SPEAKER_02: Totally.
• 6:50
  SPEAKER_01: It's what did we learn from COVID?
• 6:52
  SPEAKER_01: Hopefully, something about diagnostic capacity that we still haven't fixed, getting ready for the next pandemic.
• 7:00
  SPEAKER_00: I mean, there's there's a lot of lessons that we learned about about diagnostic capacity.
• 7:05
  SPEAKER_00: I mean, it really necess doesn't really, it really didn't focus necessarily on on the actual scientific test that was actually done.
• 7:14
  SPEAKER_00: It would have to do more with making sure that that that we had enough tests, number one, that that we've got uh ability to make those tests if it comes into demand.
• 7:24
  SPEAKER_00: We also need to make sure that there is an an approval process for these tests that allow it to be put into circulation world, you know, uh you know, widespread.
• 7:34
  SPEAKER_00: So I think I think we're very good at developing tests.
• 7:39
  SPEAKER_00: I think the proof of the pudding with some of these diagnostic tests is to really make sure that we're able to scale it up, that it gets through the channels in an expedited way where it there isn't a backlog or you know, uh for that or shortage.
• 7:54
  SPEAKER_02: I think what you said there was like the most important point.
• 7:58
  SPEAKER_02: And that was that we can scale it up because anytime we start thinking, like even like the whisperings of a new pandemic that's happening, it's the ability to actually scale up, right?
• 8:09
  SPEAKER_02: Like we've been having a lot of summer diarrheal illnesses that have been going on across the United States, and one of the issues was laboratory availability, and so you need to be able to have, so if you want to run the diagnostic, you need to have the diagnostic.
• 8:24
  SPEAKER_02: And so um I totally agree with you.
• 8:26
  SPEAKER_02: What a that's a great point to discuss.
• 8:28
  SPEAKER_01: And I think we all remember the very early part of the pandemic, once the virus was isolated or identified that it was taking seven, eight, nine, ten days to get COVID tests back, which really turned out not to really be helpful clinically at all.
• 8:45
  SPEAKER_02: Yeah.
• 8:46
  SPEAKER_02: Um, we're gonna switch around a little bit to operational preparedness to see what we can do in our own systems.
• 8:53
  SPEAKER_02: Um PPE.
• 8:55
  SPEAKER_02: So I think all of us remember from our last pandemic the lack of availability of PPE and the shock we all felt of like, we don't have gowns, we don't have N95s, and we were all trying to figure out different ways to reuse our PPE safely.
• 9:12
  SPEAKER_02: So are stockpiles enough, or do we just fundamentally need a whole different model in how we stock PPE in our systems?
• 9:21
  SPEAKER_00: I would say that stockpiles are part of the solution, but I think that the issue is not just having the stockpile.
• 9:29
  SPEAKER_00: It is really how you manage it.
• 9:31
  SPEAKER_00: It's it's almost a supply management issue to make sure that you know what you have in there, that you uh rotate supplies, in other words, know what is what's expired, what's not, know what the manufacturer is because there may be differences in how these PPE are being used.
• 9:50
  SPEAKER_00: So it's really the operational aspect, not necessarily just having that stockpile.
• 9:55
  SPEAKER_00: How you use that stockpile and how you make sure it's ready, how you prepare, you know, if you don't use it for 15 years, you know, how do you manage it?
• 10:06
  SPEAKER_00: That that is going to be, to me, the the proof of the pudding.
• 10:10
  SPEAKER_00: And I think we recognize that you know, we had some failures with stockpiles.
• 10:13
  SPEAKER_00: Just having the stockpiles is enough.
• 10:15
  SPEAKER_00: It's how you manage it and how to use it.
• 10:18
  SPEAKER_02: Yeah, totally.
• 10:19
  SPEAKER_01: Yeah, I think that's a that's a great point.
• 10:21
  SPEAKER_01: Um, and and along those lines, what do you what do you see as physical planning changes, things like airflow, uh zoning, room types that that really make a difference in real life?
• 10:34
  SPEAKER_01: You know, we spend a lot of time with COVID arguing about whether you need negative pressure rooms, airborne isolation, et cetera.
• 10:42
  SPEAKER_01: So what what are the things, maybe one or two things that really make a difference?
• 10:47
  SPEAKER_01: Because we can argue about pretty much anything, right, in terms of should we do it, shouldn't we?
• 10:51
  SPEAKER_01: But in in your view, what really makes a difference?
• 10:54
  SPEAKER_00: You know, again, I I would say that it's probably not necessarily the specific infrastructure, the latest technologies that you have, but rather how it's being managed or used.
