COVID-19 Physician Town Hall XXXII - AMITA Health

Transcription

COVID-19 Physician Town Hall XXXIIApril 9th, 20211

ReflectionDr. Reinhold Llerena, President, AMITA Health Medical Group; AMITA Chief Population Health Officer2

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Opening RemarksDon Franke, SVP, Population Health and CEO, AMITA Health Care Networks4

These physician town halls are offered for allAMITA Health physicians —independent, CIN andMedical Group.The content for each session is developed inconjunction with AMITA physician leaders.Topics are identified based on calls to the AMITAphysician hotline and through contact with AMITAphysician leadership.Please let us know what topics you would likecovered in future sessions and encourage yourcolleagues to join.5

Meeting AgendaWelcome & ReflectionDr. Reinhold LlerenaPresident, AMITA Health Medical Group; AMITA Chief Population Health OfficerOpening RemarksDon FrankeSVP, Population Health and CEO, AMITA Health Care NetworksAMITA Command Center ReportDr. Stuart MarcusEVP, Chief Clinical OfficerAMITA Vaccine Program UpdateDr. Michael KelleherChief Medical Officer, AMITA Health Mercy Medical CenterPhysician Pandemic Culture of Caring Survey Results& Well Being RecommendationsDr. Cliff Saper - Psychologist, AMITA Health Behavioral Medicine InstituteHeather Hoffman - Regional Director, Clinical Mission IntegrationTracy Collander – South Region Behavioral Health DirectorThe Third COVID Wave and Path to End the PandemicDr. Dana VaisInfectious Disease, AMITA HealthLab and Testing UpdateDr. Janis Atkinson VP Medical Affairs, Alverno Lab for AMITA HealthOpen Q&AModerated by Dr. Reinhold LlerenaPresident, AMITA Health Medical Group; AMITA Chief Population Health OfficerClosing RemarksDr. Joseph LagattutaCIN Board Chair6

Upcoming COVID Physician Townhall & COVID Consortium day2Monday3Tuesday4Wednesday5Thursday6Friday7Next Townhall5678910111213PhysicianTownhall @7am121314151614PhysicianTownhall @7am1718192021262728COVIDConsortium@ 5:30pm1920212223COVIDConsortium@ 5:30pm26272425TBD2829TBD30Email Alyssa.Howell@amitahealth.org to be added to the COVID Consortium meeting invites7

AMITA Health COVID-19 Physician ResourcesAMITA Physician Resource Hotline224.273.3900Calls will be routed to voicemail and returned within 2 hours between 8am-4pm Monday through FridayAfter hours or weekend calls will be returned the next business dayPhysician Hotline health.orgAdditional Resources & Playbooks OnlineAMITAhealth.org/covid-19-AMITA8

Submit Questions Via WebEx Q&A BoxUtilize the Q&A functionality through WebEx on your computer or through the mobile app to submit questionsComputer WebEx AppMobile WebEx App9

Recording and SlidesSlides and a video recording from this townhall will be made available on the AMITA COVID-19 resource site.AMITAhealth.org/covid-19-AMITA10

Command Center ReportDr. Stuart Marcus, EVP, Chief Clinical Officer11

AMITA HealthCOVID-19 DailyDashboardUpdated April 8th, 202112

AMITA Vaccine Program UpdateDr. Michael Kelleher, Chief Medical Officer, AMITA Health Mercy Medical Center13

AMITA HealthCOVID-19 VaccineDashboardUpdated April 7th, 202114

Expanding Vaccine Eligibility State of Illinois: 3/18: Governor Pritzker announced that COVID-19 vaccine eligibility would expand to all Illinois residents 16 y/o,starting April 12, except those in Chicago Nationally: 4/6: President Biden announced that all U.S. adults 16 y/o should be eligible for COVID-19 vaccines by April 19, aheadof prior May 1 timeline City of Chicago: 4/6: Chicago Mayor Lori Lightfoot announced that the city of Chicago would meet Biden’s April 19 date to openenrollment to all adults 16 y/o15

Pfizer trial in Children 4,644 Participants Start Date: March 24, 2021 Age Groups: 5 yr 12 yr; 2 yr 5 yr; 6 mo 2 yrEstimated Completion Date: March 1, 2022Moderna Trial in Children 6,750 Participants Start Date: March 15, 2021 Age Group: 6 mo 12 yrEstimated Completion Date: June 10, 202316

