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The outbreak of coronavirus has changed the way that healthcare currently operates. From virtual appointments to digital outreach and new protocols — everything in healthcare has shifted in the age of COVID-19. Chief Experience Officer Adrienne Boissy, MD, MA, talks about what we’re seeing, hearing and learning about patient and caregiver experience. She also shares inspiring stories of hope, encouragement and resilience.

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How Coronavirus Is Affecting the Patient Experience with Dr. Adrienne Boissy

Podcast Transcript

Cassandra Holloway:  Hi, thanks for joining us. You're listening to the health essentials podcast brought to you by Cleveland Clinic. And I'm your host, Cassandra Holloway. Today we're broadcasting virtually as we are practicing social distancing. We're joined virtually by Cleveland Clinic's chief experience officer, Dr. Adrienne Boissy. Dr. Boissy, thank you for taking the time out of your day to virtually speak with us.

Dr. Adrienne Boissy:  Of course.

Cassandra Holloway:  So the outbreak of coronavirus has changed the way that healthcare currently operates. And today we're going to be talking about how the experience for both patients and caregivers has changed, and what that looks like in our current situation. But before we dive into everything, we want to remind our listeners that this podcast is for informational purposes only, and should not replace your own doctor's advice. So there's a popular saying that goes, "A good doctor treats the disease. And a great doctor treats the patient who has the disease." I think that saying really helps to explain that the heart of healthcare comes down to the relationships and interactions that we have. And in times like this with coronavirus, healthcare has to be able to shift to still partner with patients because there's still a relationship there and there's still interaction to be had. It can't be lost or forgotten.

Cassandra Holloway:  Dr. Boissy, I know your role is focused on the patient experience and the importance of having these relationships and these interactions. So I first and foremost want to start off by asking you how you're doing, how you're managing everything. And secondly, if you'll tell us a little bit about your role at Cleveland Clinic.

Dr. Adrienne Boissy:  Sure. Well that's probably the best question we could possibly be talking about, which is this is really hard times for a lot of people. And certainly I feel very blessed that we have so many healthcare caregivers out there taking care of us. Working from home creates new challenges. I'm trying to be a mom, take care of two boys who need to be homeschooled, and a partner, and cook dinner, and work. And I'm not sure any of those is going really well. So it can be frustrating and in different ways, and I'm seeing a lot of patients virtually. And I've been doing that for a long time, so that feels pretty good. But boy, it's just a change. And I think so for everybody.

Cassandra Holloway:  Absolutely. So I want to ask you specifically about your role, if you'll kind of just give us a rundown. I think it's important for our listeners to understand how seriously the Cleveland Clinic takes patient experience and caregiver experience.

Dr. Adrienne Boissy:  Sure. So I've been in this role for about six years at the Cleveland Clinic. The chief experience officer role manages a number of departments and teams. So our charge is to really take care of that person behind the disease and make sure that we're delivering care according to the values, needs, and preferences of our patients.

Dr. Adrienne Boissy:  And that includes things like spiritual care, managing complaints and grievances crafting communication, training for clinicians and caregivers. Making sure we've got customer service pinned down, managing all the surveys and responding to that feedback.

Dr. Adrienne Boissy:  It's also shared medical appointments, end of life resources, as well as best practices across the system that we want to double down on. And really spread that are evidence-based. That's a sampling of what we do and the teams that bring it to life.

Cassandra Holloway:  Yeah. Sounds like a whole gamut of kind of experience at Cleveland Clinic that you oversee.

Dr. Adrienne Boissy:  Yeah, I call us the potpourri.

Cassandra Holloway:  Little bit of everything, very important to everything.

Dr. Adrienne Boissy:  But I love it. We're an eclectic mix of people that come with sort of this deep content expertise in the areas of suffering. And we can really leverage each other to deliver something that's unparalleled I think in healthcare.

Cassandra Holloway:  Absolutely. So in the wake of coronavirus, we really can't be together like we used to. You mentioned you're seeing a lot of patients virtually. And I know a lot of other medical providers and patients are experiencing that same thing. So I wanted to ask you, how has interaction changed the most between patient and caregiver during these times?

