DENVER — In early March, seven Colorado health care systems came together to form a unique medical community.
"Very early in the COVID pandemic, we realized this was much bigger than any one physician, or one hospital, or one health system," said J.P. Valin, the chief clinical officer at SCL Health.
The chief medical and chief clinical officers at Banner Health, Boulder Community Health, Centura Health, Denver Health, HCA Healthcare/Health ONE, SCL Health and UCHealth came together to address the dire needs of the communities they serve.
"This collaboration among our health systems is actually really special," said Dr. Darlene Tad-y with the Colorado Hospital Association on Tuesday. "I have not heard from my network of peers nationwide of anything similar to this at all."
From March 1 to May 31, these health systems cared for 4,903 COVID-19 patients collectively.
While 66% of those patients were eventually discharged, 14% of all of their patients died.
"As we have progressed collaboratively over the last three months, we have learned so much about how to appropriately care for our patients," said Dr. Shauna Gulley, the chief clinical officer at Centura Health.
"One of the most important things we learned early on was that permissive hypoxia, or allowing oxygen levels to float a little lower than normal, made a big difference in how we care for our patients," she said. "It allowed us to avoid mechanical ventilation and overall improved outcomes."
Their collective patient data revealed that while patients 60 and older had a mortality rate of 23%, ventilated patients also had a high mortality rate.
"When you put a tube in somebody, you are putting them at risk for other things like infections and damage from oxygen levels and pressure from the ventilator," said Dr. Connie Price of Denver Health.
Patients requiring mechanical ventilation not only had higher mortality than those not intubated, but also had longer hospital stays and lower rates of discharge directly home.
"A common technique in ICUs is called proning," said Dr. Kathryn Perkins with Banner Health. "It's where you turn a patient from one side to the other side, so they don't collect fluid on that one side of the lung and create more issues. We started doing this on patients that were not in our ICUs," she said, "so that they could keep those lungs functioning better. And what we're really trying to do is prevent intubating by using other techniques and using them earlier."
Avoiding intubation and finding alternative treatment plans is what these doctors are working on now for future COVID-19 patients.
"We learned to listen to the patient," Price said. "Don't pay as much attention to the numbers, listen to the patient. And we learned that the patient can kind of get through it on their own in many cases if we just avoid the intervention of intubation."
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