Episode 23: How to respond to COVID-19 with Callie Turk, COO of FlexCare Infusion

Transcript: How to respond to COVID-19 with Callie Turk

Dylan McCabe: WeInfuse Podcast episode number 23. Welcome to the WeInfuse Podcast, my name is Dylan McCabe and in every episode we give you a behind the scenes look at the infusion suite, whether it’s a provider office or a standalone infusion center and in this particular episode, I’m going to be talking with Callie Turk, she’s the chief operating officer at FlexCare Infusion Center in Oklahoma City and she is going to talk about what they’ve done to mitigate risk in the midst of COVID-19 and there’s also just some timeless business principles that we’re going to pull out of this as well, but this is very specific to what everybody is going through now. So without further ado, let’s listen into this interview with Callie Turk. All right. As I mentioned, we do have a special guest on the show today, her name is Callie Turk. She was actually on our podcast about eight months ago and if you want to hear a really good story about starting an infusion center from the ground up Callie and Aaron share that in that podcast, but Callie is the COO and Co-founder of FlexCare Infusion centers and we kind of want to get an update on how their infusion center has been going and also hear about what they’re doing to kind of deal with just the huge challenge of COVID-19. So, Callie, thanks for being on the show again.

Callie Turk: Yeah, thanks for having me. I appreciate it.

Dylan McCabe: Absolutely well with everything going on right now in the world of infusion and just the world and so many different businesses, but specifically how it’s impacting infusion centers and patients. We’d really like to hear from you about what you guys are doing to deal with this. I mean, what’s your initial reaction? How has this impacted you guys overall?

Callie Turk: Well, I think everybody would agree that it’s been very bizarre, very surreal, everything that’s going on. It has impacted us, it’s changed over time. So at the beginning of March when everything started to become more serious we had to reevaluate kind of our processes and implement new procedures to pre-screen patients and make sure that our staff were taking the appropriate precautions and that our clinic was taking the appropriate precautions but at that time there was not a lot of information out from the CDC other than if the patients have traveled to certain countries they’re at risk. Some of the risk factors were out, but we still had a lot of questions with what are the symptoms and because they vary and we’re so finding that it’s kind of all over the place. So since the beginning of March, we have come up with a lot of different ways to kind of deal with kind of the uncertainty of what we’re seeing by trying to be more proactive and trying to go with what we know right from the CDC, but also take kind of a deeper step in implementing procedures at our clinic that can kind of go above and beyond what is actually recommended. Because again, signs and symptoms of COVID vary by patient it seems like, and we’re learning new things every day. So specifically, some of the things that we have done and have implemented are pre-screening for our patients. I know a lot of a lot of offices are pre-screening their patients. So we do pre-infusion calls 48 hours prior to the infusion. So we always call and we have a set list of questions that we start with and kind of work our way down through the tree of questions if they present, or if they’ve had a fever in the past seven days and we go on to ask about additional questions and symptoms that they have sometimes depending on where we get through that process they have to be cleared by one of our nurse practitioners before they can come in. But usually we get to the second step and say, okay, well we need to postpone the infusion. So we are postponing infusions until patients have been fever free for at least seven days. But if a patient has an active cough, there’s always other things that that kind of fall into place or that do require some advanced practitioner review. So we have implemented that we have began doing fever screenings when patients come in prior to actually taking them back to one of our infusion suites to make sure that we are assessing that morning, even if they don’t feel like they have a fever or do not feel unwell, we want to make sure that they don’t have a fever and if they do, we can’t see them. We also have implemented masks for our patients and for our nurses as well. That is something that has been new in the past two weeks. They were initially not recommending everybody to mask up, but I think from a patient perspective and I think patients want that. I think they want to know that I don’t think it’s scary at first, one of my thoughts was, are patients going to be worried that we’re doing this? Are they going to feel like someone is sick? But I think now that everybody is aware of what’s going on, patients appreciate that and they appreciate the extra steps that we’re taking to make sure that we’re not spreading anything to each other. By design, our clinic has private suites and we also have semi-private suites, but they are a good more than six feet away from each other. So the CDC recommends that, which we luckily have in place by design. But that has been something that has helped us a lot and patients have been asking to come over to us because they’re not in a group setting versus our clinic that has a private setting and private room. So that has helped us a little bit. One of the other things that we’re doing is trying to limit visitors. Again, because we have private rooms and larger spaces for patients, one of the things that we thought would appeal to patients originally when we designed our clinic was you can bring a friend, you can bring a caregiver or someone with you and there’s enough room for them to sit next to you in the same room and that has been something that we are trying to deal; we’re not saying no to everybody, some patients do have members that need to drive them, or if it’s a pediatric patient, there’s a parent that needs to come. So it is a case by case basis, but we are trying to limit guests that come in. We are also trying to minimize any visitors, sales, staff that come in. We were really trying to limit it just to patients, staff and delivery personnel and of course the biggest one is increased cleaning. So it’s kind of all hands on deck, anybody that works at the office, they just have to pitch in and we’re cleaning everything multiple times a day, handles, all the surfaces obviously, our normal cleaning would include a lot of this, but I think it’s also nice to have patients see us cleaning and know that it’s being done and our staff doesn’t want to get sick either. So again, we want to protect our patients and also protect our staff. So those are a lot of the things that we’re currently doing, I guess in reaction to all of this I guess the last thing would be that our clinic does some infusions of vitamins. So vitamin infusions, wellness infusions is what we call them. So we have actually stopped all of those because they are non-essential and for the most part, that is in a nutshell, what we have done and implemented over the past few weeks to make sure that we’re ready and prepared.

