A strong foundation is necessary to launch a space shuttle, build a house, conquer a fear, or battle a threat. When COVID-19 arrived in the United States, it exposed deep cracks in what many thought was a robust and sophisticated healthcare system.
Among the dedicated healthcare professionals who mobilized immediately to help is Michelle Moccia, DNP, ANP-BC, GS-C, past president of the Gerontological Advanced Practice Nurses Association (GAPNA). As it turns out, work Dr. Moccia had begun years ago became invaluable in saving lives during the pandemic.
In 2010, Dr. Moccia became the senior emergency room director for St. Mary Mercy Hospital in Livonia, Mich. As director, she created relationships with 35 local nursing facilities, in addition to numerous group homes, home healthcare agencies, and local EMS, all of whom used St. Mary Mercy Hospital as their emergency care provider.
These relationships were achieved by holding two-hour monthly meetings at the hospital. During the meetings, Dr. Moccia would present the latest healthcare information and pressing issues facing the community. The meetings also served as a platform for the facilities’ representatives to voice concerns, troubleshoot challenges, and design community events on such topics as infection control, advance care planning, and emergency preparedness.
Over time, the participants were on a first-name basis and familiar with each other’s facilities. The collegial relationship between the leaders created a strong foundation to weather what was to arrive 10 years later: COVID-19.
Planning ahead
In early March 2020, shortly before the flood of COVID-19 calls began coming into St. Mary’s ED, Dr. Moccia had anticipated the city’s facilities would be overwhelmed. Dr. Moccia gathered the team providers and held weekly conference calls, then daily debriefs to address emergent care needs related to the epidemic. They lacked PPE, well-developed quarantine plans, and appropriate staff.
The leaders agreed COVID-19-suspicious or positive patients could not be discharged back to their group homes or nursing facilities unless they were certain the patient could be isolated and the facility had adequate staffing and PPE. At one point, there were more than 80 patients waiting at St. Mary’s until they could be sent to a safe place.
Livonia’s mayor, fire chief, planning commissioner, and emergency preparedness director soon joined Dr. Moccia’s weekly conference calls, allowing her to expand a cohesive and united front as they battled the rapidly changing needs and concerns of each facility. All of Livonia’s leaders responded 24/7 to the needs of each facility.
Considering that the older patients who lived in nursing facilities were the hardest hit by the virus and at the most danger of dying, Dr. Moccia contacted the medical directors at each facility to address these concerns and request advance care planning. Along with other hospital healthcare professionals, Dr. Moccia visited the facilities and set up COVID-19 safe areas. She also helped mobilize the hospital’s lab to create nasal swab test kits for nursing facility residents and personnel.
Making a difference
The team efforts and interventions made a profound impact. According to Dr. Moccia, the coalition of Livonia’s leaders and healthcare professionals was successful due to their strong personal relationships and a foundation based on experience, trust, and familiarity. Unwavering commitment by the ED’s frontline health care professionals, hospital leadership, and Livonia personnel, created a defense team that saved lives.
During the beginning months and to this day, team members express gratitude to Dr. Moccia for her leadership, foresight, and heartfelt care.
“COVID-19 was — and still is — an incredible challenge, and so many people rose to the occasion with courage,” Dr. Moccia said. “This work is a ministry to me. I feel honored to have served God and my community during these difficult times.”