“There are countless details that arise as the University pivoted due to the pandemic, from lectures to test-taking, and you have to figure out how you’re going to do this. And every single person, from my senior vice presidents, to our faculty and staff, to our campus operations people and our custodial staff and everybody in between has stepped up and worked really hard to help us get through this.” – President Kevin L. Alexander
In March, when the COVID-19 pandemic hit, the entire MBKU community of over 1,000 people – students, professors, staff members, administrators and health care providers – suddenly found themselves, along with the rest of the country, navigating an extraordinarily difficult ordeal, made all the more difficult by the dual nature of MBKU’s identity. It is, of course, a health care university, and like all educational institutions, had to shift all of its learning online. But MBKU is also a health care provider, with multiple clinics and many practitioners who serve thousands of patients a year.
Confronting this ordeal required concerted efforts on many different fronts, and MBKU honors those who led the way. They are MBKU’s frontline workers, serving and supporting the University’s mission so that MBKU could continue its critical roles as an educational institution and health care provider. Virtual clinics were developed to supplement online instruction and to serve ailing patients, major technological systems were scaled up practically overnight, and massive amounts of heretofore unneeded PPE were sourced, obtained and distributed.
“We sometimes think that people on the frontlines refers only to health care workers,” says Dr. Julie Schornack, who was responsible for overseeing nearly every detail large and small in MBKU’s response to the pandemic. “But in addition to those essential workers, we have all these others who were doing a spectacular job of supporting our health care workers behind the scenes.”
Clinics Serving Students
The clinical experience is essential for students in all three programs at MBKU. As a supplement to didactic instruction, seeing real patients who require care under the supervision of a professional is a component of health care education that cannot be replaced. As a result of this, the many clinicians at Ketchum Health had to get creative.
“We were tasked with creating a virtual clinical experience,” says Dr. Mark Sawamura, Chief of Primary Care at Ketchum Health. “The challenge was to not only generate volumes of brand-new content on a weekly basis, but to produce diverse topics that were based on real patient encounters. Each weekly case series had educational goals to enhance clinical decision-making, analysis of images and patient data, and assessment and plan formulation. We also had to reformat laboratory courses over additional quarters, all to ensure that the students would develop mastery of skills necessary for patient care.”
In addition to the challenge of providing effective clinical instruction while the University was shut down was the challenge of bringing students up to speed in the early summer when clinics reopened. Associate Dean of Clinics Dr. Mark Nakano created a boot camp of sorts in order to bridge any potential gaps in learning. “We basically brought the students back in controlled environments,” he explains. “We gave them opportunities to brush up on skills, practice on each other, and we introduced them to all the new disinfecting and social distancing protocols in the clinics as well.”
“There were several phases of challenges facing us in the pandemic. The first phase was to communicate effectively about the seriousness of the situation and that students were going to leave their clinical assignment. The second was to determine the delivery of education in a virtual format. The third phase was ensuring a safe restart to hands-on clinical training and reassigning students who were displaced from canceled assignments. The last phase was to ensure that students have had the necessary clinical experiences to ensure an “on-time” graduation and be ready for practice.”
– DR. JOHN NISHIMOTO, Dean Professional Affairs and Clinical Education
Clinics Serving Patients
A global pandemic does not unfortunately halt the necessity for other health care. People still have a need for glasses, contacts, or more serious eye care, and MBKU’s health clinics serve thousands of patients a year. For many of these patients, Ketchum Health is a critical lifeline to services they otherwise may not have access to, and the pandemic threatened it.
“From a clinical perspective, our biggest challenge in the Cornea and Contact Lens department was determining how to serve our diverse patient base while having minimal to no in-person contact,” says Dr. Erin Rueff, Chief of Contact Lens at Ketchum Health. “We also serve a large population of patients who wear special, customized contact lenses out of necessity. In many cases, these patients can’t do things like drive, take care of their families or go to work without their custom contact lenses. During our clinic closure, we had to get creative about how we served these patients. This meant many phone calls, emails and telemedicine visits to assess symptoms and special situations. Our doctors historically have special relationships with these patients, in particular, but this unique time has only strengthened those bonds.”
Keeping patients, doctors and students safe when they receive and provide eye care requires a commitment to protocols that are onerous yet necessary. Fran Ward, Director of Optical Services, was tasked with not just continuing to order and dispense glasses for essential workers, doctors and nurses, but also with establishing these protocols. “We sanitize tables, chairs and all the equipment after every patient we see,” she says. “We disinfect 150-300 frames daily and, of course, we maintain social distancing with opticians, students and patients.”
“Everyone in our service, including the students, adapted and contributed to making adjustments to meet our patients’ needs in a safe manner and continue our clinical education program. From flexible scheduling, to modified procedures and innovative use of telemedicine to perform as much of the exam as possible remotely with the patient safely at home, we are able to significantly reduce the face-to-face time between our patients, students, doctors and staff. In addition, our adaptive technology evaluations are largely able to be conducted remotely with student involvement while the patient is at the clinic.”
– DR. PATRICK YOSHINAGA, Chief of Low Vision
When Matt Breneman and Sam Young attended MBKU’s annual University Retreat in February, neither of them likely expected that, in just a few short weeks, they and each of their staff would become the critical linchpins that allowed an entire health care institution to stay afloat while transitioning to online education. As the Director of Multimedia Services and the Director of Information Technology respectively, Matt and Sam were accustomed to navigating changing technologies and solving problems with complex systems in order to support MBKU’s educational mission. But nothing could have prepared them for the enormous undertaking that would greet them in March 2020.