Dylan McCabe: That is so good and I know a lot of infusion centers and infusion practices are looking at so many different resources to find the information. I mean, you guys are doing a stellar job with the phone calls ahead of time, kind of like you mentioned the assessment tree that you go through. When dealing with risk assessment screening, there are a lot of different resources out there. I know the infusion center, NICA, National Infusion Center Association has one on their website, infusioncenter.org. Where are you guys going to get protocols for this?

Callie Turk: You know, it’s funny. So we have gone to NICA but the other thing is originally we were going to the CDC, but the CDC was limited to be honest, it did not have enough information for what we needed and for what was coming out. Like I said, originally, it was really geared towards if patients had traveled, they were at risk and obviously a few weeks ago when they still had the same information out, it was spreading in the community. So you have to really use your clinical judgment and really rely on your team and the medical director, everybody that you have along with the different resources that you’re finding NICA is a great resource and some of them are just your clinical judgment on what do we need to do, even if it seems excessive, patients don’t mind that, patients want us to be prepared and they want us to go above and beyond and we do too, protecting our staff is key if we don’t have our staff working and if we don’t have our staff safe and healthy, we can’t see patients. So I think we have utilized as many resources as we can and sometimes we make decisions based on what we are seeing and it doesn’t necessarily have to mean it’s documented anywhere out in the news or on a particular website, we just want to be extra cautious based on our chemical judges.

Dylan McCabe: Right. I mean, better to be safe than sorry and so when we were talking about just mitigating risk overall, and I know you mentioned it earlier, but let’s just talk about decontamination procedures and I know you’ve been in specialty infusion for over 10 years and you have training as a professional in healthcare as a nurse and so what were your decontamination procedures like before and what are they now with this outbreak?

Callie Turk: So prior to we always would wipe down; so we have private suites and so each time a patient would leave we would wipe down the chairs, the equipment I mean really kind of wiped down the room, really good, the doorknobs and the light switches. But we didn’t necessarily wipe down the front desk as much like where patients would go check in. We would wipe them down daily, but it’s not something that we would do frequently multiple times a day. So the same thing is happening in terms of we still go in and wipe down equipment as soon as the patient leaves, right after the patient leaves we clean the rooms with the same EPA level disinfectants that are recommended and we have to let those sit and dry for the appropriate time and then what we have added is a lot of extra cleaning on all of the different services that we would clean daily. Now we’re actually cleaning them multiple times a day. So mainly the parts of the clinic that patients touch frequently. So any surface wear like a transactional surface at the front desk where patients would go and talk to be checked in, we’re wiping that down between every patient. We also have a hand sanitizer and mask up front for them to use prior to them going back. Again, that originally we thought might seem scary and it was before they were recommending using masks. But we thought, and kind of the reaction has been very positive. Patients want that when they come in. We have been wiping down the doorknobs to the front of the office all of the doorknobs of the clinic that patients touch multiple times a day. We have what we call a snack bar, which again is not being used much now, but we wipe that down multiple times a day, making sure that if a patient goes back there and utilizes that area, that we wipe that down we’re doing the bathroom multiple times a day. So it’s really more about frequency of cleaning, not necessarily what we’re cleaning with. But we definitely are being a lot more cautious and spending a lot more time between patients making sure that it is wiped down.