Approximately 71% of USResidents are willing to beVaccinated25% of the population ofThe US is 18 yrs.Using 70-80% as projectedLevel for Herd Immunity,We are unlikely to achieve HIWithout vaccinating children17

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Physician Pandemic Culture of Caring Survey Results &Well Being RecommendationsTracy Collander - South Region Behavioral Health DirectorDr. Cliff Saper - Psychologist, AMITA Health Behavioral Medicine InstituteHeather Hoffman - Regional Director, Clinical Mission Integration20

Culture of Caring CommitteeCoordinating and communicating support resources for associates and physicians– intentionally caring for all through the pandemic and beyondCommittee Chair:Matt ThibeauTracy CollanderAlfred KambackiCharles GreenMichelle KelsoErica GreenCatlin MalitoJake GroenewoldAlicia MeadeAudrey HarwoodCliff SaperHeather HoffmanJim Swarthout21

Human Response to Crisis22

Culture of Caring SurveyPhysician Results Summary34 questions to over 8000 physiciansSurvey Dates: December 5 – 30,2020354 physicians from Inpatient,Outpatient, and Corporate.23

Culture of Caring SurveyPhysician Results Summary81% are married or in a relationship72% are parents; 41% care for children under1810% care for an older family member54% of physicians say that family life has beennegatively impacted24

Culture of Caring SurveyPhysician Results Summary78% of physicians have experienced heightenedanxiety or other challenging emotions63% have treated COVID patients that have passedaway and 35% have lost family, friends, oracquaintances to COVID25% of physicians' physical health has suffered25

Culture of Caring SurveyPhysician Results SummaryOver 75% of physicians felt they had supportfrom others26% of physicians have found value in systemspiritual and emotional support resources36% would use a mobile wellness app26

The Emotional Toll of the COVID PandemicConsuming Alcohol or other SubstancesFamily ConflictsAdded Responsibility of Caring for a Fear of DyingFinancial InsecurityMoral DistressHeightened AnxietyParenting ChallengesIncreased SadnessIncreased IrritabilityFear fo Losing a Loved OneFear of Transmitting the VirusWorkplace Policy and Politics StressAnxiety about Work in the Hospital 27

Verbal Responses:Common Themes and Comments28

What Keeps You Up at Night?29

Top 10 Things That Keep You Up At Night Family Worries (family and spousal conflicts, teenagers, childcare, schooling, college applications, transmissionof virus to the family, parenting challenges) Financial Concerns and Job Security (productivity, decreased patient load, increased COVID patient load,losing job, paying bills, ruined career, job burnout, keeping practice afloat) Pagers and Cell Phones (on call) Political Polarization and Public Ignoring Public Health Warnings (uncertainty) Lack of Support (office managers, administration, poor decisions, too much paperwork and too little patientcare)30

Top 10 Things That Keep You Up At Night Worry (about myself, our nurses, the patients and their families; lack of PPE and beds; conflicts with colleagues) Difficulty Winding Down and Racing Thoughts (especially night shift) Moral Distress (Am I doing the best thing I can in caring for my patients? Who will cover for me if I get sick?) Other things that physicians reported keep them up at night: sports, news, all news, TV, chile and garlic,Tucker Carlson, prostate, snoring spouse, dogs, sex) “Filling out surveys like these"31

Top 10 Things You Have Felt During the Pandemic Fear of transmitting the virus to others Hopelessness Exhaustion Heightened anxiety Fear of losing a loved one Lack of exercise Irritability Parenting challenges Anxiety about working at the hospital Increased sadness32

Top 10 Factors Impacting Your Work Understaffed Taking on more business management duties Overworked; Spouse being furloughed Decreased productivity and income Too many patients or too few Higher complexity and acuity Lack of support Too many calls with patient families Strained physician relationships Difficulty placing psych inpatients because of COVID restrictions33

Top 10 Things You Wish You Had During the Pandemic Opportunity to talk to my colleagues without being judged Adequate space, PPE and supplies Adequate staff – especially nurses and ER Staff More physician help More time in a day, shorter workdays A guaranteed salary to help during these times; hazard pay More flexibility in scheduling to allow family time and spa day Accessible COVID testing for me and my family Leaders being present and giving reassurance about job security Pediatric specific playbooks34