• 11:07
  SPEAKER_00: I'll give you an example.
• 11:08
  SPEAKER_00: A few months ago, we had knee tech come to Advent Health in Orlando to do an assessment of our facility.
• 11:15
  SPEAKER_00: And this was, of course, for high consequence infectious disease, not necessarily for a pandemic, but I think knee tech gave me a they they gave a very good point in saying, look, we recognize every facility has their own different ways of of structure.
• 11:29
  SPEAKER_00: You know, they they may or may not have the latest with airflow or with this or that.
• 11:35
  SPEAKER_00: Um, but we can make it work.
• 11:37
  SPEAKER_00: And so, you know, I think when it comes to airflow or room design, it's not, I mean, obviously it's nice to have negative airflow and be able to have waste management in a way that's really unique and efficient.
• 11:54
  SPEAKER_00: But I think we have to focus on the process.
• 11:57
  SPEAKER_00: What we don't do is we don't train enough, we don't prepare our staff on just using your existing uh capabilities.
• 12:05
  SPEAKER_00: We all have single rooms that are available.
• 12:08
  SPEAKER_00: We can, you know, we some of the some of the some of us have negative pressure rooms, and we can use what we have instead of trying to build new stuff, uh new rooms to and but just make it work.
• 12:21
  SPEAKER_00: But that requires rehearsal practice uh and operations.
• 12:26
  SPEAKER_01: Yeah, you know, I think you bring up a great point with that.
• 12:28
  SPEAKER_01: The last time, you know, now we're doing Ebola preparedness.
• 12:31
  SPEAKER_01: The last time we did it in earnest was 12 years ago in 2014, and that just simply isn't enough.
• 12:37
  SPEAKER_01: You basically have to start all over.
• 12:39
  SPEAKER_01: So I think that's a really, really important point that this has to be ongoing education and rehearsal, uh, that we just can't save it in anticipation of the next pandemic.
• 12:52
  SPEAKER_02: With that, how often do you think that should be then?
• 12:54
  SPEAKER_02: Like the instead of like Rob, you said yours was like 12 years ago.
• 12:57
  SPEAKER_02: What's the ideal time point then?
• 12:59
  SPEAKER_02: Like every two years, every year?
• 13:01
  SPEAKER_02: I mean, annually seems a bit much, but um two, three, four, five years?
• 13:06
  SPEAKER_02: Like how often should we do we should we be doing these mock preparedness trials?
• 13:11
  SPEAKER_00: So I I think I think it's I would say definitely more frequently than we do it right now.
• 13:16
  SPEAKER_00: I mean, I think, you know, after COVID, after Ebola, my leadership was like, oh, you know, thank God it's over, and we don't want to have to try to think about the past, we want to move forward.
• 13:27
  SPEAKER_00: And I think you know, that can be a mode of thinking that can get us into trouble because we have to remain prepared.
• 13:35
  SPEAKER_00: And I mean, when it comes to you don't, if you don't use it, you lose it type of mentality.
• 13:41
  SPEAKER_00: I mean, I mean, I think that at the very least, we need to prepare annually and probably more frequently than that, because staff turnover is is significant, you know, leaders come and go.
• 13:54
  SPEAKER_00: Um, I've been fortunate to be in my role uh with epidemiology for for a couple of decades, but nonetheless, um, you know, it's you've got to make sure that you continue to to train.
• 14:06
  SPEAKER_00: And I'd I'd say ideally, probably at least every six months.
• 14:10
  SPEAKER_01: So really just that's amazing.
• 14:12
  SPEAKER_01: Just to make it part of the regular curriculum.
• 14:14
  SPEAKER_01: I think that's I think you really have to take into account uh employee turnover as well.
• 14:19
  SPEAKER_01: It's that's such a it seems like you train every last person, finally, and then the staff turns over.
• 14:26
  SPEAKER_01: So you have to do it all over again.
• 14:29
  SPEAKER_02: Speaking of staff, what do you think is the best strategy for staffing the hospitals when planning for a surge?
• 14:37
  SPEAKER_02: Because as we know, staffing was also a very large challenge for us.
• 14:43
  SPEAKER_00: Vidy, I think we have to be nimble with staff.
• 14:45
  SPEAKER_00: Yeah.
• 14:45
  SPEAKER_00: And and and so number one, I mean, I'll say there's two things I think they're important for staff.
• 14:50
  SPEAKER_00: Number one is to make sure that we cross-train them.