Cassandra Holloway:  I think it's changed in innumerable ways. I mean, if you think about one of the first projects that we launched at the clinic was really around look, if we're not going to allow visitors in the hospital, how do we make sure that people are never alone? How do we make sure we're always together, and they can always see their loved ones and connect with them? And fortunately, most patients have cell phones. So we quickly stood up and operationalized how do you do Google Duo, or FaceTime, or Skype, and making sure we had bandwidth to support that for all patients across the enterprise. And for patients that don't have those things, making sure that there were iPads on all the units in order for them to do that.

Cassandra Holloway:  Another example is the virtual visit explosion, right? We've been trying to move virtual visits as an enterprise I think for a long time. And we've really flipped that. So it used to be something like 20% virtual visits in some areas, and now it's nearly 70%. So we really flipped that in a very short period of time.

Cassandra Holloway:  And patients, I have to say, we've track patient satisfaction with those experiences. And it's quite high. And the reason we can sort of imagine from all of that feedback is that patients are appreciative that we're still A, taking care of them, B, that we're keeping them safe, and C that we're not asking them to get in a car or drive, wait in a waiting room and waste all that time. And that's really empathy and action for our patients. So I think that's a big way it's changed. One that I'm most excited about is really thinking through how we engage patients moving forward.

Cassandra Holloway:  Historically, there's always been phone calls or you've got to come in person to see me. Or we maybe type each other messages in the electronic health record. And moving forward, we've had the opportunity to experiment with what patient engagement would feel like with digital touches and outreach. So how can we through the EHR connect with patients and send them almost daily messages? Whether that's education tidbits or things they might be worried about. How do they manage stress at home?

Dr. Adrienne Boissy:  So the best example of that is something we've built in the electronic health record with strong collaboration from IT, as well as marketing, as well as the clinical teams. And that's around if you test positive for COVID, you get slotted into both a group of primary care coordinators that will take care of you. And then you also get these digital touches every day. So, "Hey, how are you feeling? Hey, how's the fever? Are you getting any worse, better?" And then if there's any concern, it escalates up to that primary care group.

Dr. Adrienne Boissy:  And what's beautiful about that is it actually starts to feel like you've got a digital partner in your healthcare. And for high risk patients, they get a human call every day plus this type of digital check-in. And for lower risk patients, they're a little bit more dependent on the digital check-in as a means of just making sure that those people feel cared for. But making sure we can allocate that precious human resource to the people who need it the most. That's got a nice link to give kudos at the end, has got opportunities to do advanced care planning. And feels very empathic and conversational. That's a whole new world for us in clinical disease management. And I think that's right for opportunity.

Cassandra Holloway:  And there must be so much reassurance for the patients that if they are positive for coronavirus, they're not just out there in the void. They have a team, like you said, behind the. Backing them, reaching out to them, asking them how they are, and supporting them.

Dr. Adrienne Boissy:  That's right. And the goal as you know is to keep everybody safe, but to really try to manage people at home as much as we can. So providing that daily guidance can feel, extends the touch and extends that relationship in such a beautiful novel way that people can continue to feel cared for even when they're not within our walls. I think that has just enormous potential. And we're looking at how we're going to expand that across the enterprise.

Dr. Adrienne Boissy:  Of course, I mean the thing you always miss about that and even I miss in my own practice is looking people straight in the eye. Not on these goofy cameras, but looking at them straight in the eye, crying with them. And I especially miss the hugs. Those are things you can't replace that I'll always want.

Cassandra Holloway:  Yeah, absolutely. Like you said, nothing will ever replace that physical interaction and then how important it is for humans to connect that way.

Dr. Adrienne Boissy:  There are always things that won't change as well, right? That although we can create connection, people will always want connection. They always want that human touch. So another big source of our efforts has been around making sure that the messaging that goes out working very closely with marketing and others is empathic to the experience and the fear that our patients, and at times our caregivers have.

Cassandra Holloway:  Absolutely. And still having that desire to stay connected, like you mentioned, is incredibly important, especially in health care for sure.

Dr. Adrienne Boissy:  Yeah. I think it's a universal need. And we always talk about empathy. The beginnings at the Cleveland Clinic, right over 10 years ago was patients first and Toby Cosgrove discovering empathy at Harvard Business School. And we always classically think about it in that patient doctor relationship. I think we've pushed that over the years and been successful in advancing the argument that empathy isn't this weird thing that you use just between patient and doctor, right? It's caregiver to caregiver, it's caregiver to boss. It's all these conversations and interactions and opportunities to amplify empathy in everything we do, in every relationship we're in. That that builds our culture. And I think the more we can elevate that, the stronger our culture will be.

