By Wayne E. Rivet

Staff Writer

As Peter Wright closely watches the number of corona virus cases increase in Maine and the nation, he knows “this is not going to be a sprint, it is going to be a marathon.”

Reaching the one-year mark as Bridgton Hospital’s president, Wright is facing the most challenging moment of his healthcare career. The News conducted the following telephone interview with Wright Tuesday morning:

BN: How has BH set up for testing, and the number of tests administered at this point? Is there a selection process as to who gets tested, and is there any shortages?

Wright: Bridgton Hospital, in collaboration with our system, has been planning for this since it came on our radar in early January. The public has been aware of it and taking it seriously for about two weeks. We have erected a tent outside of our ED (Emergency Department) to be able to test patients. Obviously, our number one priority is to serve and protect our community. Yes, we need to be a testing center for people who are appropriate. Two, the protect is to help folks understand when they need to be tested and when they don’t and what the appropriate steps are to take. Most of our activity in the testing tent has been sending people home. Everybody is screened. You can call your primary care provider. Or you can call 2-1-1. They will take you through a series of questions to determine whether you should be tested or not. That’s very important because we don’t want to be wasting resources on people who shouldn’t be tested. There has been some concern in the community that people want to be tested. Wait a minute, you need to meet the criteria first.

We are seeing, like the rest of the nation, a shortage of supplies. We have not had a situation that we haven’t been able to test someone. We continue to follow and adhere to CDC guidelines, which as the CDC learns more what is going on in the rest of the world, it changes and adapts. We meet several times a day as a Command Team and then spend the rest of the day communicating to our staff about the most recent updates, here is what you need to know.

We are doing everything we can to keep our staff safe and protected. Do we have enough of every single supply that we would want? I think the fair answer is “no.” Do we have enough of the right supplies to keep people safe, I think the fair answer is “yes.”

Part of our message and training to our staff is that if you are doing “X” then this is the equipment you need. In the long-term, do I worry that we will have the equipment we need, absolutely. 

BN: If a person is experiencing serious virus complications, is that person treated here or moved to Central Maine Medical Center in Lewiston?

Wright: We have our inpatient unit with negative pressure and can care for a patient to a certain point within the skill set at the hospital. Like any other day, when a patient exceeds our skill set, then we transfer the patient to CMMC or another appropriate center based on availability. We are continuing to function like any other day. We have people with test results pending.

BN: What are the most frequently asked questions BH has received; and how is information disseminated? 

Wright: We are triaging all phone calls through the clinics. We think it is very important that patients maintain their primary communication either with their primary care provider or specialist, depending upon the circumstance. We’re seeing patients that are overly anxious and want to get in a healthcare environment and seeing patients that are overly conservative about coming in when they should. If someone is scheduled to have their normal annual physical and they are healthy, we are calling them and saying we are going to kick it down the road a little bit; if that patient as COPD and heart issues, diabetes or other chronic illnesses, we are trying to handle them telephonically or if we need to make an assessment because it is critically important, we are bringing them in. It goes in waves. Sometimes, we get tons of calls and sometimes it is eerily quiet. Our normal ED calls have dropped off. That is relieving on one end because people aren’t coming in if they don’t need to but also a concern if we don’t see a number of diabetics or heart patients that we normally did because they are sitting at home following the instructions to social distancing but perhaps they are struggling and getting worse and probably should come in. The message we want to send to everyone is, “Look, maintain contact with your primary care provider or specialist via telephone as you normally would. Don’t wait. If you are feeling bad, give us a call. Let us talk to you. If you are sick, by all means come in. We can keep people safe. There are non-COVID patients coming into the Emergency Department. We have an incredibly talented Environmental Service team that does a great job in keeping our environment clean and safe. When we have COVID or suspected COVID patients, we put them in the negative pressure rooms to protect our staff and other patients. Washing your hands and using the right protective equipment is really basic elements to stay safe.

Right now, we do not allow visitors to the hospital unless there are special circumstances, those being someone in hospice. I am sure there is an exception here or there (emergency surgery and risk of passing, we allow one person to come in). We have dramatically tightened up on our visitor policy, that’s further protection for our patients, their loved ones and our staff.

BN: Can you give an inside view of what staff briefings and meetings took place and continue to be held as this virus crisis unfolds.

Wright: We try to have a strong, positive environment. We try to govern the organization by engaging the talents in house, and come to consensus on issues as we move forward based on best practice and knowledge. When you cycle into an Incident Command type of structure, there is a reason it works. We tighten up span of control. We institute more limiting responsibilities, which means we engage more folks in how things work. We’ve spent a lot of time planning what is really going on? When will it hit? What precautions that we need to take? What resources that we need? As we learn more about it, we adjust. What surgical cases should we do? What therapies should we continue and should not, all of which has changed over time as the situation escalated and have become more knowledgeable about what the right thing to do is.

We are also trying to be educators. There are some out there that aren’t heading the warnings. So, we’re trying to role model of social distancing. When the governors were saying no meetings of 200 or more, we were saying 50. When they went down to 50, we went to 10 to 20. Now, we’re using remote technology, hosting meetings over the Internet or Zoom to keep people apart.

Planning continues to be a couple of weeks ahead. What is the potential? Is this going to hit? If it does, will there be a large influx of patients, and how will we handle it?

BN: What plan is in place regarding services if staff members become ill?

