Shared by Mr Anil Vinayak (PGP 1988), Group Chief Operating Officer – Fortis Healthcare

Based on reports coming out of China and Singapore, in January  2020, we started getting worried. We were also alerted by the  IHH Group Leadership at Singapore, of which Fortis is a part. It was a just a matter of time before the CORONA wave hits India. We needed to  be prepared. What ensues is an account of the COVID related actions, taken at Fortis.

At the outset,  a COVID action group was formed at the topmost level which had as its members Dr Ashutosh Raghuvanshi, MD &CEO , Air Marshal B Keshav Rao- Head of the Medical Strategy and Operations Group (MSOG), Dr Akash Sood- Head of Clinical Governance and me. All information coming from all directions,  China,  Singapore, WHO  was  analyzed,  and relevant actions  initiated, long before Government advisories appeared. In the initial days this group provided the leadership. Now a group comprising the MD&CEO, GCOO (Mr Anil Vinayak), Head-MSOG and CHRO meets daily.

Dharma: Dr Ashutosh Raghuvanshi, the MD CEO made it clear that we are a provider of medical services and care of the patient is our DHARMA. This became a guiding principle, a war cry.

The Plan: The first thing was to create a plan to address the COVID issues at the Hospital level. With the available knowledge, the first set of guidelines  covering Management of  Suspected or Confirmed COVID patients, Specimen Collection and Transport Ion Prevention & Control of COVID Infection;  were issued to Hospitals on Jan. 23 , 2020. The first case in CHINA was officially reported on Jan. 9 and  in India  on Jan, 30. We were ready much before the first case in India.

MSOG: The Medical Strategy and Operations Group (MSOG) at Fortis Healthcare, of which I am a member, is led by the ex-armed forces veteran Air Marshal Dr B Keshav Rao. The group oversees the medical strategy and operations of the organization. The Air Marshal said- this crisis is going to separate the men from the boys. MSOG in January only re-organized into a crisis mode with all members given individual crisis management responsibilities like clinical protocols, communications, safety of Healthcare workers,  supplies and equipment. A digital dashboard that provided  real time data on COVID patients and affected HCWS to the senior leadership, was put into place.

The MSOG has been meeting every morning since January, discussing the on-ground challenges and deciding the organization’s response to the evolving crisis.  COVID 19 was a new challenge. Hospitals had numerous questions. MSOG,  formulated and issued guidelines to address every aspect of the COVID 19 challenge  which included  screening of patients at the entrance, Flu clinics, use of Hydroxychloroquine, division of Hospital into COVID and non-COVID areas, use of Personal Protective Equipment, and even the handling of dead bodies. Guidelines were issued but were not binding. Leaders of the Hospitals were totally empowered to take decision based on the local realities. We trusted the commanders at the Front to win the battles for us.

Medical Councils :The Clinician bodies of Fortis  played a major role. Fortis Medical Council is the premier advisory body comprising of eminent clinicians. It represents the clinical wisdom of Fortis. It used to meet once  a quarter. Since March it has been meeting every week to asses the situation and provide necessary guidance on clinical issues. The Specialty Councils are membered by Clinicians of a single specialty. The Specialty Councils tackled the issues concerning treatment of patients of their specialty. They answered questions like – how do we do Dialysis now ?, how do we conduct deliveries, how do we treat heart attacks ?how do we conduct surgeries?

Communication: In January, a WhatsApp group of medical administrators was created to share and disseminate information. In March, we conducted extensive trainings on the use of the Teams Platform. The video-concalls enhanced the quality of communication. MSOG had bi-weekly calls with the medical and nursing administrators of the hospitals to ensure preparedness and execution on ground.

Sharing of Knowledge: Mumbai and Kolkata were the first to be hit by COVID wave. In April, the learnings gained  were shared  with other hospitals through numerous webinars led by the clinicians and medical administrators of these 2 cities.

Supplies: We identified 3 essential things required to fight Covid 19 -N95 masks, gloves and PPE. We could anticipate shortages . A demand projection model was built by MSOG and Supply Chain (Rajeev Sharma PGP 96-98) and on the basis anticipated patients, we calculated the future demand ( March 31). The Supply chain immediately gave bulk orders and tied with reliable suppliers for these items for the next 3 months. Till today, no HCW or patient in Fortis has felt any shortage of these essentials.

Ensuring Access: As the lockdown happened, we realized access to healthcare has got hampered.  How do we provide the patients access to healthcare? Telemedicine was quickly launched, using the MS Teams platform. Now the patients could consult their doctors, on a video Concall, sitting at home. Thousands of patients have availed the facility till now. The legal status of Telemedicine was a grey area. Still, in interest of the patients we went ahead. Thankfully the Govt guidelines came in shortly thereafter.

HR : COVID 19 brought its insecurities for the HCWS. They had their worries- what happens if I get COVID, where will I get treated? We provided additional medical insurance cover to our nurses, on top of their ESI coverage. We said any HCW- on Fortis rolls or outsourced shall be treated in our hospitals and expenses will be taken care by the organization. In addition, a life insurance of RS 50 lakh was provided to each HCW.

Impact: As I write, Fortis has treated and discharged more that 1100 Covid positive patients successfully. We have  more than 1000 beds dedicated to COVID patients. The battle continues. The HCWS of  Fortis stand committed to serve and fight.

The learnings have been- look ahead, plan and communicate.  We anticipated. We had a plan before COVID hit us. We were prepared. Authentic credible leadership helps. Also, guide from the center, but give flexibility to commanders on the ground. The commanders on the ground will win the battles, for you to win the war. The war is far from over. But the JOSH is high.