Cassandra Holloway:  Absolutely. And I think in times like this, these times, empathy is so incredibly important. And it's comforting to know that that's shining through right now among everything else that's crazy right now.

Dr. Adrienne Boissy:  Yeah. Well we have to. Another great example is something we started recently where we began bubbling up. We have these tier daily huddles that the organization uses to talk about operational issues, experience quality safety issues or giver safety across the enterprise. Those have been in place for the better part of a year. And we began using that system to bubble up stories of amazingness. Of our heroes, of our caregivers doing what they do every day. But under these circumstances, feel extraordinary and heroic at times.

Dr. Adrienne Boissy:  So we've used those to begin bubbling up those stories of heroes. So instead of calling tiered daily huddles, we now call them hero huddles. So an opportunity to make sure we're an organization that's listening and capturing, and spreading that gratitude and celebration of people who are living out our values day to day. Whether that be communities donating food, showing up to deliver flowers at our hospitals on Easter, or our caregivers simply holding the iPad in one hand so someone can connect with their daughter at the end of life and hold the hand of the patient in their other hand. These are extraordinary, beautiful moments that we can bubble up and really meet recognition at the highest levels of the organization.

Dr. Adrienne Boissy:  So those stories bubble up. And then what we do is we have an executive, one of the executives reach out and give them a call and say, "Hey, I want to thank you for what you did yesterday. I heard about this story, and this is about who we are and thank you for living it and bringing it to life." Very powerful way of just keeping the culture and the empathy and humanity alive.

Cassandra Holloway:  Absolutely. I was just going to say that. Yeah, it's so powerful hearing those stories and how important it is to leadership at Cleveland Clinic that we acknowledge this and we acknowledged people being heroes in everyday life right now for sure.

Dr. Adrienne Boissy:  That's right. And Cassandra, the best part is you don't just hear the people on the other end of the phone be like, "Oh my God, I can't believe you called me." But you also hear the executives reflect back to me like, "Wow, I can't even begin to tell you how rewarding that was. I was in tears when I got off the phone." So it's got this reciprocal influence, right? To these interactions that we can again, just creatively craft in nearly every corner of the organization.

Cassandra Holloway:  Amazing, amazing stories for sure. So there seems to be some fear and concern going around about, going to the hospital or going to the ER when you are sick because of COVID-19. So I wanted to ask you for those who are afraid to seek medical care, maybe they're suffering in silence or they're trying to wait this out, or maybe they're juggling childcare and they're not really sure where to turn, or perhaps they're out of a job. So they're kind of concerned about how they'll pay for their medical care. I wanted to get your advice to give to these people about the importance of still seeking care and what can we learn from this situation?

Dr. Adrienne Boissy:  Yeah, what an important issue. I mean, I hear that all the time from my own friends and family, so I know it's top of mind. Look, the bottom line is if you're having a medical emergency, please go to the emergency room. We're prepared to take care of you. We're prepared to keep you safe. The Cleveland Clinic has put everybody in cloth masks as you know and we're following all precautions six feet away as well as the personal protective equipment that we have readily available. So please don't hesitate. You've got a medical emergency, go. That's first.

Dr. Adrienne Boissy:   The second issue is the safety of our community and our patients as well as our caregivers has been paramount from the very beginning. So making sure we've got enough equipment to protect people, making sure we're limiting visitors very early, right? The way the governor shut down the state, I think very early had an impact on our ability to really manage this curve.

Dr. Adrienne Boissy:  So I think we have to be really cautious about we don't know what everybody's situation is. There's no singular fear. Each of us have really individual and oftentimes deep rooted fears. And we as an organization are committed to being humble and asking, right? We're not going to make an assumption that you're not coming because you don't want to take care of your health. I think that's not true at all. I think patients are out there. I do think they're scared. I also think many have probably gone through the loss of a job, or loss of childcare, or whatever it is. And I want to make sure that we're in pathic and asking about what are those barriers for people and then providing the information and resources that we can to make sure that they're getting the care of the need. We know people are delaying or putting off treatment. And I don't think it's because disease is absent. But we're really worried about people who should now, especially as we begin to reactivate seeking care and who don't. The strong, strong messages we're going to reactivate in a very, very thoughtful way with your safety as a top priority. But please, particularly we'll be making reaches out to those patients. And please don't delay care at this point, especially if you need it. And in an emergency, ER every time.