Top 5 Reasons You Haven't Utilized Existing Resources Not aware of resources Resources are not available to me No time to use them Video / virtual conferencing is difficult35

Executive SummaryRespondents seem to be a fairly representative sample of AMITA Health independent andemployed Physicians by inpatient/outpatient roles, ministry site, gender, ethnicity, and age.The Physician Survey highlighted the compassion our providers feel for their patients, theirleaders, their nursing and support staff as well as their colleagues. Physicians were willing todisclose their own vulnerabilities, fears, anxieties, frustrations, cynicism, and exhaustion.Awareness and acceptance are important psychological first steps towards behavioral andcognitive change. This survey was an invitation for input and collaboration and 75% of ourphysicians said they had emotional support from those around them. 26% found value inspiritual support. Many physicians also provided critical feedback for our AMITA Healthleaders.36

Executive Summary ContinuedThe Culture of Caring Committee has concluded that the survey data is not only crucial to consider whenaddressing needed changes in how we empower physicians to practice self-care and guide our leaders oneffective strategies in providing tools for self-care for our physicians,and listening to their concerns. Mostimportantly, we must examine what we have learned this year when we have experienced extendedtrauma, that we will use to be a better organization in the future.Survey responses of our physicians and associates direct our leaders to continue to: Listen Empower and enable Provide recognition Respond and promote a culture of caring Evaluate effectiveness and accessibility of resources Learn where future change could be beneficial37

Specific Recommendations Based on Responses from Physicians Institute daily self- care/family - care strategies such as “gratitude exercises” before coming to work and atwork Find your “Badge/battle buddy” – Colleagues sharing and supporting each other Have open dialogue with office managers, colleagues, and leaders Establish support groups for your colleagues who are also parents or those caring for elderly relatives Develop work-time budgets, and develop transitional boundary-crossing activities. Flexibility is key Meet with colleagues and office mates and managers to create call schedules, break times, back-up, vacationtimes, etc.38

Specific Recommendations for Physicians continued Meet with a financial advisor to develop a budget and a life-style that works for you since productivity willalways fluctuate Take full advantage of free EAP program and physician psychological cocounseling for you and your family ifyou are an employed physician. Independent Physicians can utilize all the AMITA Behavioral Health offerings Understand that there is no shame in asking for help or seeking mental health services We are all feeling anxious, depressed, exhausted, and experiencing symptoms of burn out. This is to beexpected during a prolonged traumatic event. Your feelings are normal. Many of us have lost friends, familymembers, and colleagues this year. Grieving is a normal reaction.39

Recommendations Based on Responses from Physicians for our Leadership Acknowledge and recognize the sacrifices and compassion of our physicians Normalize feelings of anxiety, sadness, grief, irritability, moral distress, and burnout for all of us, whileencouraging each other with healthy ways to cope Encourage use of EAP and AMITA Behavioral Health Programs. Guarantee support resources are widelycommunicated using a variety of modalities, and accessible to all independent and employed physicians. Offerfinancial counseling and strategies to stabilize pay. Training and resources on stress management, work-life balance, moral distress, and related issues. Encouragedeveloping schedules and routines that push physicians to “take reflective breaks” and time away. Acknowledge our families and the stressors they are experiencing40

Recommendations Based on Physician Responses for our Leadershipcontinued: Explore on-site day care and continue to provide transportation, lodging, and financial support for physicians inneed Provide technology support and equipment (laptops, web cams, etc.) including supplies of PPE and other safetysupplies across all locations and offices Ensure that testing is available to physicians and their families; Examine the possibility of helping familymembers access vaccines. Overnight chaplain support and prayer cards with resource QR code Assign volunteer physicians to champion site safety, and Mental Health/Wellness initiatives41

Recommendations Based on Data for our Leadership continued Continue mining and comparing the data from Leader, Physician and Associate Surveys to guide theinstitutionalization of a Culture of Caring. Promote surveying the associates, physicians, and leaders on anongoing basis. Utilize surveys, focus groups, listening sessions, virtual support groups data, town halls,consistent rounding, suggestion boxes, results of Crisis Response events, etc., to affect the culture. Enhance coaching program for physicians on caring for self and others, mentorship, onboarding and aformalized peer support program Provide opportunities for physicians to learn new clinical or support skills across departments, as well asincreasing awareness of existing training programs Via AMITA Forward, continue addressing the standardization of operations, policies and proceduresand communication42

