June 10, 2020: Partnering in Your Care: A Smilow Patient and Family Forum

June 11, 2020

Information

Hosted by Charles Fuchs, MD, MPH

Presentations by Drs. Tara Sanft, Anne Chiang, James Yu, Sarah Mougalian, and Anamika Katoch and Connie Smith, Maureen Major Campos, and Kim Slusser

ID5309

To CiteDCA Citation Guide

00:00Why do we get started?
00:02So we're, you know.
00:04So we take a good use of all of the hour.
00:08I want to welcome everyone.
00:10My name is doctor Charles Fuchs
00:12on the director of the El Cancer
00:14Center and the physician in chief
00:17of Smilow Cancer Hospital and
00:19welcome to our patient family forum.
00:21Partnering in your care.
00:23This is actually the third of
00:25our patient family forms that we
00:27initiated during this global pandemic.
00:30With the goals of.
00:31Of keeping the people that we serve,
00:34our patients,
00:35families and community.
00:36Keeping you informed about what we're doing,
00:39how we're ensuring exceptional outstanding
00:42cancer care throughout this time and
00:44how we're keeping patients and families
00:47in our staff safe in the process.
00:49and I wanna before we get started to
00:52just introduce and thank my colleagues
00:55who are joining me this evening
00:58and just a while I call your name.
01:01Why don't you wave so that.
01:03People know who I'm describing on
01:05the on the Hollywood squares panel.
01:08If they're probably looking at so
01:10I'll start no particular order.
01:12I'm I'm joined today by Kim sister,
01:15who is the vice president for patient
01:18services and our chief nursing officer
01:20for smilow cancer hospital terrorists.
01:22And who's the chief patient experience
01:25officer director of the Smiler Survivorship
01:27Clinic in a medical oncologist in
01:29our breast program lesavoy Barada,
01:32who's program manager for
01:33oncology nursing education and.
01:35Practice Ceramah Galion.
01:36Who's archief ambulatory officer for
01:39Smilow Cancer Hospital and also a medical
01:43oncologist in our breast cancer program?
01:45Connie Smith,
01:46who is the director of oncology social work.
01:50Anchang,
01:51who is our chief network officer for
01:54Smilow Cancer Hospital in a medical
01:57Oncologist in our lung cancer program.
02:00Maureen Major Campos,
02:02whose director of ambulatory
02:04patient services and Amika Kotuk.
02:07Who is the medical director for small low
02:10cancer hospital care center in Waterbury,
02:13CT and James you who is the medical
02:16director for smile or radiation oncology
02:19at a radiation oncologist providing care in
02:22our Department of therapeutic radiology?
02:25So let me,
02:26um,
02:26sort of share a some slides
02:29with you as we start,
02:31and you know our our agenda for today
02:34is beyond some introductory remarks
02:36that I'm going to offer includes an
02:39update on our ambulatory care program,
02:41how we're addressing patient
02:43safety and testing as we address,
02:45continue to address.
02:49You not see my slides?
02:51Yeah, you're right. It's funny.
02:53It says it says it's sharing the
02:56screen but. Let me start again.
03:03Is that work, no.
03:06Earlier you sometimes if you have multiple
03:09things open yet to select your screen.
03:12Which screen you're gonna share? Sorry
03:15for this technical difficulty everybody.
03:19Try this, how's that? Is there
03:22work there you go? OK, I
03:24don't know what I did but it worked.
03:28So our agenda is, uh, an update,
03:31an ambulatory care on patient safety and
03:34testing a patient support from Connie,
03:36Uh, and then terror will moderate
03:39a panel discussion with the entire
03:42group to address your questions.
03:44And so if you have questions,
03:47you can submit them while we're on
03:50going either through cancer answers
03:52at yale.edu or by clicking on the
03:55Q&A function in the zoom chat.
03:58In the zoom function,
04:00rather the QA function.
04:01So we've gone through an extraordinary period
04:05of our history as a nation and as a world.
04:08Obviously this pandemic has had an enormous
04:11impact on life around us in our community,
04:14with an extraordinary
04:15peak across the country,
04:17particularly in the northeast and what
04:20we're very fortunate now to experience is
04:22a continued decline in the number of cases,
04:25and I think we're on the better end.
04:29Of this pandemic,
04:30such that things are now reopening
04:32across Connecticut New York,
04:34what island,
04:35Massachusetts,
04:35the communities that we serve
04:38as many of you know,
04:39we are at Smilow Cancer Hospital
04:42and Yale Cancer Center,
04:43a National Cancer Institute designated
04:46comprehensive Cancer Center that is a
04:48designation that is only granted to about
04:5140 centers across the United States.
04:53We,
04:54the only comprehensive Cancer
04:55Center in the state of Connecticut
04:57serving throughout the Region 2.
05:00Provide cutting edge clinical care.
05:02Groundbreaking clinical,
05:03research, education, outreach,
05:04and that's something we
05:06emission that were devoted to,
05:08and I'm so pleased to say,
05:11were devoted to throughout this pandemic,
05:13and I'm so proud of the work
05:17that all of our staff have done.
05:20Throughout this time to keep our
05:22patients safe and to preserve
05:24the sacred mission of providing
05:26outstanding care to our patients,
05:28an I think the experience of our
05:31patience is been one that's continued
05:33great care in a safe environment
05:36and one where also we have ensured
05:38that our patients are safe.
05:40We have so many health care
05:42heroes that we want to thank.
05:45Many of them were on this call today
05:47and we also want to recognize the
05:50extraordinary courage of our patients.
05:53Who each day inspire us and from
05:55whom we are so privileged to
05:58work with at our Cancer Center?
06:01No,
06:01we we now as we sort of get back to
06:04a returning to full operations and
06:06I want to point out the fact that
06:08we continued to provide cancer care
06:11throughout this period of time,
06:12but we obviously are bringing back
06:14all our services back to the sort
06:17of normal state we have are what
06:19we refer to as our transformation
06:21team and work boots.
06:22Because as we resume full activities
06:24in Arkansa Center,
06:25we also want to take advantage of the
06:27fact that we want to look carefully at.
06:30We are we always providing.
06:32Care in the most innovative way
06:34that provides the best experience
06:35for our patients?
06:37And so we have work groups
06:38on the inpatient side on the
06:40outpatient ambulatory side.
06:41In terms of how we provide supportive
06:43care and no less importantly,
06:45how we deliver clinical research.
06:47How we avail clinical trials to
06:49patience and to work across all
06:51of our departments to do it.
06:52I will say that on the
06:54clinical research side,
06:55you know we've had to put a bit of a pause
06:58in terms of our clinical trial work,
07:01but I want you to know that
07:03research is resuming.