Cassandra Holloway:  Safe place to be for sure. Don't delay care. Seek care when you need it.

Dr. Adrienne Boissy:  Yes, I took much longer to say just that, but you did that very well.

Cassandra Holloway:  So you mentioned visitor restriction policy. So I want to talk a little bit about that. I think one of the most frightening kind of thoughts about being hospitalized with COVID-19 is this idea that you're alone when you're hospitalized. Since there are restrictions on visitors. And when you do interact with caregivers, they're wearing PPE, their face is covered up, you can't see them smile. It's really kind of hard to judge that body language. What are we doing to try to comfort those who are really, truly isolated because of COVID-19?

Dr. Adrienne Boissy:  Yeah. So we do believe that together is always better and stronger, and have tried to be creative about visitation. So we did limit visitors very early. The news to share is we're actively iterating on that and looking at how to expand our visitation in accordance with what the state is saying around reactivation and beginning to open up some procedures.

Dr. Adrienne Boissy:  A couple things to know. So in outpatient areas for example, you can still bring visitor. That's been a part of the visitor policy from the beginning. So that no visitor piece really applies to the inpatient setting. And there are exceptions to that. We've been very sensitive around end of life, so compassionate visits like that for pediatrics as well as for labor and delivery. So there are allowances for that even in today's state. But we are actively looking at that.

Dr. Adrienne Boissy:  Regardless, I want to drive home the idea that we're a pretty creative bunch. So in addition to the iPad visitation, or the Google Duo, or whatever ways to actually put people in front of you. There are a couple stories I want to share about how we have enabled this.

Dr. Adrienne Boissy:  One is glass is a really interesting separator. A bunch of nurses have taken multiple patients down to the lobbies where they can have a birthday party with their child who's on the other side of the glass when we can't create visitation in person. And they have birthday cake, and can open the gifts together, and get on the phone, and sing happy birthday. So these beautiful ways of still connecting and making sure that we create that wherever possible. Another example, right? You're seeing people write on the glass, right, to create that connection.

Dr. Adrienne Boissy:  It's also important for people to know that services like spiritual care to care for your emotional wellbeing or any emotional trauma or suffering that people are having is available 24/7. And whether we use that old-fangled technology called the telephone or we're doing it on an iPad, I can't tell you how many stories I've gotten from chaplain saying, "At first I had a lot of skepticism about this virtual stuff. But now after this conversation of talking to a couple who one of them is going to lose the other after 30, 40, 50 years of marriage, they're so moved by it." And those services are available both in person and virtually. So anytime 24/7 available. We're also available boots on the ground in terms of any complaints or concerns that patients have. We have healing services available, right? So if people benefit or want guided meditation or arts to look at, we have teams that can do that virtually. Ideally now, and as time goes on, have always been available. And not just for the patients, but for the caregivers.

Cassandra Holloway:  I love how you've described so many kind of aspects to a patient not being alone and kind of combating that fear of, "Oh my gosh, I'm COVID positive, I'm in the hospital. I'm by myself, I'm isolated." It's not really that way. There are so many services and opportunities for the COVID positive patients to interact and to still have that that human connection for sure.

Dr. Adrienne Boissy:  That's right. And some people, loneliness has different layers, right? It will impact people differently. And I think we want to make sure again, that we're understanding what that time means for people and how to make it meaningful. Is it playing tic-tac-toe or do you really want to see your kids, or do you want to write, or you prefer art therapy? We're trying to be matching what that person really needs and would create value for them with the service we bring.

Cassandra Holloway:  Sure. It hits home to what we talked about earlier, relationships and interaction, and getting to know your patient. And treating the patient for who they are, not just for the disease they have.

Dr. Adrienne Boissy:  One of my favorite quotes.

Cassandra Holloway:  So you mentioned the glass doors leading into the ICU and kind of that whole experience of patients and caregivers communicating via these glass doors. So many of us have seen the posts on social media going around about the patient who was treated at Cleveland Clinic and recovered, and was then discharged. And this patient left a really heartfelt warming message to the caregivers thanking them for taking care of him and pouring all of their care and their time into seeing that he recovered from COVID-19. As the chief experience officer at Cleveland Clinic, how does seeing something like this make you feel, and how does a story like this boost patient and caregiver morale?