Taking Care of Yourself43

Cumulative Toll of Burnout It is imperative to look at our own mental health moving forward COVID pandemic has exacerbated burnout throughout healthcare In 2020, a survey from Mental Health America of 1,119 healthcare workers indicated that 76% had reportedburnout from the Pandemic. The 2021 Medscape National Physician Burnout & Suicide Report notes that 42% of physicians are burned out(12,000 respondents)Signs that we are experiencing a cumulative toll of burnout: Finding less joy in work Less energy and enthusiasm Depression and anxiety Feeling that it is not fair to take time off; feelings of guilt Increased rumination Irritability and moodiness at work and home44

Associate Resources “Top 10”1. Culture of Caring Resources page on iAMITA2. myCare site3. CREATION Life4. AMITA Health Blog: Getting Over the Emotional Trauma of COVID-19 (blog)5. Work/Life Balance Workbook (pdf)6. Introduction to Grounding and Deep Breathing (video)7. HeartMath Healthcare (website/videos)8. Compassion Fatigue (pdf)9. My Kids are Driving Me Crazy! (pdf)10. Tips to Stay Positive During Trying Times (pdf)45

Physician Well-being Online l-being46

Burnout Self-AssessmentAMITA Independent Physicians:AMITA Medical Group:47

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Crisis Line, Ethics Consultations For associates and physicians experiencing moral distress: 24/7Crisis Hotline – 708.681.HELP (4357) To request an Ethics Consult: go to Ethics on iAMITA or contact49

Employed Physician Resources EAP Wysa Appa pocket companiondesigned to supportyour well-being needs50

Taking Care of Yourself: Emotional PPE Practice Mindfulness Monitor Yourself Manage Your Physical Health Take Breaks Practice Self Compassion Stay Connected Honor Your Own Contribution Breathe51

Thank You For All That You Do!52

Culture of Caring Survey CommitteeTracy Collander: Tracy.Collander@amitahealth.orgHeather Hoffman: Heather.Hoffman2@amitahealth.orgMichelle Kelso: Michelle.Kelso@amitahealth.orgAlicia Meade: Alicia.Meade@amitahealth.orgDr. Cliff Saper: Clifton.Saper@amitahealth.orgVictoria Storm: Victoria.Storm@amitahealth.orgFather Jim Swarthout: James.Swarthout@amitahealth.org53

The Third COVID Wave and Path to End the PandemicDr. Dana Vais, Infectious Disease, AMITA Health54

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WHAT WE LEARNED Asymptomatic and pre-symptomatic transmission Most cases mild, but about 14 % requiring hospitalization (death 3.8%) Droplet/aerosol transmission Rt influenced by social dynamics and total number of cases Super-spreading : major role in transmission56

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Roy and Milton classification obligate: under naturalconditions, disease occursfollowing transmission of theagent only through inhalation ofsmall particle aerosols (e.g.,tuberculosis); preferential: natural infectionresults from transmissionthrough multiple routes, butsmall particle aerosols are thepredominant route (e.g.,measles, varicella); opportunistic: agents thatnaturally cause disease throughother routes, but under specialcircumstances may betransmitted via fine particleaerosols58

TRANSMISSION: AIR SURFACESARS-CoV2 on hard surfaces (early studies): plastic and stainless steel: 6 days;bank notes: 3 dayssurgical masks: at least 7 daysLater studies: skin for up to 4 days clothes: 8 hours library books bound in natural and synthetic leather: 8 daysSARS-CoV2 in the environment: hospital isolation rooms, quarantinehotel: half and one third of the samples; none viable in culture (only onestudy: viable virus in hospital air samples collected at least 2 metres froma person with COVID-19)SARS-CoV2 in town (Tufts University in Medford, MA): risk ofinfection from touching a contaminated surface 5 in 10,000 (lower thanestimates for SARS-CoV-2 infection through aerosols, and lower thansurface-transmission risk for influenza or norovirus)59

