2019 Annual Report Dear Friends
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Extraordinary people, extraordinary times 2019 Annual Report Dear friends, This is truly an extraordinary time. While this report focuses on Northwell Health’s efforts and achievements throughout 2019, no document created at this moment can ignore the defining event of our era. The coronavirus pandemic is reshaping the world and health care — and the people of Northwell have responded with heroism, ingenuity, sacrifice and love. During the surge, we cared for more COVID-19 patients than any other health system in the nation, saving lives, developing solutions to critical treatment shortages and advancing scientific understanding of the new pathogen. The seeds of these accomplishments were sown long ago, as was made clear by the successes of 2019. Our commitment to clinical excellence was celebrated by US News and World Report, which recognized five of Northwell’s acute-care hospitals with 23 top-50 rankings in adult medical specialties as well as nine of 10 pediatric specialties for which Cohen Children’s Medical Center distinguished itself. In addition, academic and professional associations recognized our achievements, including the Society of Thoracic Surgeons, which lauded the Sandra Atlas Bass Heart Hospital as one of just three cardiac programs in North America to achieve its highest performance rating. Our tradition of supporting and stimulating innovation was evident in advances like the rollout of PurpleSun’s ultraviolet disinfecting technology, which eliminates 97.7 percent of operating room pathogens in seconds. At the same time, scientists at the Feinstein Institutes for Medical Research continued to lay the groundwork for improvements in treatment for disorders that impact millions, such as sepsis and hemorrhagic shock. Equally meaningful were the recognitions Northwell received as a workplace where people can thrive. The health system was named to Fortune’s Best Places to Work list for 2020 and was also acknowledged as one of Fortune’s 100 Best Places to Work for Diversity. We are honored that Northwell’s employees play a tremendous role in the success of our $1 billion Outpacing the Impossible campaign, which raised more than $130 million in 2019. To date, more than 8,800 colleagues have contributed gifts totaling more than $13 million — which includes support of our COVID-19 Fund. Crisis reveals character; that is always true in health care, but never more than during a disaster. As we look back at 2019 and gaze toward the future, we are proud to share with you these stories of the skill, commitment, courage and compassion that define Northwell. Michael J. Dowling Michael Epstein President & CEO Chairman On the cover: This impactful image, proudly displayed at our corporate offices, celebrates the many individual contributions that helped Northwell meet the COVID-19 threat head-on. Michael A. Epstein, Chair of Northwell Health’s Board of Trustees, left, and Michael J. Dowling, President & CEO of the health system. Northwell Health | 20192017 Annual Report 3 SPECIAL SECTION: COVID-19 At North Shore University Hospital, celebrating the facility’s 1,000th discharge of a COVID-19 patient. Extraordinary people, extraordinary times When the World Health Organization (WHO) declared that a new virus ravaging the city of Wuhan, China, constituted a global public health emergency, Northwell Health was in the midst of a seasonal flu that was already straining hospital emergency departments and inpatient capacity. Though the risk of an outbreak in the US was then seen as minimal, on January 22 the health system took the precaution of elevating its level of vigilance. 4 Northwell Health | 2019 Annual Report In a move that would prove critically important as supply chains tightened and broke, Northwell also began investing more than $5 million in the purchase of PPE, ventilators, lab equipment and supplies, and other essential material. By mid-February, China had approximately 80,000 cases of the disease caused by the coronavirus: COVID-19. New York State’s first case was confirmed on March 1, and Northwell saw its first patient on March 8, at a Westchester urgent care center. As cases spiked in the New Rochelle area, Northwell assisted the state Department of Health (DOH) in establishing a drive- through satellite testing facility. Northwell would later help the DOH establish numerous other testing sites throughout its catchment area, and would also set up testing for pregnant women with a scheduled delivery date at any of the health system’s hospitals. Meanwhile, to supplement the work of DOH’s Wadsworth Center in Albany, then the sole lab performing tests for coronavirus, Northwell Labs began manual testing of samples on March 8, a feat recognized in a visit by Governor Cuomo. The lab transitioned to a fully automated process within weeks, allowing throughput of thousands of tests daily. Early action in ordering supplies helped Northwell stay ahead of shortages (top). Swabbing for infection at one of Northwell’s drive-through testing sites (middle). New York Governor Andrew Cuomo consults with Michael