07:04And really, even during this period of time,
07:07the great work at our Cancer
07:09Center has been recognized.
07:11Young Cology Nursing Society,
07:13which is a major international
07:15meeting our nurses at Smilow,
07:17submitted a number of key research,
07:19an care innovation breakthroughs
07:21number of them were recognized.
07:23That meeting,
07:24which will happen in a
07:26virtual form down the road.
07:28But it's just a real credit to our
07:31nurses and I want to share some
07:34other recent developments from our
07:36Cancer Center that were presented
07:38just last week at the national.
07:41Or the international major cancer
07:43cancer meeting otherwise referred to as
07:46the American Society of clinical oncology.
07:48Two important breakthroughs of examples
07:50I want to share with you with the
07:53work that continues to go on today.
07:55So prostate cancer,
07:57a major cancer that effects.
08:00You know,
08:00hundreds of thousands of men worldwide.
08:03A lot of good treatments going on,
08:05but clearly a need to further improve the
08:08care for men with advanced prostate cancer.
08:11A scientist by the name of
08:13Craig crews here at Yale,
08:15discovered a way that he could create
08:18a drug that would select a protein
08:20and destroy that protein otherwise
08:23referred to as protein degradation.
08:25And so if he could,
08:27if you knew that there was a protein that
08:29was critical for a particular cancer,
08:32he can now create a drug that
08:34if you take and you take orally,
08:37it will destroy that protein and
08:39then damage the cancer because that
08:41protein is so Kate and what he did
08:43is he just he developed a Protea
08:46Protack of protein to greater,
08:47again something that was key
08:49to prostate cancer cells,
08:51and that pro tech or that oral
08:53drug then led to a clinical trial
08:55led by doctor Daniel Petrol Akira.
08:57Yeah, and that phase one trial,
09:00which was just reported last week
09:02for men with advanced prostate
09:04cancer who had progressed through
09:06all available therapies.
09:07That drug actually lead to
09:10reduction in cancer in several men.
09:12This is early work,
09:13but I will tell you it's a really
09:16important finding because this is
09:18a whole new Ave for cancer therapy.
09:22That way we could selectively target
09:24a particular protein that not only
09:26selectively kills the cancer.
09:28But actually potentially reduces
09:30side effects from cancer be cause
09:32it is so selective,
09:33and I think this could open up a
09:35whole new Avenue of cancer therapy
09:37for a variety of cancers as well.
09:40We've had great success from the
09:42leaders of our lung cancer program.
09:44Doctor Roy Herbst,
09:45who leads our program and is the
09:48chief of medical ecology.
09:49Let us a large international study
09:51that was let it Yale of a drug
09:54called us emergent if which is for
09:57a particular type of lung cancer.
09:59Those cancers that had.
10:01Great mutation in a gene called EGFR.
10:04And what he did he did is he took
10:07individuals lung cancer who were
10:09undergoing surgery in an effort to see if
10:13you give this drug this pill after surgery,
10:16can you improve the Curie with
10:18surgery as opposed to surgery alone?
10:20And the trial was completed?
10:22It was reported out last weekend and
10:25what they find they found that the
10:28individuals who got this drug had
10:30an 80% improvement in their disease.
10:32Cancer free survival.
10:33Let me tell you that number is staggering.
10:36We've never seen a number like that.
10:39Successful studies in this space
10:40have maybe a 30 or 40% improvement.
10:43This is really a groundbreaking landmark
10:46study out of our center and was so excited.
10:49Doctor Sam,
10:50who leads are cancer survivorship
10:52program can tell you more.
10:54But this week is cancer survivors week.
10:57We celebrate our survivors.
10:58We had planned for a impersonal vent.
11:01But Doctor San Fran colleagues are
11:03having a series of online virtual forms
11:06and we encourage you to participate
11:09in this one thing we want to get
11:12across today with our form is to
11:14communicate to you the importance of
11:17returning back to the Cancer Center.
11:19If you are concerned about cancer,
11:21if you're being treated for cancer,
11:24don't let that go unchecked.
11:25Why do I say it?
11:27Because this was a headline
11:29from January this year when we
11:31reported our can statistics,
11:32we saw that we had the largest
11:34reduction in cancer mortality.
11:36United States ever.
11:37Why?
11:37Because of screening prevention treatment,
11:39let's not lose that progress.
11:41So come back, it's safe.
11:42And as you'll hear from my colleagues,
11:45we are open for business and we providing
11:48this continued state of the art care.
11:50In a safe and protected environment.
11:53And you know, finally,
11:54I just want to conclude because I'd
11:57be remiss not to also recognize the
11:59events that are going on in our communities.
12:02Our nation, you know.
12:03Sadly, the senseless murder of George Floyd
12:06is bored again to the 4th root for front.
12:09The longstanding issue of systemic racism
12:11and racial injustice in our country.
12:13And, you know,
12:14as as a community of caregivers
12:16and researchers and educators here,
12:18it's Milo and Yale.
12:19We are committed to the common
12:22humanity that hold us together and.
12:24Not only we focused on defeating cancer,
12:27we have a duty and responsibility
12:30that's equally compelling.
12:31That is,
12:32to eliminate injustice,
12:33intolerance that both shorten
12:35the lives of individuals and
12:37limit the potential for so many.
12:39So, you know,
12:41at our center,
12:42we are intensifying our focus to
12:44address the issues of racial inequality
12:47that affect our entire community,
12:49and together, we are committed
12:51to our commitment to diversity,
12:54inclusion, equity.
12:54Social Justice to ensure
12:56that all individuals,
12:57regardless of race,
12:58Creed identity,
12:58will flourish in our
13:00community and I look forward,
13:01we all look forward to working with
13:03our colleagues with all of you on
13:05this very important, important effort.
13:07So let me stop there.
13:08I know I ran a little long,
13:10but I'm now going to turn
13:12it over to doctor Sam,
13:13who is going to moderate
13:15the rest of the form.
13:19Thanks, Charlie,
13:19those are really nice words.
13:21Uhm, I'm a great way to open this up.
13:24We would like to hear now
13:26from doctor Sarah Moog Alien.
13:28She is our chief ambulatory officer and
13:30she and her team have moved mountains
13:33literally across the state and back again.
13:37So Sarah, Why don't you update
13:39us on your transformation?
13:42Ah, thanks Terra.
13:43Um and thank you Charlie and all
13:45for the opportunity to speak
13:47with everyone this evening.
13:48It's great to see so many people on line
13:50and live on on Facebook as you mentioned.
13:53I'm a member of the ambulatory workgroup,
13:55which is led by Maureen Major
13:57campus and Anchang,
13:58both of whom were on the panel this evening.