• 14:52
  SPEAKER_00: In other words, staff need to be able to understand that in an emergency, in an emergency, in a pandemic situation, they may be asked to do things that they don't normally do.
• 15:02
  SPEAKER_00: The OR staff might be able, might have to be able to manage a you know a ventilated patient for a long period of time.
• 15:09
  SPEAKER_00: So so understanding the cross-training, and uh, of course, they all have to understand principles of infection uh control that needs to be um that needs to be uh reinforced.
• 15:18
  SPEAKER_00: The other thing um is to make sure, and and this is more of a leadership, is to not be as make sure that we can adapt to a staffing model.
• 15:30
  SPEAKER_00: If you're gonna have to take care of a lot of patients, you're gonna you can't just focus on a one to two or one to six or whatever the rules are.
• 15:38
  SPEAKER_00: You're going to have to make sure that you can handle a larger number of patients.
• 15:42
  SPEAKER_00: So all the staffing models with respect to ratios, I think is somewhat out the window if you are dealing with an influx of patients.
• 15:50
  SPEAKER_00: And so I think we recognize that during COVID, uh especially when you're dealing with short staff, uh, you know, a shorter number of staff um in the hospital.
• 16:00
  SPEAKER_00: So I would say it's it's both staffing ratio and cross-training.
• 16:04
  SPEAKER_02: Yeah, totally.
• 16:05
  SPEAKER_02: So do you mean this for the non-physician staff or including physician staff as well?
• 16:12
  SPEAKER_00: I think physician staff also can benefit from that.
• 16:15
  SPEAKER_00: We had a lot of surgeries during COVID who absolutely many of my surgical colleagues went home and they uh didn't know what to do.
• 16:23
  SPEAKER_00: I'm sure they wanted to help, but we, you know, we, you know, maybe they could help.
• 16:28
  SPEAKER_00: There's certainly a uh no shortage of needs for physicians to help take care and manage patients.
• 16:35
  SPEAKER_02: So I think pediatric trained people should be able to work on adults, and adults should be able to go down to pediatrics, you know, depending on how young they are going to.
• 16:47
  SPEAKER_02: So I think just having the malleability like you stayed in is very important.
• 16:52
  SPEAKER_02: And remembering that for the next pandemic is even more important.
• 16:56
  SPEAKER_01: Yeah, exactly.
• 16:58
  SPEAKER_01: I think you're exactly right.
• 16:59
  SPEAKER_01: Cross-training is super important to maximize your staffing capabilities, which is something we don't always emphasize, right?
• 17:06
  SPEAKER_01: Everyone gets locked into their their areas and uh tends not to want to venture to other parts of our facilities.
• 17:13
  SPEAKER_01: And kind of along those lines, Vince, which clinical areas in our in our facilities do you think are the most vulnerable and and what really reduces risk in those areas?
• 17:25
  SPEAKER_00: Yeah, I mean, obviously, when we talk about exposures, it's you know, when you're exposed to patient secretions and you know, I think we're talking a lot about aerosol generating type of procedures, anesthesia, airway management.
• 17:40
  SPEAKER_00: So I I mean that's a critical part because obviously they're that's they're most exposed and they need to protect themselves.
• 17:46
  SPEAKER_00: But I would say again, emphasize what we talked about earlier.
• 17:51
  SPEAKER_00: It's it's really every area in which risk could occur.
• 17:55
  SPEAKER_00: And the problem is that we have not necessarily implemented the training and the practice that needs to be done, you know, donning the PPE correctly, making sure that the you know, we're we want to work with working with the administrative and engineering controls to um it's it's really a lot of it is process, not necessarily equipment.
• 18:16
  SPEAKER_00: Um and so it is practice, practice, practice.
• 18:20
  SPEAKER_00: Can't emphasize that enough, and and drilling and training.
• 18:25
  SPEAKER_01: Yeah, you know, and along those lines, and I'm curious to know in your organization, it's probably a mix.
• 18:30
  SPEAKER_01: In our organization, some of our sites are heavily reliant on semi-private rooms.
• 18:35
  SPEAKER_01: And it seems like so much of the transmission and concerns were about patients in semi-private rooms.
• 18:42
  SPEAKER_01: I'm curious in your organization, if you are it maybe it's a mix, if you're heavily reliant on semi-private rooms, it's still hard to believe that in 2026 we have so many patients who are not in single rooms.
• 18:55
  SPEAKER_00: Yes, we still have we still have semi-private rooms.
• 18:59
  SPEAKER_00: Uh they are getting less as more built as more new construction is going on.
• 19:04
  SPEAKER_00: So it's less of an issue, but absolutely that needs to be managed.