Wright: It depends. If 10% of our workforce gets infected, yes. If 90% gets infected, no. This is why we are trying to emphasize to our staff that recommendations are out there about social distancing, we need to go 10 steps further than that. You are essential personnel. The side benefit of closing down some services is that we would normally do is that now we have access to more staff. We are retraining those folks, someone who might work in a procedural area or OR may need to retrain to be critical care. It’s part of our planning (for continuity in operation). 

Our staff is always willing to serve — always have been and always will be. We are extremely grateful for that. The challenge is making sure we provide them the training to do their new jobs appropriately. We are inventorying what previous skill sets they have. There are some nurses who are currently in retirement, and popping their heads up saying, “I’ve been out of the game for a year or so, but I’m willing to serve.” 

At some point, if this gets large enough, what if the governor deploys the National Guard? How would we respond because it’s reasonable to assume that a percentage might serve in the Guard. 

The good news is our community of healthcare professionals is really heartfelt. They are stepping up left and right asking what they can do. I am impressed every day at how they respond.

BN: In watching your live press conference with Bridgton selectmen last week, one theme was for agencies to come together under a command center. What has been done, how has it worked?

Wright: Pretty good. We’re not in full-blown emergency disaster mode. We’re aware the virus is out there, but we haven’t gotten to the point that it has overwhelmed resources. I stay in contact with municipal officials and I am at their disposal when they need me. If this gets bigger, we will send a liaison to the Emergency Command. Those two set-ups, town and hospital, need to be in perfect harmony (Unified Incident Command, where we would deploy a staffer that has direct contact to me and my team).

BN: While there are policies and protocols developed for situations like this, as well as training sessions, what have you seen that has worked well (examples), what shortfalls have surfaced? 

Wright: We are always used to the concept of shortage of medication because it is an every day thing. What is challenging for us now is if this gets bigger, how do we gain access to personal protective equipment? That is our biggest challenge. The Feds have assured us that they are doing everything they can to assure the manufacturers that make this stuff get it out to us. This is a global pandemic. Every country, every province, every town is looking for the same stuff. The manufacturers’ abilities are limited, so they have to look how do we prioritize where the situation is the worst, or prioritize to the area where the situation isn’t so bad yet and help them prevent. The flattening of the curve. We’re not trying to contain this virus anymore. We’re trying to mitigate the spread. Slow the spread so we don’t have everyone get sick at once and overwhelm the system to take care of them.  

BN: As the hospital administrator (number of years in this type of role), what have been the most trying elements?

Wright: The idea that we don’t know how long this will go on. In my career, I’ve dealt with emergencies like a bus turning over and a surge of 55 patients. We’re  sitting here waiting, and I was reminded that the last time I waited for patients to come were the days and weeks following 9/11 where the plan was that hospitals in New York and Connecticut were going to shift existing patients north so they could handle the fallout. The idea of sitting and waiting not knowing how big this is going to be or long it will take, it’s hard for me (and everyone) on how to support the staff to give them some peace. People think that as the hospital administrator that I am at the top of the pyramid. I frequently say it is the other way around. A good organization is run like an upside-down pyramid. My job is to support the leadership team, whose job is to support the staff on the front line because they take care of patients. We will be successful because we can endure this marathon. Most of the time, things in our industry are predictable. In the winter, we see more patients at certain times due to skiing. In the summer, it really starts to hit. With this virus, I really don’t know what will happen in the next 30 to 36 days. I do know that we’ll be here and get through this together. Resiliency is driven by the love and outpouring of support we get from the community. You’ve seen the signs. When you drive to work and see that stuff, you’re reminded who you are doing this for and why you do it. It’s heartwarming. I know we can get it done. The hardest part is not knowing what next week brings.

BN: We had scheduled this interview as a look back over your first year at the helm. What would you say were your successes and what work still needs to be done?

Wright: I don’t think it’s me, but as a team as a whole. I believe we have been able to stabilize primary care. I am happy that we’ve returned GI services and general surgery. We’re expanding on podiatry and looking into orthopedic and urology. So, all of those services that folks have said they want locally, we’ve made some great strides on bringing them back. It is clear that the community loves the hospital and the people who work here. I think there was a period of time that it got foggy. I think we’ve cleared that fog, and I think we were able to rebuild trust in the system. Does that mean everyone? No. I talk to people all of the time that say they used to go to Bridgton, but now go elsewhere. What I feel confident about is that every day the number of people who used to go to Bridgton (Hospital) and go some place else, gets smaller. Is it zero? Not yet. But, every day we engage with one person or multiple of people who come back. Who feel we are moving forward. I have engaged with some of our strongest opponents during that tumultuous time, the people who spoke out the loudest. Some of them feel better about where we are now and where we are going. It’s a strong indication that we are going in the right director. This too is a marathon and we’re in it for the long haul. I know trust isn’t built overnight. All I ask is for people to give us one chance at a time, and to allow us to make that once chance a good one. There have been some opportunities that we haven’t performed to the best of our ability, and when people reach out to me that “this went wrong,” one they know they can call me and talk to me about it; two, they know I will do something about it. I am most proud of the people who have called, expressed concern about something, and I have been able to make it right. I often say, we are human and we make mistakes. It’s how we handle them and make them right. We have an enormous number of people who work tirelessly around the clock and invade their family time and personal time to make sure people get what they need.

BN: Finally, how would you sum up your first year as BH president?

Wright: It’s been very successful. I am very grateful that the staff have embraced me, been kind and very welcoming, and so has the community. I think we are successful in moving the organization forward and restoring critical services. And, I think there is more work to be done. We’re buckling down and getting to work. I have 17 1/2 years before I retire, so I’m in it for the long haul.

For updates, check the Bridgton Hospital website.