Dr. Adrienne Boissy:  I think it just gets you every time. I mean, I've been reading the letters from patients and complaints for years. And every time we miss, it hurts. And every time we get it right, boy is that a beautiful thing. And I don't know how it makes other people feel, I could just speak from my perspective. People want to know that their work matters. Even I want to know all my work matters some days. And when I read notes like that, when I hear stories like that, when we have an opportunity to bubble that up and tell that across the enterprise, I think everybody can see themselves in that story. They want to be that type of nurse. They want to be that type of caregiver. They want to be that type of loved one. They want to know that if they were a patient, even if they were a caregiver, that that's the kind of quality care that we would provide.

Dr. Adrienne Boissy:  So I think they see themselves in the story. I think it creates an aspirational vision of who we are and what we value. And there's nothing like that sort of wind beneath your wings to keep going, right? On days where you really don't feel like walking any further. You don't feel like getting up that day, and you don't feel like putting your left foot in front of your right foot. These are the types of powerful stories that can just get you to get up and put your shoes on, and come in the next day. They fill our buckets.

Cassandra Holloway:  Absolutely. It's so inspiring, and really just tells a beautiful story about how it's a human experience for everyone involved.

Dr. Adrienne Boissy:  Yeah. I want to pick that up because I think too, we have to recognize as a system stories are nice. And they're powerful as you've highlighted. And I just want to reinforce what has to happen in order for a patient to feel like that is finely tuned operations, and processes, and people that are all focused on the values we believe in. Right? If any one person was just like, "The only thing that mattered was your clinical care." We might not get a note like that. But we, I hope as an organization recognized that the highest quality care means safe care, right? High quality care, finely tuned operations and processes, innovative care, and care that sees the person as a person first, and then the disease.

Cassandra Holloway:  Absolutely. So I want to talk a little bit about the caregiver side of things. We've talked here and there about it. I know you mentioned the hero huddles, which is a fantastic activation that the clinic is doing. What else is Cleveland Clinic doing to support these frontline essential workers during COVID-19?

Dr. Adrienne Boissy:  Well, we're really lucky that the organization stood up in office of caregiver experience right when Tom became CEO. And I think that was one of the most important things we've done, because I've always advocated that it's been the human experience, right? You don't do these weird things for patients. And then these weird separate things for caregivers. They're one. Although they have different needs at times.

Dr. Adrienne Boissy:  But the idea is we should show up for our caregivers in exactly the same way. So even if you go on the internet today, you'll see sort of this whole resource toolkit. That I have to give tremendous credit to Linda McHugh and her team Joy Jones, all of them in the office of caregiver experience have really built out. So whether it's meal delivery every day at the hospitals, whether it's a 24/7 hotline when people are feeling overwhelmed and stressed out, whether it's talking about the really difficult issues and making sure that our caregivers can grieve. There's a 24/7 hotline for that. We have psych support available at all times. We have built out advanced care planning because you're seeing a lot of our caregivers trying to think through, "Oh my gosh. Wait a second. If I get really sick, what does that mean for my family? I haven't done any of this stuff. I don't have a power of attorney and I haven't done my living will." So we have built out a toolkit that's virtually supported with counseling for caregivers to fill that out. So that doesn't have to be another layer of stress on people.

Dr. Adrienne Boissy:  They've also built up hero fuel stations, right? So people can simply get food and water without having to make one more trip to the grocery store. Setting up places that they can stay if they need to, right? Local hotels. And I think engaging the community more broadly, you've seen this tremendous outpouring of support for the caregivers, which has really just been spectacular. Those are some of the things I can think of. Did I miss anything?

Cassandra Holloway:  No, that's so many different inspiring kind of support topics and resources that have been created. That before and during this whole thing. For sure.

Dr. Adrienne Boissy:  Yeah. The two other things that I would be remiss if I didn't mention is one that the enterprise pause. So the idea that a couple of years ago, Silvia Perez-Protto, who heads up our end of life center and programming, had connected with others around the country who had created something called The Pause. You're nodding your head like you're familiar with it.

Dr. Adrienne Boissy:  But the idea for those of you who aren't is that at the bedside, when we lose a patient, we actually huddle around with the family or caregivers, anybody involved and take a pause, a moment of silence after a brief script is read to honor that patient and honor their family. That has also made its way into the daily huddles so that at the executive level, there's also an enterprise pause for every patient we've lost across the organization.