R - reproduction number;estimated average measuringthe spread of infection in apopulationR0 - everyone is susceptible; atonsetRt - effective R; overtime,includes immunity; lags behindR is influenced by socialdynamicsRt is affected by the totalnumber of casesNature 583, 346-348 (2020)60

SUPERSPREADING Events when many people are infected at once,typically by a single individual (R0 up to 10) uneven, sputtering form of transmission, inwhich some individuals infect many people butmost infect only a few Individual factors: biological, behavioral Venue factors: crowded indoor spaces with poorventilationNature 590, 544-546 (2021) doi: https://doi.org/10.1038/d461

MITIGATION STRATEGIES Masking Social distancing Enhanced hand hygiene Testing and isolating; contact tracing Vaccination/ herd immunity62

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WHAT WORKED - the pandemic playbook Early and effective action to control borders and monitoring ofarrivals Testing, tracking and tracing everyone suspected of beinginfected Welfare support for those in quarantine to contain the virus Effective leadership and consistent and timely public messaginghttps://www.bbc.com/news/uk-5645503065

GLOBAL STORIES Sweden’s pandemicexperiment: bet on quickly attained herdimmunity;13,000 deaths (Norway: 700);highest death/capita in theneighboring countries;second wave worst;GDP dropped by 3% similar to theother Nordic countries66

ONE: preparation- S Korea: reforms to bolsterpublic health emergencypreparedness and responseTWO: test, track, trace- East Asia: contact tracing Jan2020- Walk-through testing, TAT 5-7hrs- Track-and-trace team followingsuspected cases (mobility data)THREE: quarantine support- Shopping, free meals- Mental health services- Financial aidFOUR: protect the elderly- Prioritize care and support- Surveillance testingFIVE: vaccination strategy67

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GLOBAL STORIES Europe’s third wave: B.1.1.7 variantspread to 27 countries; “opening ofthe society not done in a safe andcontrolled manner” Germany: 2.6 mil cases, 75Kdeaths; 13k deaths in one day AprilFrance 4.3 mil cases, 92K deaths;30,000 new daily cases (rollingaverage) from 10kItaly 3.4 mil case; 105K deaths; 22,000 weekly average69

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“No one is safe until everyone is safe”

Lab and Testing UpdateDr. Janis Atkinson, VP Medical Affairs, Alverno Lab for AMITA Health75

-Mar30-Mar1-Apr3-Apr5-Apr7-AprHoursGraph of Turn Around Times in HoursSurgical Screens and Symptomatic TestsAlverno Lab HS PCR SARS CoV214012010080604020November 10 2020 through April 7SymptomsSurg Screen76

Graph of Per Cent Positives (Pos/Total tests)Symptomatic versus Surgical Screens AMITA HealthAlverno Labs SARS CoV2 Test3530TrendingUp, Slowly% POSITIVE2520151050DatesSymptomsPreOp77

Variants in IL from IDPH WebsiteTesting for variants has doubled in one week, B.1.1.7 is majorityVariantTypeCount Date 3.30.21B.1.1.7218B.1.3513B.1.427/429P.1TotalCount Date4.6.21471(78.5%)5( .8%)2747(7.8%)1977(12.8%)2676001 weekVariants 4.6.21B.1.1.7B.1.351B.1.427/429P.178

Genomic Sequencing at IDPH Laboratories Sequencing now at IDPH Springfield andChicago laboratories Alverno has enrolled with IDPH and is nowsending 10 samples/week for surveillancescreening Cases can also be sent to IDPH throughAlverno upon request but must have approvalfrom Local Health Department79

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FOR COVID VARIANT SEQUENCING:Per IDPH Memo 4.5.21:“Sequencing is for epidemiologic purposes only. Areport will not be issued to the patient or the providerwith results.”For Assistance:Call Customer Service Alverno: 800-937-5521Or Contact your local health department81

4600 households, 9542 individuals tested after Lockdown in April, June and Oct-Dec2020Seroprevalence against SARS-CoV-2 pan-immunoglobulins: Found in only 6.92%Of those, only 39.8% had neutralizing antibodies80% of the patients with antibodies had been asymptomaticGood news – antibodies in these patients – whether symptomatic or asymptomaticlasted for 9 months82