Dowling at Javits Convention Center, where Northwell provided operational oversight of a field hospital that treated more than 1,000 COVID-19 patients during the height of the pandemic. Northwell Health | 2019 Annual Report 5 SPECIAL SECTION: COVID-19 Above: Northwell converted the Rust Auditorium at North Shore University Hospital into a dedicated COVID-19 unit. Right: Lobby space at LIJ’s Katz Women’s Hospital was converted into a makeshift triage area. New York reported its first two deaths on emergency medical technicians (EMTs) and paramedics March 14, beginning a period of explosive growth from Northwell’s Center for Emergency Medical in hospitalizations and mortality. At Northwell, Services. From March 21 to April 17, they transported hospitalizations went from 49 on March 16 to a 810 COVID-19 patients from overrun hospitals like LIJ peak of 3,425 on April 7. Forest Hills and Valley Stream to facilities with more capacity. This “load balancing” was a decisive benefit of Emergency departments and urgent care centers Northwell’s status as an integrated health system. were being overrun. Moving fast, the health system added nearly 2,000 beds, finding space in lobbies All the while, there continued to be a severe shortage and auditoriums, as well as operating rooms, of swabbing kits needed to perform COVID-19 testing, catheterization labs and other procedure rooms, which frustrating patients and doctors alike. To help ease the were largely sitting empty after Northwell cancelled scarcity, Northwell Health’s 3D Design and Innovation elective surgeries and other procedures on March 16. Center in late March teamed with the University of At the request of the Governor, Northwell also took South Florida to test, design and manufacture nasal responsibility for overseeing clinical operations at a swabs using 3D printers from Somerville, MA-based 1,000-bed field hospital staffed by Army clinicians Formlabs Inc. Around the same time, intense pressure within the Javits Convention Center in Manhattan, as on the supply of mechanical ventilators prompted well as the USNS Comfort, the 1,000-bed Navy hospital Northwell to begin 3D-printing parts to allow bi-level ship that docked at Pier 90 in Manhattan. positive airway pressure (BiPAP) machines to do the job. Thanks to this innovation, more than 300 BiPAP All Northwell hospitals were hit hard by the pandemic, machines were converted into ventilators, heading off a but volume was especially staggering at some. Among need to ration the availability of life support. the many unsung heroes throughout the crisis were 6 Northwell Health | 2019 Annual Report Intense pressure on the supply of mechanical ventilators prompted Northwell to begin 3D-printing parts to allow bi-level positive airway pressure (BiPAP) machines to do the job. Above: From left, Stanley John, director of respiratory therapy at NSUH; Hugh Cassiere, MD, medical director for respiratory therapy at the hospital; and Todd Goldstein, PhD, director of 3D Design and Innovation at Northwell, found a way for the common BIPAP breathing machine to work as a ventilator. Below: Collaborating with the University of South Florida Health and the 3D printing company Formlabs, Northwell 3D-printed its way out of a nasal swab shortage. Northwell Health | 2019 Annual Report 7 SPECIAL SECTION: COVID-19 Similarly displaying remarkable speed, open avenues for care without the risk agility and creativity under pressure, the of exposure, Northwell exponentially Feinstein Institutes for Medical Research expanded its telehealth offerings. From formed a COVID-19 Clinical Trial Unit to March 1 through April 30, Northwell spearhead clinical trials throughout the conducted more than 112,000 telehealth health system. Such studies typically take visits throughout the health system. A months to organize, but the first three critical advance: making more than 6,200 trials with Gilead Sciences and Regeneron clinicians available via its AmWell platform, Clockwise from left: Exhaustion and Pharmaceuticals went from preliminary up from just 200 practitioners before the gratitude as a recovered COVID patient is discussions to enrolling patients within 72 outbreak began. discharged. hours. Altogether, the Feinstein Institutes Throughout the crisis, skilled-nursing Scientists at Northwell’s Feinstein instituted seven COVID-19 treatment facilities, home care nurses, palliative care Institutes for Medical Research focused on clinical trials that enrolled more than and hospice professionals played critical understanding a cascade of reactions. 1,000 patients. roles. One of the biggest challenges was Expanding remote monitoring capabilities As the virus spread, finding ways to care ensuring that patients were discharged reduced clinicians’ potential exposure for patients with non-COVID medical safely; because of their vulnerable to infection. problems became a pressing concern. To condition, many could not go directly home. 8 Northwell Health | 2019 Annual Report “ I always knew we had great people at Northwell Health, but the crucible of COVID-19 has demonstrated it in countless ways that have left me speechless.” – Michael J.