Dr. Adrienne Boissy:  And again, this allows us to heal the caregiver as much as it allows us to heal the patient or the patient's family. And that attention to the emotional experience of our caregivers, I think speaks volumes.

Dr. Adrienne Boissy:  The other one I wanted to mention was you were mentioning earlier about all the PPE, and it can be so scary to see somebody. Susannah Rose from our team is heading up a research project around putting on the front of that PPE pictures of that person in a different time in their life, right? So they look more human to the person they're taking care of. And maybe that would spark a different dialogue and a different interaction and just let them know I'm human too, even though I look really weird and scary and yellow, or light blue. Underneath here I got a heart. And I'm here to take the best care of you that I can. I think that again, just creative ideas of infusing that humanity everywhere.

Cassandra Holloway:  Absolutely. I love the idea of putting a picture on you, kind of smiling and saying, "yeah this is who I am. There's a human underneath all of this equipment," kind of thing.

Dr. Adrienne Boissy:  That's right. And then some people said, "Well we can't make it too lighthearted. We want people to feel the gravity of the moment." And I also, I think that's true and people need some levity, some breakthrough in the constant newness of what it is today. There were some great Harvard Business Review article about that we're all experiencing grief around some of this. So those moments we can create some lift and levity are equally important.

Cassandra Holloway:  Absolutely. And thank you for bringing up the pause every time I hear stories about it. It always is just such an impactful practice and emotional tribute to the patient's lives. And I think it's definitely so important to mention that we do that.

Dr. Adrienne Boissy:  Yeah. Well the true credit goes to Jonathan Bartells at University of Virginia who's been a partner to us roll this out, but now it's an app on your phone. And we partnered to create sort of a national effort around rolling it out and making it available. And again, it's just a beautiful thing we could do for both patients and caregivers.

Cassandra Holloway:  Absolutely. So the last thing I wanted to mention with this kind of topic is the kudos board that was rolled out. So if listeners are interested in visiting that, it's at clevelandclinic.org/kudos. And you can go and give your support and share stories, and acknowledge caregivers and frontline workers by a simple message or a video, or a story. And I think that's worth mentioning as well.

Dr. Adrienne Boissy:  Absolutely. We don't give enough kudos. One thing we changed in our patient satisfaction surveys was we stopped distributing any negative or modifying feedback and are delivering only positive comments to our caregivers. And again, the same thing. They watch the video on the kudos board or they get the positive comment in their email and they're like, "Oh my God, I totally needed that today. Thanks for helping me keep going." So everything you do matters right now and is seen and felt by our caregivers across the enterprise. And it's not just us, it's across the country and the globe. So keep it coming.

Cassandra Holloway:  Absolutely. Yeah. Everyone's together at this point. So the mission of Cleveland Clinic is to care for our patients, our caregivers, and our community. And there have been so many inspiring stories going around about how Cleveland Clinic is helping our communities and the people in our community who might not even be our patients right now. So I'm wondering if you could share a couple of these stories. I know you've mentioned a couple of them with food delivery services and that sort of thing. But I'm wondering if you could share a couple more stories and how they make you feel.

Dr. Adrienne Boissy:  You're trying to kill me, aren't you? So some things that popped into mind about the community and really some of the leadership of Adam Myers in foresee our community health and primary care institute is to be credited. So one that I heard about recently was they had congregated all interfaith community chaplains and religious organizations to have a conversation about how we're continuing to come together and making sure we're supporting patients, as well as them in the community. There's also active outreach now about how do we help local businesses and small businesses in Cleveland think about reactivating in ways that we can help where we can. That's a part of clinical transformation work moving forward.

Dr. Adrienne Boissy:  I also want to call out, you're reminding me of the story of the clinician, was it out at Avon who had bubbled up through the hero huddles about, they were managing a local nursing facility that had a number of cases. They were preparing Avon Hospital for a large influx of patients, and then dramatically turned that around and began to manage that on their own within the facility rather than having to transfer all of those patients.

Dr. Adrienne Boissy:  And another beautiful part of that was there was a partner in that work wherein they were driving around delivering and collecting supplies to make sure that they had all the supplies they needed at the facility. And just this beautiful synergy and teamwork between the nursing facilities in the Cleveland Clinic and that partnership allowed us to manage those patients differently and keep them out of the hospital. I think in the end, they only wound up transferring maybe I want to say two or three patients. This is how we should be working as much as we can. And it's beautiful to see it when it comes together.