When the shutdown happened, Matt and Sam were suddenly responsible for taking a world that relies on close human interaction, exchange and communication, and allowing it to continue functioning without the humans being “close” to each other anymore. “Everything was a challenge,” says Matt. “It seemed like every time we turned around, we would need to figure out a way to execute another process in a now remote world. The biggest challenge was staying a step ahead with these new processes to support the colleges, faculty and students.”
Typically institutions of MBKU’s size and complexity require a lot of careful planning and the requisite time for implementation when approaching the process of changing or introducing systems. Matt and Sam had no such luxuries. “We did not have time to prepare, research or discuss,” says Sam. “But we took action and helped make it possible for the employees to work remotely and distance learning to happen. It was a lot of hours and stress, but I’m really proud of my IT team for stepping up and helping the University go full distance learning without any preparations.”
Campus Safety & Security
“I am extremely proud of the response of the President’s Executive Council (PEC) team to this pandemic. Although classes switched over to online learning, the team managed to create and implement safety guidelines to allow students, staff and faculty back on campus quickly. I also admire the adaptation to the recent changes by all students, faculty and staff at MBKU. Their willingness to adhere to the implementation of the COVID-19 policy to ensure the safety of every one’s health is a measure of the kind of community we have here.”
– JESUS BARRERA, Director of Campus Safety & Security
The Battle to Source PPE
Last April, it was suddenly impossible for the typical shopper to walk into a grocery store or go online to find enough toilet paper or hand sanitizer for their household. So, what might one do if they were responsible for reliably obtaining supplies for an entire university? This task became the unexpected full-time job of Deb Woods, Auxiliary Services Manager and manager of the Campus Store.
“She was really relentless in her pursuit of trying to identify reliable vendors and solid supply chains,” says Dr. Julie Schornack. “She had to make sure that the University at every level, whether it was sending our people out into clinics, or whether it was seeing patients within our own four walls, had all the personal protective equipment, and all the disinfecting supplies that were required to keep us all safe.”
The term “PPE” wasn’t even that familiar to Deb Woods at the beginning of the pandemic; obviously, she knows it intimately now. “Never, in the history of the University, has any employee been tasked with procuring items in such vast quantities amidst an active pandemic,” she says. “I had to determine how and where to store them, create policies for dispersion to departments and students, and anticipate needs not only when we would return to the University but also what students would need, driven by their rotation locations, to stay safe and healthy. There was no policy or precedent. As PPE procurement became my life, the support of University leadership was unmatched. I became fully immersed in masks, goggles, gowns, gloves, sanitizer of all types, face shields, etc. The backing of upper management in approving the budget required to make these PPE acquisitions was vital. MBKU calls itself a family, and when the family is at risk, they strive to protect each other.”
“I’m so proud of my team: staff, administrators, students and faculty members. Once we recognized the enormity of the pandemic and got our heads around the challenge that was before us, we came together and we implemented a safe and effective strategy to reopen the clinics.”
– DR. MARK NAKANO, Associate Dean of Clinics
When Dr. Brandon Grove was hired at Ketchum Health to serve as Chief Medical Officer and establish the new Family Clinic, the goal was ultimately for students in the School of PA Studies to have a home base of sorts, a clinic they could rotate through that was more academic in nature than certain preceptor sites. It would also provide more opportunities to get a diversity of clinical experience in the relatively short and utterly intense PA curriculum, where exposure to some disciplines is harder to come by than others.
Typically, one such discipline is behavioral health. The pandemic changed that. The stress of living in a constantly evolving health crisis, the vast shutdowns and resulting isolation, and the fear and concern about the virus itself have all contributed to a burgeoning mental health crisis, which has had an evident effect on the types of patients Dr. Grove sees and which puts him and MBKU students on the frontlines in a new way.
“It’s been harder to get patients into psychiatrists and therapists and psychologists, and because of that, we’re actually doing more behavioral health issues here in family medicine,” says Dr. Grove. “We get a range of patients, struggling with bipolar disorder, severe depression and acute anxiety issues. So I’ve gotten a chance to work with students with these patients and they’re getting to see what behavioral health looks like from a family medicine standpoint.”
The COVID-19 pandemic has been a national and worldwide tragedy, and its costs are still being counted. No one at MBKU wanted to see the strength of the University tested by such a devastating crisis. There is solace, however, in what the virus was not able to destroy: the familial bonds that MBKU takes pride in, the resolve of dedicated and compassionate interprofessional health care providers, the selfless hard work of the people who make up MBKU’s clinical support systems, and the fervent belief in the importance of quality medical care for all who are in need of it.
Many in the community of MBKU had their fair share of stressors at the beginning of the pandemic, from shifting instruction online to maintaining rotations as health care providers themselves. Dr. Azita Alipour, Assistant Professor in the College of Pharmacy, was among these, but she also had an additional factor adding strain to her life. Her husband is a general surgeon and the Director of Robotic Surgery at St. Joseph Hospital in Orange County, and is one of many helping to save lives on the frontlines. In addition to performing emergency surgery on COVID- 19-positive patients, Dr. Alipour’s husband was also seeing other patients in abnormally severe conditions since they were understandably hesitant to seek medical care.
And while Dr. Alipour was able to teach her MBKU classes and consult with mental health cases as a psychiatric pharmacist at St. Joseph, the pandemic also, like so many others, gave her yet another career: elementary school teacher to her two children. “The MBKU community and culture shined by encouraging all employees to work from home during this time and provided us with the needed resources and guidance,” she says. “This allowed me to not only to keep teaching my course, but also be able to take care of my two kids at the same time from home. I am so appreciative that I work for an institution that took such great steps to keep our MBKU community safe while also maintaining our high standards for academic excellence.”