14:02Let's go to the first side.
14:05I think I'd like to start by
14:08saying that earlier this year we
14:10were all overwhelmed by COVID-19.
14:12It was knew it was scary and we
14:14quickly needed to come up with
14:16solutions to continue to care
14:18for our patients with cancer.
14:20Over the last couple of weeks,
14:22however,
14:23I've developed a new perspective and I'd
14:25suggest that we can reframe the experience.
14:28What started as a public health
14:30crisis may actually lead us to
14:33transform the care that we provide.
14:35Um, as many of you likely know,
14:38many of our practices relocated for a
14:40couple of months in the middle of COVID-19.
14:43Several of our care centers joined
14:45forces into one physical location.
14:47Many of our New Haven based
14:49ambulatory clinics moved to Guilford,
14:51North Haven and Trumbull.
14:54Um, however, is,
14:55I'll show you in just a second,
14:57many of our clinics have now relocated
14:58back to their original spaces or
15:00more spacious temporary locations,
15:02and we can now start getting down to
15:04the business of transforming our care.
15:06So we're in the process of
15:09ramping up our visits in clinic,
15:11all while maintaining social
15:13distancing where addressing the
15:14backlog of patient visits that were
15:17cancelled or postponed or encoded 19.
15:19Um,
15:19we're going to optimize our schedules
15:22are clinic visit times are clinic hours,
15:24and we're working on ways to enhance
15:27the patient experience using
15:29technology and touchless contact
15:31before and after clinic visits.
15:33Next slide,
15:33please.
15:36Just to give you a sense of all of
15:39the moving parts up in the last week,
15:42the breast center in gynecological
15:44oncology programs have moved from
15:46the Shoreline Medical Center in
15:48Guilford back to space in the
15:50North Pavilion on MP4 and MP8.
15:51We've kept a couple of groups,
15:53namely neuromedical, oncology,
15:55GI medical, oncology liver and
15:56the thoracic oncology program.
15:58At the six divine St location in North Haven.
16:02The Fairfield Care Center,
16:04which had been previously merged
16:06with Trumbull, is now open three
16:09days a week and starting next week.
16:12The Orange care center will reopen full time.
16:16Next slide, please.
16:21I don't show you this slide to to
16:24get into the details of the data,
16:27but I do show it to to demonstrate
16:30that we've continued to
16:31provide care for our patients.
16:33We saw initially a sharp decline
16:36as as COVID-19 hit very suddenly
16:38in our in person visits,
16:40but over the last few months we've
16:42restarted or we have continued to
16:45see patients both in person and
16:47via telephone and video visits,
16:49and with the incorporation
16:51of technology based.
16:52It is it's we're now seeing close
16:54to the number of patients that we
16:56were seeing prior to cope with 19.
16:58Next slide, please.
17:02As we now have the
17:04opportunity to move forward,
17:05we have a central guiding principle.
17:08We need to keep our patients
17:10and our staff safe.
17:12We know that patient visits are
17:14going to increase as screening tests,
17:16procedures and surgeries come back online.
17:19We also know that in person,
17:21clinic and treatment visits are absolutely
17:24critical for many of our patients.
17:26And finally, we've adopted a number of
17:29strategies to achieve social distancing.
17:31Namely, minimizing physical contact
17:33between patients and staff and
17:35time spent in waiting rooms.
17:36We've extended clinic hours to reduce
17:38this patient traffic or cleaning and
17:40disinfecting after every patient.
17:42We have mandatory screening both
17:44on the phone the day before a visit
17:47and in at the time of the visit.
17:49Appan arriving to the building.
17:52All of our staff and patients are
17:54expected to wear face masks masks.
17:57And we have a separate treatment space
17:59for patients confirmed to help Cope in 19,
18:02so they're not being treated in
18:04the traditional clinic setting.
18:05Next slide, please.
18:09We've developed a number of
18:10guidelines to help us achieve
18:12social distancing in clinic,
18:13and I show you this schema just
18:15to demonstrate the complexity and
18:17the number of steps that a patient
18:19must go through to see a physician.
18:21To have lab work to receive
18:23an infusion treatment,
18:24and at each of these stops requires the
18:26wait time it can result in patients
18:29gathering together and we've put
18:31in place a number of guidelines to
18:33minimize wait times and to minimize
18:35the number of patients in any waiting space.
18:38So, for example,
18:39fewer patients are being scheduled per hour.
18:41We're continuing the robust talla
18:43health practice that we've developed
18:45over the last few months.
18:47We've extended our clinic hours
18:48from 7:30 to five,
18:50including over lunch,
18:51which we traditionally have have
18:53kept as a break for our providers.
18:56Um infusion treatments are
18:57now scheduled across the day,
18:59not rather than being primarily
19:01in the morning.
19:02We've asked patients to have their
19:04labs drawn on an offsite location
19:06at an offsite location prior to
19:08treatments to avoid weights.
19:10In the lab,
19:10there are fewer staff on site in
19:13clinic and we have a continued no
19:15visitor policy with, of course,
19:17a number of medical exceptions.
19:19Next slide, please.
19:22I think with regards to tell a
19:24house at the use of technology
19:26has really become transformative.
19:28We now have this wonderful
19:30opportunity to redefine and optimize
19:32the way we deliver cancer care.
19:33It can be done from anywhere,
19:36and that's convenient for you,
19:37but it also limits the number of
19:39patients in it within a clinical space,
19:42it's going to become a critical component
19:44of the care plan for many of our patients.
19:48You should know that we're working to improve
19:50Telehealth Technical Support Resources,
19:52both for patients.
19:53An providers we're working to enhance
19:55the staff support during video visits
19:57and just a quick heads up a new video.
20:00Visit platform with more features
20:02and capabilities is coming in the
20:05next few weeks so stay tuned.
20:07Next slide, please.
20:10Anyone who is interested in
20:11having a video visit can.
20:13These are some of the things that you need.
20:16You need just to have a
20:17smart phone or a tablet.
20:19You need to have a my chart account with
20:22the log in information and you need
20:24to have the my chart app downloaded
20:26onto your smart phone or tablet.
20:29It's really quite easy.
20:30Even some of my most technologically unsavvy
20:32colleagues have been able to figure this out,
20:35so it's it's pretty simple and
20:37it works very well.
20:39Next slide, please.
20:41If you need any help there,
20:43a number of resources available for you to
20:46access to try and get this up and running.
20:49Next slide.
20:51I would be remiss if I didn't mention
20:54the patient family Advisory Council.
20:56These folks are involved in all of
20:58our major initiatives and really serve
21:00as the voice of patients and family
21:03members as we tried to roll out new
21:05things as we roll out new initiatives,
21:07new projects across the Cancer Center.