Dr. Adrienne Boissy:  You keep asking about my feelings. I'm so touched by people who keep standing up and rising up, and the feeling that probably best encapsulates it is really humility. It makes me feel that what I do is somewhat irrelevant other than making sure we're rising those around us, right? We're lifting them up and enabling their greatness to shine. That is how that has landed on me. And personally like I said, it's been really hard. And for me, these stories make me feel like it's possible to keep going. It's possible for all of us to keep getting up and keep going in service of our patients. And at times, maybe just in service of each other. So I've tried leaving little notes on all the leader's desks to make sure that they know their work is appreciated and valued. All of us can make that choice every day, whether it's posting something to the kudos board or just within your sphere of influence. Or even for someone you don't know, just do that extra thing I think is a lesson to be learned from all of this.

Cassandra Holloway:  Absolutely. So I did want to mention one impactful story that I've seen a couple of time about the childcare collaborations and medical students coming forward and administrative professionals coming forward offering their time and their efforts to help figure out some of the juggles of childcare and with daycares being closed. And I think that was just a really impactful story that jumps out to me that I remember hearing about.

Dr. Adrienne Boissy:  Yeah. So right. I mean med students, right? They're not in class. They're not in school. They could easily just go do something else. And instead, in fact, what they've done is jumped in and helped create COVID registries for our patients, for our researchers, and for our clinical teams to take care of. They've also as you have said, donated into the pool of people who can help take care of caregivers', kids. It's unbelievable.

Dr. Adrienne Boissy:  The other one I heard the other day is we have thousands of volunteers, right? We've managed volunteers in our shop, and thousands of volunteers who donate hundreds of thousands of hours a year to the Cleveland Clinic just to give back. And they jumped at the gun. They wanted to know if they could start making masks or could they show up and help with the iPads. And in fact became part of a pool that we would activate should we get to a point where we actually needed people to help with the hope hospital or just run tests. I mean, it's so humbling to see this goodness all around you. And honestly, I started with feeling blessed despite it all, and I'll certainly end in the same place.

Dr. Adrienne Boissy:  So I don't know if you heard, but there was a call that went out to help support our caregivers in other organizations in particular in New York. So for volunteers at the Cleveland Clinic to go and offer their services. And over 500 people responded to the call wanting to go volunteer. There was a group that went last week. And I have to say that I can't imagine the personal sacrifice that people are making to get on a plane, fly to a place you've never been before, practice before, and just dive in to the experience recognizing the people who are there might be exhausted and needing a break. And that selflessness of our caregivers just shakes me to the core in terms of speaking to who our nurses are, who our clinicians are, who our admins are, who finance are. All of us are caregivers. And the way they showed up for organizations and patients around the country. And in particular, most recently New York. It makes me incredibly proud to be a part of this place. And knowing that this place has a heart. I don't even know what else to say. They are really my heroes.

Cassandra Holloway:  Great. That's wonderful. So many inspiring stories. So the last thing Dr. Boissy I wanted to ask you about today is just kind of addressing our patients directly. So if you could give one overarching message to all of our patients at Cleveland Clinic, what would you tell them?

Dr. Adrienne Boissy:  Breathe. We got you. No matter where you are mentally, physically, we've got your back. We're here to be a trusted lifelong partner, and we're not going anywhere.

Cassandra Holloway:  Beautiful. Love it. Thank you so much Dr. Boissy. You've offered so much great advice and information. And I think most importantly, reassurance for our listeners and myself and just finding hope and comfort that we're in this together and together we rise. So thank you for your time.

Dr. Adrienne Boissy:  Thank you too. It was an absolute pleasure.

Cassandra Holloway:  So for the latest news about COVID-19, visit clevelandclinic.org/coronavirus. If you want to listen to more Health Essentials podcast featuring experts at Cleveland Clinic, subscribe wherever you get your podcasts from, or visit clevelandclinic.org/hepodcast. And don't forget to follow us on Facebook, Twitter, and Instagram @ClevelandClinic. All one word to stay up to date on the latest news and information about coronavirus as well as your own health and wellness. Thanks again for listening. Stay safe, and remember that we'll get through this together.

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