Around the beginning of March, as the effects of the COVID-19 pandemic were beginning to become evident in North Carolina, UNC Health began to prepare. These preparations included actions to protect our most vulnerable patients, protect our people, and to preserve limited supplies of personal protective equipment. UNC Health and other hospitals in our region moved to a modified System Level of Care and began to perform priority, urgent and emergent procedures and surgical cases only. We took similar actions to identify patients whose exams could be rescheduled without harm, with the goal of reducing the number of patients coming to the hospital and reducing utilization of resources.

On Monday March 23rd, faculty and residents moved to a clinical service coverage model of limited division faculty and trainees onsite, with other assigned faculty and residents working from home or outpatient location reading rooms. Drs. Ben Mervak, Leon Bacchus, Lauren Burke and Katrina McGinty worked with Jay Crawford, Greg Beavers, and our UNC PACs team to test working from home solutions and deploy PACs workstations to allow working remotely. We implemented workforce protection strategies involving physical and temporal segregation for those of our people who needed to be in the hospital. All of our department administrative staff were set up with resources needed to work from home, and all meetings and conferences were moved to Webex or Zoom videoconferencing systems.

During this time, I asked the Neuroradiology, Chest, MSK, and Abdominal Imaging divisions to adjust their work assignment schedules to provide for 7AM – 10PM attending faculty coverage to begin Monday April 6th. This was done in anticipation of an increased need for night & evening consults as the number of COVID-19 inpatients increased. I felt the best way for us to impact hospital operations was to review images and finalize reports quickly through these extended hours.

Thanks to decisive actions and hard work of our state and local governments, UNC Health, and the people of North Carolina, the “worst case scenario” that other countries and regions of the US had seen were substantially lessened in North Carolina. However, with this “flattening of the curve,” we do have a substantial number of very sick patients in the hospital and a persistent high volume of COVID-19 infected patients seeking care in our emergency rooms. It is also very likely that we will continue to be affected by substantial presence of COVID-19 in the community and in our hospital for many months to come.

With this reality in mind, UNC Health and the Department of Radiology are working toward the transformation to resume needed medical care to our patients. We are doing a lot to ensure the safety of our patients and our people. This includes things like providing masks to all patients and healthcare workers at all times, screening patients and workers for signs of illness, and making changes to patient care and work areas to allow for physical distancing.  Patient schedules have been modified to extend the length of time between scheduled patient exams to eliminate the need for patients to wait in common areas. Physical modifications and work process changes have been put in place in all work areas and reading rooms, to allow minimum 6 feet of physical distance or barrier separation between people. The efforts to resume safe patient care already taken over the past few weeks have already resulted in a noticeable increase in the volume of our clinical work.

These modifications to our workplace have made it challenging to complete some of our core work, especially the consultation with our clinical colleagues from other departments that are needed to provide the best care for our patients. To overcome this difficulty, we have put in place remote consultation via videoconferencing and collaboration tools. Many of our divisions have also established routine scheduled “virtual imaging rounds” as an effective means of making consults accessible.

I believe we are fortunate to live in the State of North Carolina, and to have a strong UNC Health team, guided by world class experts on our UNC faculty. I am proud of the contributions to patient care made by our department, and I would like to thank you all personally for the work you have put in so far, and the work to come in the next few months.

 

J. Keith Smith, MD, PhD, FACR
Professor and Interim Chair
UNC Department of Radiology