October 29, 2020

VUMC’s resilience amid COVID: Caring for ourselves as we care for others

Caring for ourselves and for one another will be fundamental to the people of Vanderbilt University Medical Center in the coming weeks as COVID-19 is surging, and over the year as the enterprise adapts further to changes while expanding locally and regionally.


by Holly Fletcher

Caring for ourselves and for one another will be fundamental to the people of Vanderbilt University Medical Center in the coming weeks as COVID-19 is surging, and over the year as the enterprise adapts further to changes while expanding locally and regionally.

Just as our health is shaped by the details of everyday life, the well-being of the Medical Center’s workforce underpins its ability to respond and lead when people need it most, leaders said during this quarter’s virtual Leadership Assembly.

Jeff Balser, MD, PhD, speaks at this week’s virtual Leadership Assembly. (photo by Susan Urmy)

And with no end in sight to the pandemic, uncertainty and stress will persist, said Jeff Balser, MD, PhD, President and Chief Executive Officer of VUMC and Dean of Vanderbilt University School of Medicine.

COVID-19 is a marathon of sprints — not a onetime race.

As hospitalizations increase around the state, and with VUMC’s projections rising through the holiday season, finding ways to fortify each other — and oneself — is critical.

“The people of VUMC will be dealing with COVID for some time, and the next few months could be particularly difficult. It’s because of this reality we need to be focused on taking care of one another,” said Balser.

It’s important for each person to recognize the ways they are being impacted personally, professionally, socially and economically, and remember that those around them could be under similar — or greater — duress. Many families around the region, including family members of our workforce and those of our patients, are being hit by reduced income and increased life stressors as the economy changes.

“It’s sometimes hard for health care professionals to admit we need self-care — these are necessities, not luxuries. We intend to protect our people and our communities. We will always be a strong voice for safety practices. Thank you for safety hygiene, wearing masks, social distancing and avoiding large crowds. We’re all in this together,” said C. Wright Pinson, MBA, MD, Deputy CEO and Chief Health System Officer.

VUMC is on the frontlines of the global push to find treatments and vaccinations for SARS-CoV-2, the virus which causes COVID-19. The FDA recently announced approval of remdesivir for use in adult and pediatric COVID-19 patients 12 years of age and older who require hospitalization after preclinical findings from VUMC’s Mark Denison, MD, and researchers at the University of North Carolina at Chapel Hill.

Earlier this month the global biopharmaceutical firm AstraZeneca announced that it was advancing into phase 3 clinical trials two long-acting antibodies discovered by James Crowe Jr., MD,’s lab and optimized by AstraZeneca.


Leadership Assembly Key Takeaways:

Growth and performance: ‘A good story’

VUMC’s clinical volumes rebounded strongly from the temporary falloff when Safer At Home orders went into place and scheduled procedures were cancelled or postponed. Surgeries and new patient appointments are back to pre-pandemic levels, which is a “good story to tell,” Balser said, explaining that the clinical recovery has been largest driver of VUMC’s success at maintaining solid financial footing, and is fundamental to supporting the VUMC workforce during the pandemic.

“Our ability to deal with economic stress has a lot to do with clinical volume. We recovered and we recovered very quickly,” said Balser.

C. Wright Pinson, MBA, MD, talked about the importance of self care and reviewed VUMC’s operational performance. (photo by Susan Urmy)

Economic stress is rife around the country, and VUMC is taking pro-active steps to bolster the personal finances of its workforce.

VUMC raised its minimum wage to $15 on Oct. 1, which increased wages for about 1,800 people. The initiative has been underway for many months, and leaders did not want the pandemic to threaten its implementation.

Additionally, market-based pay increases are in the midst of being rolled out for nearly half of the VUMC workforce, to make pay more competitive with regional and national markets — a measure that will help retain and attract staff, said Balser.

In addition, Balser announced that there will also be a 2% across-the-board merit pay increase effective Jan. 1, 2021.

“We want to do everything possible at this stressful time to support people in as many ways as possible, including economically,” said Balser.

VUMC’s ability to care for people across the region is also growing, with new clinics in Jackson and the Nashville area, a growing list of services in Wilson County, and, now, the upcoming acquisition of Tennova Healthcare hospitals in Shelbyville and Tullahoma, in addition to partial ownership of Tennova Healthcare-Clarksville.

The addition of community hospitals is part of the strategy to provide high quality inpatient care close to home for those who need lower acuity care.

Rationalizing the site of care with health care cost and care intensity, sometimes referred to as “tuning acuity,” creates capacity for higher acuity patients at VUMC. VUMC is the referral center for the highest-intensity services in the region, and in many cases serves as the region’s sole resource, said Pinson.

In addition, given patients’ positive response to telehealth initiatives, there are efforts underway to expand the options available for at-home telehealth supported care, Pinson said.

“I believe the future is very bright. Our leadership and services are needed now more than ever. We are meeting this moment together, with our caring spirit and with our distinctive capabilities,” said Pinson.


Taking care of yourself enables VUMC to care for others

Finding ways to revitalize yourself and act with compassion is essential. The stressors of 2020 — ranging from natural disasters, political contention, racial injustice and the pandemic — are taking a toll on people’s mental and physical well-being.

Stress can also limit one’s ability to communicate with compassion and intentionality.

The diversity of VUMC’s nearly 27,000-person workforce is as textured and complex as the larger community. That diversity is a core VUMC strength in providing care to the community — and it’s important for each person to remember “we need to help one another no matter what we believe or how we differently we think,” said Balser.

The coming months will be challenging, and so too is supporting each other, he said.

“We are essential to the health and well-being to millions of people here in this region and all over the world,” he said.

It’s important in the pandemic era for leaders to seek out ways they can bolster their team and celebrate wins — even if they are small. Finding successes and victories helps people and teams remain focused, even amid chaos.

Taking care of oneself and ones’ colleagues demonstrates leadership, and is profoundly important for taking care of the patients in this region.

COVID-19 has changed lives, the workplace, communities, and homes — and these dramatic changes can and do cause stress, said Pinson.

“How we’ve adapted and stayed highly engaged is impressive. Covid-19 is still here and it is not going away. We must be prepared for the new challenges ahead — and stay vigilant and continue to adapt. As leaders we need to be prepared and armed with tangible ways to help reduce stress in our workforce,” said Pinson.


Coping with a ‘mental health pandemic’

Anxiety, depression and thoughts of suicide are surging across the country, said Jennifer Blackford, PhD, professor of Psychiatry and Behavioral Sciences and director of the Division of Psychology.

The ‘mental health pandemic’ that is strengthening its grip as volatility persists will have both short- and long-term health consequences, said Blackford. It’s critical for people to take steps now to reduce stress levels — and the rush of cortisol in the body — to mitigate potential impacts down the road.

“We’re not getting rest and recovery. The continuous cortisol will have an impact on our bodies. The long-term impact is breathtaking,” said Blackford.