21:11And we couldn't legitimately could
21:13not do anything without them.
21:15So thank you very much.
21:17Next slide.
21:19So the take home messages are few.
21:22We've continued to see patients with only
21:25a small drop in the overall patient volume.
21:29We anticipate that visits are going
21:31to increase as things as surgeries and
21:35screening procedures come back online.
21:37And as we start to address the
21:40backlog of patience,
21:41those who had appointments who
21:43were delayed during Cove it,
21:45we're going to start slow.
21:46But we're going to build up very
21:48quickly and to support social
21:50distancing with measuring and
21:52assessing every step of the way we
21:55anticipate that will be adjusting
21:56things in real time from day to day,
21:59from one week to another.
22:01Talla health is not going anywhere,
22:03and I'm really excited to have
22:05this opportunity to bring that into
22:08cancer care delivery.
22:09And the collaboration of all of our staff.
22:12All of our patients is what makes
22:14Milo Smilow,
22:14which what makes us a very special
22:17place to receive treatment into work.
22:20Next slide.
22:22Just a quick thank you to everyone
22:25who's been involved in all of
22:27the moving pieces.
22:28All of the initiatives the
22:29moves over the
22:30last couple of weeks and months.
22:32We really could not have done
22:34it without you, so thank you.
22:38I'll turn it back over to Terra.
22:41Thanks Sarah, that was great.
22:43I'm very informative and you know,
22:45just your presence in the
22:47clinics has made our lives feel
22:49little less scary sometimes.
22:51So thank you for all of your hard work.
22:54Can you and Ann and Maureen
22:56your physical presence and your
22:58support has been really just.
23:01Very much appreciated during this time.
23:05So now we're going to move
23:07on to Lisa Barber Radha,
23:08who is going to take us through some of
23:11the additional safety measures that are
23:13in place for the Cancer Center lease.
23:16Is the program manager of oncology
23:19nursing education and practice.
23:21Good
23:21evening and thank you doctor Fuchs
23:23and doctor Sam for having me tonight.
23:26As Terra mention I am the manager for
23:29oncology nursing education and practice
23:31and my job is really to ensure that they
23:34care that patients and families receive
23:36is safe and of the highest quality.
23:39and I think throughout the last three
23:41weeks three months our goal has been
23:44to continue to provide that same
23:46level of high quality care but with
23:48really an added layer of safety.
23:50From every aspect and Doctor Magali and
23:53touched on several of these strategies
23:55that I'll spend the next few minutes
23:58going into a little more detail about.
24:00And so one of our primary strategies
24:03for ensuring safety as we increase the
24:06number of visits in our outpatient
24:09setting is really around screening.
24:11And we have three primary strategies
24:14to complete screening before visits.
24:16The first is a new strategy using
24:19my chart where a survey is sent out
24:23in advance of any outpatient visit
24:26for my chart users an the survey
24:29will ask questions about symptoms.
24:31As well as potential Coleman exposures.
24:35If a my chart questionnaire is
24:37completed in advance of your visit, um,
24:40somebody will be looking at those results
24:43and assessing their response to that survey.
24:46If the survey questions were
24:47answered and there are no concerns,
24:50you will be able to proceed
24:51with your visit as planned.
24:53If the my chart survey is not completed
24:56in advance or their additional
24:58questions that need to be asked,
25:00you'll get a call from one of our staff
25:03who will go through those same questions
25:05in more detail and then make a plan with
25:09your provider around the safety of the visit.
25:12Given any symptoms you might have.
25:14In addition to those two strategies,
25:17we also continue to do on-site screening
25:20on arrival into any of our facilities,
25:23be on-site.
25:23Screening includes temperature measurements
25:25of anyone who enters the building,
25:27as well as questions about symptoms.
25:30If you have what we would
25:32consider a positive screen,
25:34which would include a temperature over 100
25:37or yes to any of the symptom questions.
25:41I discussion really is had with
25:43your clinical team around what
25:45the safest next step is.
25:47The safest next step may be that your
25:49appointment is delayed or rescheduled.
25:51It might be that your appointment
25:54is changed to Atella health visit.
25:57Gillian outlined.
25:58Or you may be rescheduled for an appointment
26:02at one of our designated locations,
26:05which I'll talk more about shortly.
26:08If you have a positive screen,
26:09Colvin 19,
26:10testing may also be recommended,
26:11which I'll talk a little bit more
26:14about in few minutes.
26:16In addition to patient screening,
26:18we also continue to ask all of our
26:21employees to self screen and what that
26:23means is all of our employees are asked
26:26to continually monitor themselves for
26:29any symptoms of Kovid including fever,
26:32cough, shortness of breath,
26:33nausea, vomiting,
26:34headache,
26:35muscle aches and loss of taste or smell.
26:38We also ask that employees
26:40check their temperature twice a
26:42day and if they have a temperature
26:45over 100 or any symptoms of Kovid.
26:48They are asked not to report to work
26:50and to report to Occupational Health
26:53for additional assessment. Fantastic.
26:57So to talk a bit about testing,
26:59which is a an area of a lot of
27:02discussion employees with symptoms
27:03of COVID-19 will be tested for
27:05Cove it and they aren't allowed
27:07to turn return to work until their
27:10deemed safe by occupational health.
27:13Additionally, over the last two weeks,
27:15employees who do not have symptoms
27:18also now have access to COVID-19
27:20testing across the health system.
27:23As of Monday, over 1800,
27:25employees have been tested with
27:27a very small number of positive
27:30tests and asymptomatic employees.
27:32In fact, under 1% of staff or
27:36asymptomatic have tested positive.
27:38What that means is that all of the
27:41strategies that I'll be outlining
27:43specifically use of masks universally
27:46as well as social distancing
27:48have been extremely effective in
27:51limiting the number of cases.
27:55Of transmission across our locations.
27:59Patient testing, I'll touch on as well so.
28:03Smilow Cancer Hospital is not
28:05currently recommending routine
28:07testing of asymptomatic patients.
28:10This includes routine testing before
28:12treatment in any of our ambulatory setting.
28:15We continue to closely monitor
28:17all of our testing data.
28:20The latest literature an
28:21recommendations from experts,
28:22and continue to discuss this regularly
28:25and use it to guide our decisions to
28:28ensure we're delivering the safest care.
28:31We're currently testing all patients
28:34before admission through either our
28:36emergency emergency room or any other
28:39method of admission were also testing
28:42before procedures that require anesthesia,
28:44including surgery and other
28:47high risk procedures.
28:49We're testing patients based on no
28:52on risk factors such as exposure
28:55and any symptoms of Cobit.