Conclusions:Even at the epicenter of the pandemic, with more than 50,000confirmed cases as of April 8, the estimated seroprevalenceremains low in Wuhan China (6.92%)Low percent of neutralizing antibodies in the seroconverted groupThese low seroconversion rates are supported by other studiesshowing a variable seroconversion rate after infection (average60%) with lower rates for asymptomatic patients (as low as 36%)Taken together, these findings suggest that vaccinations will berequired to promote herd immunity – infection induced by naturalimmunity will not likely be enoughLimitations – this type of assessment does not take into accountother types of immunity such as memory T and B-cell activity83

Antibodies elicited by mRNA-1273vaccine (Moderna) persisted through 6months after the second dose asdetected by three different assays andfor all age groups (18 to 71 years)NEJM April 6, 202184

US News & World Report85

Outpatient Testing at Acute Care CentersPhone to scheduleoutpatient collectionCurrent Collection methodPatient typeScheduled?Collected byABMCDrive throughPreop onlyYesLab and NursingSAMCLab outpatientOutpatient andPreopNoCath Lab, DaySurgery,PhlebotomyHinsdaleDrive throughOutpatient andPreopYesResidencyLaGrangeCollection service CLOSEDBolingbrookTent Walk-upPre-op- Drive throughOutpatient andPreopYes for Pre-opLab- Walk-upPre-op- NursingGlen OaksLab outpatientPre-opYesPhlebotomyRMCLab outpatientYesOP Lab773-990-6340M-F 7-4Asymptomatic onlyYesLab and Hospitalstaff312-770-3006Tu and F9-12Both847-316-6500M-Tu-F-Sat 9-12BothOutpatient andPreopOutpatient andPreopSMEMCDrive through and MOBSFH EvanstonDrive throughOutpatient andPreopYesPre-op RN andLabSJH ChicagoLab outpatientOutpatient andPreopYesOP LabHFMCDrive throughPre-opYesPre-op RN'sJolietDrive throughOutpatient andPreopYesHospital staffAuroraLab Oupatient areaPre-opYesPAT RN's and OPLabSJH ElginLab outpatient areaKankakeeDrive throughOutpatient andPreopOutpatient andPreopHoursBoth asymptomaticand symptomatic?SiteF-Mon 8-4W-Th 10-2M-F 6A-8PSat 6:30-3Sun 6:30-1Asymptomatic onlyBothAsymptomatic only - selfcollectWalkup M-F 12-3Sat-Sun 8-12Preop M-F 7-5,Sat-Sun 7-3BothAsymptomatic onlyAsymptomatic onlyAsymptomatic onlypre-op 833-565-0791acute 815-741-7533M-Tu-F 8-5Sat 8-3Sun 8-12BothAsymptomatic onlyPhlebotomy847-931-5694Hospital staff815-937-2187M-F 7A-6PSat 7-12M-F 8A-12, 1-6PSat-Sun 8A-10AAsymptomatic onlyBoth86

Updated List of Patient Service Centers for asymptomatic PCR testing(travel, etc.)2nd FloorSuite 203AddisonBartlettBourbonnaisCarol StreamChicagoChicago HeightsState /ProvinceILILILILILIL1975 Lin Lor LaneSuite 50ElginIL847-593-9863630-323-3087(847) 669-2879800 Biesterfield Road908 North Elm Street12159 Regency Sq PkwyWimmer Building Suite 402Suite 116Ste 159Elk Grove VillageHinsdaleHuntleyILILIL(815) 725-1129(815) 725-11492000 Glenwood AvenueSuite 110JolietILAlverno PSC Old Town(312) 867-1979(312) 867-1995711 West North AvenueSuite 208ChicagoILAlverno PSC Olympia FieldsAlverno PSC Plainfield ILAlverno PSC RemingtonAlverno PSC RiversideAlverno PSC 6(773) 763-7648(708) 503-3825815-436-7748630-226-5338224-273-4498(773) 763-761020303 South Crawford Avenue15720 South Route 59235 Remington Boulevard7503 West Cermak Road7447 West Talcott AvenueSuite 100Suite 262Olympia LILAlverno PSC St Elizabeth(773) 772-7029(773) 772-70511431 North Western AvenueSuite 137ChicagoILAlverno PSC Tinley ParkAlverno PSC WestchesterAlverno PSC WestmontAlverno PSC Woodridge(708) 429-0625708-492-0341630-856-7898224-273-5546(708) 429-0712708-492-0349630-968-1679224-273-563916650 South Harlem Avenue2434 Wolf Road6311 South Cass Avenue2363 63rd StreetSuite 1Tinley ParkWestchesterWestmontWoodridgeILILILILAccount NamePhoneFaxAddress Line 1Alverno PSC AddisonAlverno PSC BartlettAlverno PSC BourbonnaisAlverno PSC Carol StreamAlverno PSC Chicago ArcherAlverno PSC Chicago 0(815) 928-6192630-462-0397224-273-6091(708) 756-52171339 West Lake Street1041 West Stearns Road656 North Convent Street630 East North Avenue6084 South Archer30 East 15th StreetAlverno PSC Elgin8478883504(847) 888-3542Alverno PSC Elk Grove VillageAlverno PSC HinsdaleAlverno PSC Huntley847-593-9855630-856-38088476692862Alverno PSC JolietAddress Line 2Suite G7City87