• 19:08
  SPEAKER_00: And so understanding uh their transmission or their infectious status, obviously before placement, is is critically important.
• 19:17
  SPEAKER_01: Great.
• 19:18
  SPEAKER_02: So, Vince, where do you think hospitals and public health agencies still did not connect during the crises, during the last pandemic?
• 19:26
  SPEAKER_02: Like what, like in retrospect now, right?
• 19:28
  SPEAKER_02: We've been it's six years out.
• 19:30
  SPEAKER_02: I mean, I should say a little less than that, depending on how many different surges we're talking about.
• 19:35
  SPEAKER_02: But, you know, it's been it's been a bit since we've been in the COVID pandemic, but where do you think now that we can connect and do better between the two, right?
• 19:44
  SPEAKER_02: Between the public health agencies and the acute care hospitals.
• 19:48
  SPEAKER_00: I I think we can still do a better job.
• 19:52
  SPEAKER_00: And I know that maybe it's cliche ish, but we can still do a better job of communication.
• 19:57
  SPEAKER_00: You know, we've got our each of us have our own emergency operations command center going on, and and there are alerts that our public health partners put out.
• 20:08
  SPEAKER_00: But I think what we need to have more of is really that department to hospital connection where you where you have a debrief every day on what we need to do.
• 20:20
  SPEAKER_00: I think communication still uh was lacking and and can be improved.
• 20:25
  SPEAKER_00: The other area of of communication is for for us and for our public health department is to make sure that it's not only acute care that manages these, uh that that have a role to talk with patients.
• 20:38
  SPEAKER_00: It's also our primary care facilities, our community health centers.
• 20:42
  SPEAKER_00: And so I think it's easy for me to focus really on acute care because that's kind of my role.
• 20:48
  SPEAKER_00: But I think there needs to be better connections between public health, acute care hospitals, and all the other clinics in the community that might be seeing patients.
• 20:58
  SPEAKER_00: So a coordination of communication among many different levels.
• 21:01
  SPEAKER_02: Yeah, so ensuring that we bring all of our community partners with us and not just the acute care hospitals, not just waiting for the academic centers or the big community hospitals, but making sure we get all the small little clinics because they are just as efficacious at speaking to patients as the rest of us.
• 21:17
  SPEAKER_02: So yeah, I agree with you.
• 21:18
  SPEAKER_02: Frequent communications, open, transparency.
• 21:22
  SPEAKER_02: So yeah, I get it.
• 21:24
  SPEAKER_02: It's great.
• 21:26
  SPEAKER_01: Okay, and why don't we move into the final section here?
• 21:28
  SPEAKER_01: We've got a couple of questions for you, Vince, about the future.
• 21:31
  SPEAKER_01: So we talked, we've touched on this a little bit with practice rehearsal, but for sustaining readiness, how how do we keep preparedness alive?
• 21:41
  SPEAKER_01: Uh when leadership attention and funding inevitably shift, people lose interest, they just move on to the next news cycle.
• 21:50
  SPEAKER_01: I'm just curious what you're doing in your organization, what you think might be useful for sustaining this process.
• 21:57
  SPEAKER_00: Rob, if I knew the answer to this, I'd be a Very rich person.
• 22:02
  SPEAKER_00: It it is.
• 22:03
  SPEAKER_00: I mean, it's it's it's really hard to keep this first and foremost.
• 22:08
  SPEAKER_00: Um about a couple years ago, I did a presentation.
• 22:11
  SPEAKER_00: I did talk about pandemic preparedness, and I had a physician leader come up to me later and say, Hey Vince, you know, can you please not scare my docs and and please remove the word pandemic out of your slide presentation next time?
• 22:24
  SPEAKER_00: I mean, I mean it was really and and and I I get it.
• 22:28
  SPEAKER_00: I mean, my leaders are not, I mean, they want to do what's right, but they've got so many priorities.
• 22:32
  SPEAKER_00: They've got patients who have sepsis and they've got HAIs to deal with, and that's just within the infection, uh, you know, infectious disease aspects, you know, they got length of stay and so forth.
• 22:42
  SPEAKER_00: So I am trying to figure out a way to make sure that we prepare, that we put in the resources for that uh without making them feel fatigued, and it is a challenge.
• 22:54
  SPEAKER_00: Um, but we know it's important.
• 22:56
  SPEAKER_00: So if you have any great novel ideas on how to do that, please ping me.
• 23:01
  SPEAKER_00: I'll be happy to look at that because it can be a challenge.
• 23:06
  SPEAKER_02: I got a question for you.