28:57Patients can currently be tested
28:59at designated ambulatory locations
29:01across the state and health system,
29:03and symptomatic patients can also
29:05be tested at the Smilow Rapid
29:09Evaluation Clinic in New Haven.
29:11We've implemented advanced cleaning and
29:14disinfection processes in all of our
29:17areas in our exceeding recommendations
29:19that are currently outlined by
29:22the Center for Disease Control.
29:23Hospital rooms are cleaned daily and
29:26deep cleaned after patient discharge.
29:29Exam rooms,
29:30an individual infusion spaces are
29:32disinfected after every patient and
29:34deep cleaned at the end of every
29:37day and throughout our locations.
29:39Additional hand sanitizing
29:41stations have also been installed.
29:44Additionally,
29:45we have designated patient care areas
29:47where patients with COVID-19 or cared for,
29:50and this strategy allows patients
29:53without COVID-19 to continue to receive
29:56safe care while minimizing their risk
29:59for covert exposure in our setting.
30:01We have dedicated inpatient units
30:03for patients with COVID-19,
30:05as well as a dedicated ambulatory
30:07location for smile locations which
30:09we've talked about here before,
30:11called the Smilow Rapid Evaluation Clinic.
30:14Here,
30:14patients that are Cove in positive
30:17can receive care as determine
30:19necessary by their medical team.
30:22In that clinic is staffed by oncology nurses,
30:25an advanced practice providers with
30:28specialized training in both oncology
30:30and the care of patients with COVID-19.
30:33Additionally,
30:34for our patients are smilow
30:36patients who have been
30:38infected with COVID-19,
30:40we implemented daily monitoring calls.
30:44To monitor patients for worsening
30:46symptoms an provide patient education
30:49an isolation and maintaining safety
30:51at home these calls are made by a
30:54group of oncology nurses who have
30:56made over 350 calls to our patients
30:59to keep them safe at home and also
31:03facilitate in person visits if needed.
31:06Over the next week we plan to
31:08incorporate self monitoring of
31:10oxygen saturation levels at home.
31:12As an added layer of safety to our patients.
31:17Visitors, we continue to restrict visitors
31:20in both the inpatient an ambulatory setting.
31:23While we don't like restricting visitors,
31:25an fully understand the impact of
31:27these restrictions on our patients and
31:30families and how difficult this is,
31:32it has really been a critical step in
31:36containing transmission of the virus.
31:38Request for exceptions to the visitor
31:41visitor Policia reviewed at the
31:43individual unit level and exceptions
31:45are made based on medical necessity
31:47and individual circumstances.
31:51Surgeries and procedures,
31:52like the other locations I've
31:54discussed are operating rooms
31:56and procedural areas have really
31:59implemented additional measures for
32:01stringent cleaning and sterilization.
32:03They've developed covert free surgical
32:05pathways to minimize risk and have
32:08added other strategies to limit the
32:10amount of people in waiting rooms,
32:12including use of mobile check in
32:14an reducing onsite paperwork.
32:18Social distancing isn't really one
32:21of the most important strategies
32:23that we used to minimize risk,
32:25along with masks,
32:26which I'll talk about shortly.
32:29We have several strategies in
32:31place to promote social distancing,
32:33including limiting the number
32:35of people allowed in elevators,
32:37and we've minimized that number
32:39to four people per elevator.
32:41We really rely on all employees to
32:43help enforce this to step off of the
32:47elevator to allow patients priority.
32:49If the elevators at capacity and
32:52elevators are cleaned regularly.
32:54Common areas like cafeterias have
32:56eliminated self-service stations and
32:58have implemented stickers on the
33:01floor to promote social distancing
33:03and use of the six feet barrier.
33:05Plexiglass barriers have been
33:07installed at most of our checkins.
33:10A man and a Sarah mentioned.
33:12We aim to minimize time in waiting
33:14rooms and while We want you to arrive
33:16early enough to complete your screening,
33:18we really don't want you arriving more
33:20than 15 minutes before your appointment
33:22time to keep the number of people in
33:25any given waiting room to a minimum.
33:27We've also made individual
33:29modifications to waiting rooms,
33:30decreasing the number of chairs,
33:32and increasing the amount
33:34of space in between chairs.
33:36As mentioned,
33:37some locations have also extended
33:39their hours of operation in order
33:41to decrease the overall number
33:43of patients seen in an hour.
33:45On next slide please.
33:48Personal protective equipment in
33:50conjunction with social distancing,
33:52is key to decrease the risk for transmission.
33:56Patience anybody entering the
33:57building is expected to wear a mask
34:00that includes staff patients in any
34:03visitors who may be in the building.
34:05Cloth masks are considered acceptable
34:07to be worn by both patients and
34:09visitors and are also supported by the
34:12Center for Disease Control and a cloth.
34:14Masks should cover both the
34:16nose and the mouse.
34:17If for any reason there's concern
34:19about the integrity of the mask,
34:21we will provide you a mask if needed,
34:24and if you don't have one,
34:26one will be provided to you.
34:29We will ask that you wear a mask throughout
34:32your time in the in our locations,
34:35especially when in close contact with
34:37your caregivers and you will may be
34:40asked to remove your mask for important
34:43elements of your physical exam.
34:45All staff will be wearing a mask at
34:47all times, even in our common areas,
34:50and you may see staff were additional
34:52types of protection like a gown,
34:54an eye protection which may be used
34:56for selected high risk activity.
34:59Email Tori considerations.
35:00I think Doctor,
35:01Mongolian and I covered the majority
35:03of the strategies used apply also
35:05to our ambulatory setting.
35:07Exam rooms are thoroughly cleaned.
35:08Radiology equipment is also clean in between.
35:11Patients are vital sign machines.
35:13Any equipment that's in contact
35:14with patients is wiped down in
35:16between the patient and then the
35:18last strategy which doctor Mcgillion
35:20reviewed and the panel.
35:21I think they touch on a bit more
35:24as the use of Talla Health which we
35:27will continue to use as a strategy.
35:30Decrease the overall number
35:32of patients in anyone setting.
35:35So In summary, I've talked a bit about our
35:39comprehensive strategy to keep patients
35:41safe while they are here for care,
35:43while also continuing to provide high
35:46quality expert cancer care to our patients.
35:48All of these strategies have
35:50also taken a tremendous amount
35:52of communication and education,
35:54and I just want to acknowledge the
35:56efforts of the team on the call as well
36:00as our nursing educators and our other
36:02nurse and provider leaders in helping
36:05to continue to spread these messages.
36:07To ensure that all of our staff are
36:10well prepared to keep you all safe
36:13when you're coming in for care.
36:15Thank you.