Open Q&AModerated by Dr. Reinhold Llerena, President, AMITA Health Medical Group; AMITA Chief Population Health Officer88

Open Q&APresentersAMITA Command Center ReportDr. Stuart Marcus EVP, Chief Clinical OfficerAMITA Vaccine Program UpdateDr. Michael Kelleher Chief Medical Officer, AMITA Health Mercy Medical CenterPhysician Pandemic Culture of Caring Survey Results & WellBeing RecommendationsDr. Cliff Saper - Psychologist, AMITA Health Behavioral Medicine InstituteHeather Hoffman - Regional Director, Clinical Mission IntegrationTracy Collander - South Region Behavioral Health DirectorThe Third COVID Wave and Path to End the PandemicDr. Dana Vais Infectious Disease, AMITA HealthLab and Testing UpdateDr. Janis Atkinson VP Medical Affairs, Alverno Lab for AMITA HealthSubmit Questions Via WebEx Q&A BoxComputer WebEx AppMobile WebEx App89

Closing RemarksDr. Joseph Lagattuta, CIN Board Chair90

Virtual Peer Support for Providers and Associates – Q2 Offerings (April-June)AMITA Health Behavioral Medicine and Spiritual Care teams continue to provide internal virtual peer support groups. Thesegroups provide psychological and spiritual support, as well as self-care recommendations in a safe, confidential forum.Therapists facilitate and assist with steering participants to additional resources. Open sharing and interaction is encouraged.WeeklyThrough Q2TopicTimeFacilitatorCall 331.303.8777MondaysVirtual Support Group for Associates and Providers2:30 - 3:30 pmChris McCarthyPasscode: 462 155 494#WednesdaysVirtual Support Group for Associates and Providers4:30 - 5:30pmChristine Lobraco & Lisa TamezPasscode: 815 598 513#ThursdaysVirtual Support Group: Anxiety, Grief, Exhaustion,and the Challenges of Work / Life Balance7:30-8:30amLisa TamezPasscode: 160 665 092#FridaysAnxiety, Grief and Exhaustion Virtual Support Group12 - 1:00 pmChristine Lobraco, Victoria Storm, & KristenPoniatowskiPasscode: 230 64117#If your work group, program, unit, or department staff wish to have your own virtual peer support group at a time you designate,contact Clifton.saper@amitahealth for a request form.91

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CME Credit for AMITA Health COVID-19 Physician TownhallsThe evaluation survey needs to be completed for each session attended for credit dating back to 3/27. GMEwill issue certificates each month, stating the total CME awarded for said month.AMITA Health Resurrection Medical Center is accredited by the Illinois StateMedical Society to sponsor continuing medical education for physicians.AMITA Health Resurrection Medical Center designates this Activity for amaximum of 1 AMA PRA Category 1 credit(s)TM. Physicians should only claim credit commensuratewith the extent of their participation in the

Submit Questions Via WebEx Q&A Box . Financial Concerns and Job Security (productivity, decreased patient load, increased COVID patient load, losing job, paying bills, ruined career, job burnout, keeping practice afloat) . effective strategies in providing tools for self-care for our physicians,and listening to their concerns. Most