Dylan McCabe: So when you talk about that and those decontamination procedures and mitigating risk for your patients and you guys are clearly going the extra mile, it’s great that you have independent rooms that patients can get infusions in, you can keep people distant, you can limit the amount of visitors and all that and that’s just; I’m kind of in line with what you’re saying regarding how patients feel about it, I would feel good if everybody had masks on, because as these stories come out about what people are going through, when they get this virus, especially people that their immune system is compromised, it’s awful. And so the last thing you would want is to be somebody like me, I’m a healthy guy. I’m 40 years old, I wouldn’t want to get this and then accidentally give it to my mother or somebody else I care about that’s older that can have a harder time with it. So I think it’s great and I’ve noticed people out and about in the grocery stores wearing masks and stuff like that. So you guys have gone the extra mile there, I guess what’s one key takeaway that you’ll use from all this with protecting your patients and protecting making sure your facility is sanitized going forward. What’s something that you think you’ll do maybe that you guys weren’t necessarily prepared for before?

Callie Turk: So I think that with any company, whether you’re large or small, you all have some sort of emergency preparedness plan, whether that’s written or in your mind, you know how that’s going to go and when you have something to this scale that comes up, whether it’s a natural disaster, whether it’s flooding of your clinic, whether it’s a pandemic you can learn from everything negative that happens and turn it into a positive. So I think what we are learning is not so much, I mean, the cleaning aspect and getting the preparations and supplies in place for patients has been easy and we’re agile enough to do that quickly because we had supplies on hand, but the supply chain that breakdown did not support what and when I say that the supply chain terms of medical supplies, we were at risk of running out of masks to support our patients over a certain period of time, which we luckily have been able to receive more masks and get those in place. But we were running into that issue of what would happen, what are our steps, if this happens, if we run out of supplies, because as we all hear in the news, that is real and happening everywhere, and you as a clinic, you need your own supplies to stay afloat, but you also don’t want to hoard supplies either, you want to be prepared for the volume that you have. So I guess from my perspective, what I have learned and what I probably, well, I think everybody’s takeaway is we could have been more prepared and not necessarily, I think the world could have been more prepared. The United States could have been more prepared, but I think that now we know going forward and how we need to prepare from a supply standpoint, I will always have more of a supply of masks on hand than I originally thought our par level would be. So just because of going through this experience because I feel like some of those things that you don’t necessarily use on a daily basis that aren’t necessities become a necessity in this case and so for us personally, that’s what we have learned is that the supply chain and having par levels of certain things that you don’t think that you would use 200 masks in a day for our clinic specifically, we would not, that would not be normal and maybe for some, it would be, but we definitely weren’t prepared for that surge of the need of supplies. So for us, I guess that would be the biggest takeaway for me and for our staff and then also trying to figure out and really have it in your mind, what staffing is going to look like, what you need to really think about if one of your staff members get sick and is out for two weeks and not just one, but maybe what if another one of your staff members, what of your staff members can’t make it to work and really prepare for that? Sometimes you can’t prepare until it’s actually there, but you can be a little bit proactive in the what ifs. So I guess that would be my big takeaway from this is that everybody probably could have been a little bit more prepared for this but again, I don’t know that you can prepare for something of this degree.

Dylan McCabe: Right, yeah, unless you’re a prepper. Those are the only people that are not caught off guard by all this. So let’s talk about that. How do you protect your employees? I mean, I’ve got multiple healthcare professionals in my family. I have one of my nieces, I think she’s 23 years old or 22 years old, she’s a nurse and my mother started sewing masks for her. So now I think she’s got like six or seven masks that my mother has made for her that are washable because the health care facility she’s in, in Houston is running out a mask. So what are you guys doing to protect your staff from masks to get sick and so forth?

