Transcription:

Introduction: Compassion, trust, courage, innovation, the values of Temecula Valley Hospital. We probably present TVH Health Chat, here's Melanie Cole.

Melanie Cole: To protect patients from the spread of COVID-19 Temecula Valley Hospital has implemented new preoperative protocols. Welcome to TVH Health Chat with Temecula Valley Hospital. I'm Melanie Cole. And today we're discussing having surgery at Temecula Valley Hospital. Joining me is Barry Highsted, he's the Director of Surgical Services at TVH. Barry, I'm so glad to have you with us today. So how are you and your team evolving care for your patients during this pandemic? What's changed? How did you guys start evolving this care? Tell us about the process.

Barry Highsted: We have been very cognizant as we've watched the pandemic unfold about what we need to do to protect our patients and staff. And we did actually, as everybody will know, we closed down for a while. We didn't do any scheduled surgeries while we figured out what we needed to do, to be sure everybody was protected. So we've now started up doing elective scheduled surgeries again, and some of the things we're doing to protect everybody is that for people coming in for surgeries, we're having them come to the pre-anesthesia testing, which we always did. But now that also involves having a COVID test. So we're testing patients. Pre-Surgery a couple of days out, two to three days out and we're asking them to go home, wear a mask and self isolate until they come back in again. So that's their part of it, so their part in protecting themselves and others.

In addition to that, we are requiring all staff to wear masks. We are really working with hand hygiene show for patients and for all staff to really concentrate on hand hygiene using soap and water for at least 20 seconds. And if that's not available then to use a hand sanitizer, and then when they are in the hospital, we have actually just started today now, testing everybody that came through the emergency room. So we, up until now, we've just been testing people that are symptomatic because of the emergency nature of what they're coming in for. But now we are testing everybody as they come in through the emergency room, if they're going to be admitted. So everybody that every patient that comes into the hospital is now tested. We do have certain units that we keep for people that have tested positive or who are under investigation.

So those are closed units and those patients sequestered, they get fantastic care, but everybody should know that they're not out into the general population of the hospital until they are cleared or a discharged from the hospital. So we're not, co-mingling the two populations. And then of course we've restricted visitors. We sadly don't have our volunteers right now, which are a great help to us. They really provide that homey feel and do some wonderful things for the hospital and for the patients. And we're not allowing those in right now. And we only allow one visitor at a time for each patient, but that does mean that somebody can come with them into the preoperative area and be with them after surgery to come and pick them up. So we're starting to lift some of the restrictions, but we're very conscious about protecting everybody too.

Host: Well, thank you so much for that very comprehensive and encouraging answer. Barry, so you mentioned elective surgeries. What kind of surgeries are we talking about?

Barry Highsted: We do all kinds of surgeries at Temecula Valley Hospital, but we concentrate a lot on orthopedics. So we do a lot of total joint replacements. We're very good at that. We have great outcomes, wonderful inpatient unit and therapies. We have a cardiovascular program where we do cardiac surgery and vascular surgeries. We did a lot of general surgeries, which are things like belly cases, gallbladders, hernias. We have a neuro program, a neurosurgical program and a lot of spine surgeries. We have quite a bit of head and neck too, and nose and throat. We concentrate on a lot of that. We've got specialists that do some great work there too. So yeah, we've just done our first cochlear implant and we got another one coming up. So we're doing some very cutting edge. We've got some great equipment here being a newer hospital. So yeah.

Host: That's really exciting. Now we've heard about positive and negative pressure rooms because of COVID. And so tell us a little bit about that. Explain to the listeners what that means. And as far as if they do have surgery or elect to have surgery at Temecula Valley Hospital, what that means as far as their infection risk.

Barry Highsted: Oh, that's a great question. Thank you. So operating rooms we always have the pressure of the air in an operating room positive. So in other words, if you stand outside of an OR door, you can feel a breeze blowing out. And the reason for that is that it, the air is cleaned and comes through the air conditioning system and there's a higher pressure inside the OR. So we have the ultra clean air inside the OR, and then that blows out to the less restricted areas. So when you're in an operating room, the air is as clean as it can possibly be. We don't want to take in air from the hallways into an OR, when we're doing surgery. We do have the capability in some of the areas to go into negative pressure. And we do that in some of the patient rooms that have communicable diseases, not just COVID with some others too where those rooms can be.

And this is inpatient rooms where the patient's beds are, where that can be negative pressure. So anything that the patient has wouldn't be communicated outside. We can do that in some of our procedural areas too. We have some negative pressure. So if we had a patient say that had a communicable disease like COVID or TB, and we were doing some kind of procedure on their airway, we would not want that to get out into the hallways. So that would be then negative pressure so that any of those viruses bacteria contaminants would be taken out through an air scrubber inside the system. So that's a great question. Normally, we like it positive pressure because we want to keep everything clean for the open surgical site. But there are occasions when we would need it, turn it negative to protect people on the outside too.

Host: Well, thank you for that explanation for the listeners. And we understand you have a team available on call 24/7. Tell us a little bit about the team that you work with Barry, and I've even heard that your surgical staff plays softball as a team previously, so they know how to work with one another. Tell us about your multidisciplinary team approach and all the people that work with you.

Barry Highsted: Okay. Yeah. Well obviously we have the surgeons that come here and bring the cases to us, bring their patients. And that's a great honor. We have a wonderful team of anesthesiologists that come and work here too. And then as far as my team is concerned, that is made up of nurses and technicians. And we have registered nurses. Every patient in the operating room has a registered nurse assigned only to them for the entirety of their surgery and either a nurse or a surgical technician that works along with the circulating nurse to provide that patient care. Before coming into the OR in the preoperative areas that is staffed by registered nurses also. So they prepare the patients for surgery and get them ready and answer any questions, do all the paperwork and all of that. And then into the operating room with the circulator nurse, technician, and then after surgery and the recovery room that is staffed by registered nurses also.