36:18Lisa, thank you. Wow that was a packed
36:20full of information and I know that you're
36:23you and your team are always updating
36:26based on the most recent CDC guidelines
36:29and the newest research coming out about
36:31covert as we learn about this disease,
36:34so I know you're on meetings
36:36from 7:00 AM until midnight.
36:38Probably so thank you for giving us
36:40all of those key pieces of information,
36:43and I'm sure patients really
36:44found that helpful.
36:47I'm our last, uh,
36:48speaker before we open it up to
36:50questions and answers is Connie Smith.
36:53She is our knew, head of oncology,
36:55social work.
36:56Bonnie Indec has retired many of
36:58the people on the call may remember
37:01her were excited for Bonnie to move
37:03on to her grandchildren and we're
37:06really excited to have Connie here.
37:08So welcome Connie.
37:11Thank you very much Terra.
37:13I'm very happy to be here and I want to
37:16thank you and Doctor Fuchs for the invite.
37:19I just want to kind of
37:21quickly share that you know,
37:23part of the benefits of being part of a
37:26comprehensive Cancer Center is having
37:28for the best care that you can receive.
37:31And certainly we treat our
37:33patients holistic Lee,
37:34both medically and cycle socially.
37:36And that's where social work
37:38comes in and social worker,
37:40the social worker that smile oh.
37:42Our clinical licensed social workers,
37:44their clinicians, that are here to me,
37:47are patient Psycho social needs.
37:50Definitely during the Cove at pandemic.
37:52What we saw was a increase for
37:55psychosocial support to our patients
37:56and social work definitely was up
37:59to the task and we wanted to make
38:01sure just like they were still
38:03containing a being being treated
38:05by their medical providers.
38:06We wanted to make sure that we're
38:09meeting there cycle social needs
38:11and that they were going to be
38:14continue to be seen and treated.
38:17Provide IT support by the social worker,
38:19so don't got time.
38:22Social work was really busy providing
38:24what we consider remote care.
38:26A lot of our social workers were
38:28still in contact tact with our medical
38:30medical teams that were attacked
38:32with patients via the telephone.
38:34We actually, with the help of doctor Sam,
38:37implemented a program where we were
38:39actually making calls to our patients
38:42at Smilow and letting them know
38:44that we did not forget about that.
38:46We still immensely care about them and
38:49wanted to make sure that they were OK.
38:52Items are patients we realize.
38:55Being home during the pandemic
38:56could feel very isolated,
38:58like the vast majority of the population,
39:00but certainly you know some of our
39:02patients who are most vulnerable
39:04felt that they need it.
39:06Just having that someone to call and
39:08just check on them was beneficial and
39:10so many of our social workers make
39:13many calls and continue to make those calls.
39:15So you might be one of the people who go see,
39:19respond to you might actually receive
39:21a call if you have not already
39:23done so and the purpose just again.
39:26As a institutional let you know
39:28that we care about you and we care,
39:30care, care?
39:31We care to make sure you know that we want.
39:34We want to hear your concern running here.
39:37If you're anxious about coming
39:38back into the care center,
39:40certainly we want our patients to know
39:42that that's a real feeling an we want
39:44to work with you on getting through that.
39:47But certainly we want our patients to
39:50know that we want to back and we want
39:53to see you as much as we can face to face.
39:56The social workers are still
39:59going to continue to see peace.
40:01Hopefully weather is in our main
40:03campaign work street or at the
40:06care centers around Connecticut.
40:07We have social workers who are very
40:10much waiting to meet our patients needs,
40:13so one of the things I also quickly want
40:16to talk about is is our support group,
40:20groove social workers.
40:21We very much again try to meet the
40:24patients and to understand where the
40:27patients are so we do have quite in
40:30my group supposed to support groups.
40:32Um and not support group.
40:36Sorry, there's a little bit of a
40:39language I hear some. Feedback. Is.
40:48It's OK.
40:49You don't hear it on my phone,
40:51so I'm not too sure except.
40:55Maybe if you speak slowly, if you
40:57spend sleeping here.
41:00You're a sentence.
41:01Your full sentence.
41:03OK, um, so just want to quickly
41:07talk about the support groups.
41:09Many of any of our support groups are legal,
41:14which is great because patients
41:17can participate from the comfort
41:19over their own homes.
41:21And certainly we have many support groups.
41:24If people are interested in support groups,
41:28I would encourage you to
41:30reach out to the your clinic.
41:34Or provider that can direct
41:35you to the social worker.
41:37I also believe the support
41:39groups are on smiles web page,
41:41but certainly someone can always
41:43call me on more than happy as
41:46the manager to take those calls
41:48because again we want to make sure
41:51Peter kids are connected with all
41:53the services that they might need
41:55during their care here at Smilow.
41:57So I would just say to everyone
42:00social work is here.
42:01We want to work with you.
42:04Um and provide the psychosocial
42:06support that you need.
42:11Excellent, that was better.
42:14I don't know why I'm feeling
42:15like I have feedback now.
42:20So we're going to encourage
42:23the participants to submit
42:25any questions through the Q&A.
42:27To thank our panelists for coming.
42:33Let's see if we can get a question that um
42:36involves someone who hasn't talked yet, um.
42:40James you. You come from our Department
42:44of therapeutic radiation oncology.
42:47Here is a question from a patient.
42:51Some kind of talking in general
42:53about immuno suppression after
42:55radiation therapy so he writes.
42:57I have recently completed radiation therapy
43:00for recurrence of non Hodgkin's lymphoma.
43:02I'm currently working remotely in a bit
43:06concerned given my age that he's going
43:09to be 65 an compromised immune system.
43:12I'm about whether or not he
43:14should return to his office,
43:16so this is a tough question,
43:18but maybe you could speak a bit, too,
43:21um, your opinions on people who are
43:24having radiation and their immune status,
43:26and Anne.
43:27What have you been telling your patience?
43:30Sure,
43:30thanks for that question.
43:31I mean it's it's a question we get asked
43:35all the time even in Non Cove at times.
43:37What does radiation do to my my
43:40immune system? Can I get a flu shot?
43:42Can I be near other sick people?
43:45So in general radiation is a lot
43:47of things to the immune system,
43:49some of them beneficial and some of
43:51them were trying to harness here.
43:53It's Milo Cancer Hospital,
43:55but what radiation negatively
43:56does to the immune system?
43:58Uh, it doesn't.
43:59Two ways, uh,
44:00by directly killing beneficial immune cells,
44:02called lymphocytes,
44:03but also in the long term,
44:05suppressing the bone marrow of a site.
44:08If there's a lot of bone
44:11marrow being radiated,
44:12so radiation impacts your immune
44:14system directly in relation to how
44:16much of your body is getting radiated.