• 23:08
  SPEAKER_02: Are you ready for it?
• 23:10
  SPEAKER_00: Go.
• 23:10
  SPEAKER_02: If you could push three system level changes prior to the next pandemic, what would those be?
• 23:21
  SPEAKER_00: I think we actually talked about them, and I'll just summarize that.
• 23:24
  SPEAKER_00: So I think it's a great question.
• 23:26
  SPEAKER_00: Um, we we do have to continue to remain prepared uh in the way that we can, make sure that our our policies, our training, our communication is there.
• 23:36
  SPEAKER_00: And and maybe it doesn't, of course, have to rise to a all hands-on-deck type of thing, but we could at least have some sort of low-level uh health system readiness that allows us to continue to train and focus on on um on preparedness at an operational level.
• 23:56
  SPEAKER_00: The second thing we've also talked about is making sure that our workforce is sustainable and adaptable, make sure that they continue uh get getting uh updated on infection control on a regular basis.
• 24:09
  SPEAKER_00: We talked about potential staffing models that might change, but we have to make sure our workforce is ready.
• 24:15
  SPEAKER_00: Um and then I think the last thing is really just to make sure that our supply chains are good.
• 24:19
  SPEAKER_00: I mean, I think we've learned a lot.
• 24:21
  SPEAKER_00: We have PPE, we you know, we know where our ventilators are within Advent Health.
• 24:25
  SPEAKER_00: We can shift them if necessary.
• 24:27
  SPEAKER_00: I think we have made a lot of improvement on supply chain and and the need to um to to uh get those deployed.
• 24:36
  SPEAKER_00: But again, it also has to be assured that you have the stockpiles along with operational uh readiness as well.
• 24:43
  SPEAKER_00: I those will be my three top priorities.
• 24:45
  SPEAKER_02: So preparedness, sustainability, and adaptability, and supply chain, right?
• 24:51
  SPEAKER_02: Those are the top three that you said that you would you would recommend for any of the system level changes.
• 24:57
  SPEAKER_01: Yeah, and you know what's interesting about supply chain.
• 24:59
  SPEAKER_01: So we're doing our Ebola preparedness, and instead of looking for you know for masks and NN5s, now we're looking for papers, and we're having the same old problems trying to find the right papers, right?
• 25:10
  SPEAKER_01: Because every healthcare system in the country is looking for papers.
• 25:14
  SPEAKER_01: And so it's this it feels like the same old story.
• 25:17
  SPEAKER_01: So I think your your point is so well taken.
• 25:21
  SPEAKER_01: How critical supply chain management is.
• 25:26
  SPEAKER_00: It is, and you know, anything that we can share in this podcast to, you know, to that might help, you know, our partners um and listeners to you know uh to to to help encourage them to be prepared uh with their system is is great.
• 25:44
  SPEAKER_00: I you know just wanted to thank you very much for allowing me to share uh my thoughts with you.
• 25:50
  SPEAKER_01: Yeah, and I think you've highlighted that's really one of the purposes of chess is for people to get together and learn from each other.
• 25:57
  SPEAKER_01: In my time on this group over the last few years, I've learned so much and appreciate the opportunity to learn from people all over the country who may have different experiences, different kinds of healthcare systems.
• 26:11
  SPEAKER_01: But after every meeting, I feel like I've gotten smarter, which I really can't say about a lot of meetings that I go to.
• 26:18
  SPEAKER_02: Yeah, I mean, I still remember during the pandemic when we were meeting so often, I just remember thinking, like, I wish this meeting was longer because we were just sharing resources, talking about the problem that we had at our institution, which inevitably, if it didn't already happen at your institution, was about to happen.
• 26:35
  SPEAKER_02: So it was this this it's this shared community um and the feeling that we get that we're not alone, even though it kind of feels like we're alone.
• 26:43
  SPEAKER_02: So thank you so much, Dr.
• 26:45
  SPEAKER_02: Sue.
• 26:46
  SPEAKER_02: We really, really appreciate you coming on the podcast, talking um about your system and everything that you do to keep you and your system safe.
• 26:54
  SPEAKER_02: We really appreciate it.
• 26:56
  SPEAKER_00: It's been a pleasure.
• 26:57
  SPEAKER_00: Thank you so much.
• 26:58
  SPEAKER_01: Yeah, thanks, Vincent.
• 27:00
  SPEAKER_01: And uh thanks everyone for for listening.
• 27:03
  SPEAKER_01: And if you're interested, join chess.
• 27:06
  SPEAKER_02: Yes, join chess.