We do have other members of the team that are not so visible. We have an outstanding team of technicians that work in our sterile supply unit and they decontaminate, assemble, pack, and sterilize all of the surgical instrumentation, which is an enormous task and it's very detail oriented. And those people are all certified in their specialty and provide a great service to ensure that everything is available for the surgeons and the staff when they do the surgery. So there's some of the unsung heroes, and we also have people that assist with the cleaning and sanitation of the operating rooms and the turnover of the rooms between cases to ensure that every patient has a clean and ultra cleaned environment for their procedure. So we have a real good team that works closely together. Like you say, it is a 24/7 coverage. So we have teams on calls for cardiac surgery and for general surgery, some of them are highly experienced with many, many years of experience in their specialty.

Others have got two or three years experience, but are supported by them, the more senior members. And they work really cohesively well as a team, I've worked at a lot of hospitals and I must say, this team is among the best I've ever worked with. And like you mentioned, they play softball. Now, I don't really want to talk too much about how they do with softball, because I don't know if they're technically very good, but they have a great time. And I think they've won some awards, not necessarily for the technical softball skills, but for just the amount of fun that they have. So they're good friends in and out of work. You know, whenever we have a new team member start, they all huddle around them and make sure that they're comfortable and understand where everything is and that can provide the best care they possibly can for the patient. One thing about Temecula Valley Hospital is we hire not only for technical skill, but we hire for attitude. We want the right people here with the right frame of mind to provide outstanding care to the patients and that really shines through. So I'm very, very proud of the team, they're excellent.

Host: What a lovely answer, Barry, and I've heard that patients can even pick music to listen to before surgery. Is that true? Tell us about that.

Barry Highsted: Yeah, absolutely. And you know, our surgeons, some of them like to listen to music as they operate, it helps them to relax. It keeps their mind focused. And we always, if a patient wants to listen to some kind of music, we're very, very happy to play that for them in the rooms. Each of the operating rooms has a nice sound system. It's not blasting out loud, it's in the background, but if there's something somebody wants to hear, absolutely they can let us know and we'll find it, we'll play it for them. And we can even play it during the surgery if they wish. So yeah, really. We can do that and we have done that, and do that on a daily basis. Yeah. We often check with the patient, you know, what kind of music do you like to listen to? And, you know, we play that when we come in and the team always all introduce themselves and make the patient, the center of what we're doing. So, you know, the patient is part of the process with the staff then they're not a visitor, they're a visitor in our OR, but they, you know, it's their procedure. So it's very personal to them. So we like to involve them in every part of it that we can.

Host: Now you mentioned the surgeons and that they bring the cases to you tell us about the surgeons and what it's like to work with them.

Barry Highsted: As I mentioned about the way that the staff are picked for the hospital that I won't say the surgeons are picked for the hospital or because the surgeons bring their cases to us. But every surgeon that we work with not only is highly skilled, but they are very personable and work very well with the surgical teams. This isn't something that one person can do alone. It's like a pilot on an aircraft. You know, you need all of the ground crew, you need all of the people in the cabin and your co-pilots and air traffic control and others to support you. And so that's how our surgeons are. They are the captain of the ship. But they understand the teamwork that goes into doing surgical cases. And so the ones that come here as I said earlier, not only are they technically very skilled, their personalities are such a fit for this community hospital, where we try to provide the best service we can for the local population.

And people actually coming in from outside of the area now because of the reputation. So the surgeons are definitely a part of that with the personalities, the way they fit in. And the good time we have with them, you know, when they're here, it sounds strange in an operating room, but when the seriousness of the surgery is done and we're moving between cases or whatever you know, we'll have a coffee or something. And you know, we just enjoy being with them. So the surgeons bring their own personalities, they bring great patients to us, and we just enjoy working with them so much.

Host: That's wonderful as we wrap up Barry and what a great segment this was, you've been so informative, really encouraging and hopeful for people that do have to come in for surgery or are considering elective surgery at Temecula Valley Hospital, as we wrap up, what else would you like patients to know about having surgery at TVH and the safety and care you're offering them and what you're doing to keep the community and your staff safe at this time?

Barry Highsted: Well, as mentioned at the beginning, we you know, we're testing patients as they come in, we're all wearing masks. We're asking patients to wear masks in the hallways. When patients come to us for surgery, they can rest assured that we are certified. We have surveyors come out and we meet all the regulatory requirements, obviously, but we go above and beyond that to provide safe patient care, we will never start any kind of procedure if there is a question, like I said, we always involve the patients. We huddle the day before the surgery, and we go over every surgery coming up for the next day. We look, if we have all the equipment, implant, staffing, any anything that could cause a conflict to be ensured that we're totally ready on the day when the patient comes in for their surgery. We also have a great backup of equipment.

We can provide emergency surgeries that come in and just know that the team are very well trained. They're certified in what they do, they're licensed. And we aim to provide outstanding care. When somebody goes to a hospital for surgery, they expect that the surgery will go well. And we want to provide that. We want to provide a safe and effective surgery, but if we want to go above and beyond that, to ensure that the patient experience was exceptional too, and that they felt part of the team, they felt welcomed and any questions were answered. And they, we wow them with our customer service. So safety, absolutely. But customer service is right there with it.

Host: Thank you so much, Barry. Really, really an informative segment. Thank you again for joining us to learn more about Temecula Valley Hospital surgery information, please visit our website at TemeculaValleyhospital.com/services/surgery. That wraps up this episode of TVH Health Chat with Temecula Valley Hospital.