44:19So this person getting radiation
44:21for their lymphoma.
44:22If the lymphomas in their little pinky,
44:25the radiation is not going to do
44:27a whole lot to the immune system.
44:30But if it's in a large area on their
44:33body with a lot of bone marrow,
44:35then radiation could reduce
44:37the means of this system.
44:38But the advice I would give this
44:40person is there are other risk
44:42factors that you also have to
44:44take into account number one.
44:46They have lymphoma to begin with.
44:48There you know close to the
44:50age of 65 or older.
44:53And we know that cancer patients are at
44:56higher risk for having problems with Cove.
44:58It.
44:58So my advice would be doubled
45:00down on the CDC recommendations
45:02for social distancing.
45:04Be as clean as you can,
45:06you know no high fives anymore,
45:08that sort of thing,
45:09but also really talk to your
45:11employer about maybe working from
45:13home even longer because there
45:15are a couple of risk factors
45:17in their radiation one of them,
45:19but I would say in this case it's minor.
45:25Thanks James, that was very helpful.
45:28Um, a namika. You're in the Waterbury
45:31care center and I know Sarah Anneliese
45:33took us through a lot of the changes
45:36that we've seen throughout the system.
45:38Could you comment a little bit?
45:41A patient Rd in our waiting rooms
45:44different now in the care centers.
45:47Why is social distancing enforced?
45:48So maybe you could tell us a
45:50little bit about how things are
45:52for you guys out in Waterbury.
45:54Absolutely,
45:55and that is a very good question and a
45:58lot of patience are concerned about that.
46:01So as we saw in Sarah already said,
46:04those are exactly right.
46:06Lines appear following all
46:07patients who come to the center
46:10are first screened at the door.
46:12We have masks to hand out to them and.
46:17Chairs are all interconnected,
46:19so we sort of coverage chairs
46:22so that people cannot sit there
46:25and we've sagit appointments.
46:27Each position can see only
46:30two patients per hour.
46:33Because of that,
46:34you know we sort of decreased the
46:37inflow of patients at any given time,
46:39so their best to maintain
46:42and we are able to maintain.
46:45Official distance we make sure that
46:48our our wedding rings are not able
46:51crowded at anytime or even crowded
46:53any times and I have to say that
46:55it has been working very well.
47:01Excellent, thank you. Um?
47:03Let's see what what questions are coming in.
47:07Here's a good one.
47:09So with regard to parking fees,
47:11I think either more re nor Kim.
47:13Um Slessor might be able
47:15to help us with this one.
47:18With regard to parking fees for
47:20smilow patients who are dropped off
47:22at the air rights garage entrance,
47:24how can the driver avoid a $25 charge
47:27since the parking ticket cannot
47:29be validated until the patient
47:31gets to his or her appointment.
47:33So there I think they're asking
47:35about like parking procedures
47:36that might be have changed now
47:38because they can't park in.
47:40In Smile,
47:40Oh and then walk the patient
47:42in to get the ticket validated.
47:47More rain, did you want to take that
47:49or I'm happy to take it? That's
47:51OK, you can. You got it.
47:54OK, so that is a really great question
47:56'cause I know a lot of our patients
47:59and family members are used to going
48:01to the to the appointment with the
48:04patient and because of our visitor
48:06restrictions that has changed.
48:07But yet our our families are used
48:09to driving into the garage and
48:11then you know and then wanting to
48:14drop them off at that entrance.
48:16I just want to remind all the patients
48:18and families we do have the main
48:20entrance still available in our circle.
48:23Ann. I would really recommend.
48:25Family members dropping their
48:26patients off there because there are
48:29are also people there to assess,
48:30and the elevators are right there that
48:33can bring you straight to the clinic.
48:35So that's what I would recommend.
48:39If you do have to accompany your your
48:42family member to their appointment,
48:44we do have some exceptions and that
48:47happens really when we're doing
48:49our pre screening phone calls to
48:51determine and then you're able to
48:53accompany your loved one to their
48:55to their appointment again.
48:57All of our entrances have the screening
49:00so patients and visitors are screened
49:02in no matter what entrance you go too,
49:05so you don't have to enter through
49:07the air rights garage.
49:09To have the appropriate screening done
49:11so that would be my recommendation
49:13so that you don't have to put in
49:15the parking garage until your loved
49:17one comes out from their appointment
49:19that you're able to to drop them
49:22off at the main entrance.
49:23Maybe run a couple errands or go home
49:26for a short period of time and come up,
49:29but that's what I want.
49:33Thank you Kim. Thanks so much.
49:36I thought I saw a question here and maybe
49:39an chain you can help us with this. Uhm
49:42I can find it.
49:45It had to do with how our patients
49:48receiving the telemedicine visits.
49:50And you know what's the
49:52feedback Ben and have they, uhm?
49:54You know what's your sense
49:55about how all of this,
49:57how they're doing with all of this,
49:58of course. Now.
50:00I under these circumstances,
50:02maybe you could comment on any
50:04feedback you've gotten from our
50:06patients. Sure, I think this is an
50:10example. As I said in my um response
50:13to the The Great question where where.
50:18The opportunity to wear this pandemic
50:21is really transforming our healthcare.
50:23So what we're learning is that now
50:26through tell health we can
50:28connect with our patients at home
50:30at a time when it's been very hard
50:33for people to leave, leave their
50:36house and feel comfortable
50:37doing that. We have
50:39seen patient since Milo who've
50:41come in for their treatments,
50:43but we've really been able to
50:45see about 50% of our patients.
50:48Um, in their home surroundings and
50:50the feedback from patients and from
50:52doctors and staff has been really great.
50:54I've been able to see my patience.
50:57What's on their walls?
50:58Ask them about it, see their pets,
51:01their families.
51:01It's kind of a zoo sometimes,
51:04and it's really and I'm able
51:06to also evaluate if they
51:07have a rash they want to ask about or or
51:11just to see
51:12how their feeling if there
51:14bright or if they're just
51:15not looking so good.
51:18But it goes
51:19both ways, but no patients are
51:21happy to see their docs to and
51:23say Gee how's it going for you?
51:26And we really appreciate your
51:28efforts and I think it's been
51:30away for UM patients to remain
51:32connected to their care team.
51:33But also for the
51:35care team to remain
51:36connected to patients because
51:37you guys are why we do
51:39what we do, and so it's really
51:42important for us to be able
51:44to see you during this time.
51:49Thanks Ann Uhm. Maureen, uhm, you know,
51:54tell us about how you see the the
51:57staff doing um during this time.
52:00An you know, especially the nurses and
52:03these are dedicated MA zan front desk staff.
52:06We've come in day after day regardless
52:09of what was going on in the world.
52:13Do you see them doing what?
52:15What's been the UM conversations with them.
52:19You know, I think that that is
52:21been the most remarkable part of
52:23this journey for me as a leader
52:26is working with the staff and and
52:28taking their through what was a
52:31very emotional time for the world.
52:37Internet patient care delivery and
52:40to run towards patients and help them
52:43an ease their worry with whether
52:45it was a smile or a thank you or
52:48how can I help or let me keep your
52:51next appointment or calling them
52:53on the phone and saying we're here.
52:56If you need something I think that
52:59was the most remarkable part of my
53:02journey with the staff I I think
53:05that most of the staff.
53:07All of the staff really felt that
53:10they were giving back to the world
53:12that that needed them at this time,
53:15and so I think it's been a really
53:17remarkable time there.
53:19There's been, you know,
53:20I think about the early days of Cove.
53:23If there was communication that
53:25was coming out,
53:26that could have counteracted
53:27each other very quickly.
53:29The staff is simulated themselves,
53:31and some of their peers came down
53:33with with Kovid and struggled,
53:35and they not only gave.
53:37Our patients,
53:38but they gave to their own
53:40community of of team members,
53:41so they reached out.
53:43They they created buddy programs
53:44and body systems where they would
53:46call each other to make sure that
53:49the that the disease or the illness
53:51was not getting worse and that they
53:53were making good sound judgment
53:55clinical decisions for themselves so.
53:58You know,
53:59I think it's been a remarkable journey.
54:01I think people are happy that it.
54:04The information in that things
54:06had quieted down a little,
54:08so that maybe we can get to
54:10this new transformation.
54:11This has to be all worth something.
54:14I think we're all putting our
54:16efforts and energies into that,
54:18including our frontline staff
54:19that are everyday asking how we
54:22can make things better.
54:24A great question,
54:25thank you.
54:26Thanks for that. And then you know,
54:30we're almost at the end of the hour here.
54:33There is one here that I think
54:34maybe an or Sarah could take as
54:37many smilow providers have been
54:39relocated to the North Haven facility.
54:41Please comment on how long that
54:43arrangement is expected to continue.
54:45So we heard about the services
54:46that have moved back there.
54:48Still some services who are displaced
54:50from their original home are we.
54:52Is this kind of what it's
54:54going to look like for awhile?
54:56Or what can you tell our patients about, uhm?
54:59The rest of the services who left smile,
55:03oan are in their various locations.
55:09I'll go ahead and take that.
55:11Uhm, you know this is it's
55:13a really great question.
55:14Um, an one that we would kind of like
55:17to know the answer to ourselves.
55:19The reason that we're in North Haven?
55:22Um is due to some hospital
55:24commitments for our space.
55:25We don't know what the plan is.
55:28Uhm, because we don't know how this
55:30pandemic is going to play out over the
55:33next several weeks to months and we
55:35want to make sure that when we move back.
55:38We are moved back for good.
55:40Um, so we've made extensive plans,
55:42put extensive plans into place
55:43to make sure that we have all
55:45the space that we need,
55:46that we have all the resources
55:48that we need to take care of our
55:50patients in every location,
55:51both North Haven and back
55:53at at Smilow in the North Pavilion. I
55:55wish that I could give you a
55:57definite answer. I can't right now,
55:59but as soon as we know will make
56:01sure that we communicate that to you.
56:06OK, thank you, um Charlie.
56:08We have two minutes left. Um, how?
56:11How should we closeout the the hour?
56:16You'll have to unmute yourself.
56:19Thank you I, I wonder if any of
56:21our panelists are speakers want it?
56:23You know, there's so many questions
56:25that we probably didn't get to is. Is
56:27there anything questions?
56:28I'm trying to keep track of?
56:30We could try it.
56:31We're going to try to copy
56:32and paste these and maybe we
56:34can answer them in writing.
56:36I was just going to ask if
56:37any of our panelists wanted to
56:39mention something that we didn't
56:41get to that you could think of.
56:43We wanted to cover.
56:46I I know with our positions on the line,
56:49there were several questions
56:51about a screening, particularly
56:52mammograms and things like that.
56:54If if one of our medical oncologist
56:57could talk a little bit about
56:59how we're doing with that.
57:03Sarah, did you want
57:05to take that? Sure,
57:07screening mammograms are restarting.
57:08Um, all patients that had rescheduled
57:11or cancelled screening mammograms from
57:13March onward or being contacted kind of
57:15in the order that they were cancelled.
57:18So you should be getting a phone
57:20call in the next few weeks to
57:23reschedule that mammogram.
57:25If you have a specific concern
57:27or specific date,
57:28feel free to call the radiology
57:31Department to reschedule your mammogram.
57:33But screening mammograms are happening.
57:35Now. Um along
57:37that line, uh, should patients be calling to
57:40reschedule appointments that were cancelled?
57:41Or will someone call them to reschedule?
57:44I was in the middle of answering
57:46that question on line,
57:47but all of our teams have been keeping
57:49lists of of patients that have been
57:51rescheduled or that have been cancelled,
57:54so you should be contacted to
57:55reschedule your appointment.
57:56If you have a specific concern or
57:58a specific date or a specific issue
58:00that you need to discuss again,
58:03feel free to call your provider's care
58:05team and will get that appointment
58:06scheduled for you as soon as possible.
58:12OK. Well, I thought we heard some really
58:17great um pieces of information tonight.
58:20It was really nice to see everyone's face.
58:23You know, I've heard words like
58:26transformation lessons learned,
58:27inspired opportunities.
58:28Uhm, you know, I think this is our
58:31third patient and family forum.
58:33We're going to continue to keep
58:36everyone abreast of the situation.
58:38And you know, we look forward to.
58:42Getting uhm, you know the best care
58:44that we can with these circumstances,
58:47which is world class care in
58:49a really Safeway so Charlie?
58:51Uhm, thanks again for letting
58:53me moderate tonight.
58:54Any other parting words before we sign up?
58:58Our panelists, outstanding work
59:00and once again thank you to our
59:02patients and the family members
59:04that they continue to inspire us.
59:06This form for those for your friends who
59:09weren't able to join us this evening.
59:11It'll be available.
59:12It's available for viewing on video
59:14on Facebook and on our website,
59:16and I know what the last forum.
59:19I think over 1000 or more
59:21of you did online after.
59:23So for those who weren't able to make it,
59:26please tell your friends
59:27colleagues that it's available.
59:29For viewing after tonight.
59:33Thanks so much everyone.
59:36Aiden stay safe, stay well and we
59:37look forward to seeing you all.
59:40Goodnight