Callie Turk: So they have to follow the same criteria that patients would have to follow. So we take them through that same tree, if for some reason they have a fever or have been sick, have a cough, all of that stuff. We work them through that tree and they won’t be able to come to work. We have had one example of that they were fever free, but we wanted to make sure that everything was good. So we got to the office and had them work from work. So working from home as an option and you really have to make sure that you were equipped to handle that and that you’re flexible with that because some of this is not preventable and you have to be flexible in how you deal with it in order to continue to see patients and still make operations work and flow. So one of them is allowing them to work from home if they’re sick, that is a big one, but also if they do get sick or feel sick, we take them through the same criteria as a patient that we would for pre-screening. But then also the cleaning of all the equipment, their desks, the same cleaning that we do in the infusion center for patients is helping them as well and as I mentioned earlier, they’re masking up throughout the day as well, so that they’re protected. But that’s kind of, and then just education too. I think everybody feels better when they know why we’re doing the things that we’re doing, patients, staff, everybody, it may seem extreme, but there’s a reason behind everything we’re doing and prevention is key. So we’re just trying to stay ahead of it.

Dylan McCabe: And you guys are clearly prepared and I think it’s like any other setting when you sit in a situation and you think that the people across from you who are serving you are well prepared, it puts you at ease and so that’s so good. So let’s move it up in a positive direction. I know that there’s a hashtag up, I think it’s called find the positive and a lot of people even posting on social media, how this has impacted them in a positive way and their home life and their families and so and so forth. I know patients that are coming into your infusion center need to stay on schedule. They need to keep these diseases in check. What has been a positive outcome of all of this for you guys?

Callie Turk: A positive outcome for this is that I think we are establishing a really good, not that we didn’t have a good relationship with our patients, but I think it strengthens a lot of the relationships that we have because they know that we are following up with them so frequently, we are truly concerned about them being safe and it’s not about us getting more and more patients in everyday operationally. It’s about, if you don’t feel well, you don’t need to come at you. You can’t come in one, but we need to protect you as a patient. But then also I think establishing that with the referring providers that we have, that we were taking this seriously, we’re doing everything that we can and I think it shows how you react to this type of situation. I think if you can do it in a, again, it’s not going to be seamless, but it’s all about how you react and respond and I think for us as a team, our team has responded very well. They have not been reacting. What would you say overreacting, I guess, to some of this, and they’ve been trying to keep patients calm, keep referral sources calm, and that has helped us tremendously, but I think it’s also strengthened a lot of our relationships with our referring providers with just a lot of the back and forth communication. So that has definitely been a positive that we found just within our community of referring sources and patients.

Dylan McCabe: That’s so good. I know I saw an article put out by Mark Cuban that said the way you treat your customers and staff now is going to determine your ability to keep them long term. You’re showing people what kind of culture you have now as a business and in the way that you respond to all of this. So that’s so good and I know that you guys use WeInfuse software and you have in that software that tool of those alerts and appointment reminders, how are you guys using that to help in your communication with your current patients?

Callie Turk: So it’s actually been very helpful because we have seen a handful of patients that have not been able to infuse. So we’ve had to cancel appointments and then also the patients that we’ve pre-screened, and they just declined to come in because of everything that’s going on. They just don’t want to expose themselves if they don’t have to. So we have had a lot more patients go back into our flow that we do need reminders on theirs. There would be no way to remember all of the patients that we would need to go back and reschedule and what providers we need to follow up with about the cancellation of their patient’s visit without WeInfuse telling us that in the flow. So that has helped us tremendously. One thing that we have not implemented yet that I know we are looking forward to is the text messaging for the appointment reminders. So I know that that just came out two weeks ago or a week ago. I forget now, but that’s definitely something that we’re looking forward to using that I think the delay on our side is really because of everything that’s going on now we wanted to make sure that we had someone talking directly to a patient prior to their infusion, but to ask them the pre-infusion questions, but that’s definitely something that will help us in the future hopefully in the near future. So it’s been great.

Dylan McCabe: Absolutely. Yeah, that’s the whole goal is to simplify the situation and in a chaotic time like this, it’s great to hear that you guys are utilizing the tool to put everybody on the same page, not only your team, but your patients as well. So, well we could go on and I’m glad that it has created some positives and it’s so interesting because you guys are going to see these patients, some of them for several years, and it’s so neat to hear all of the positive things you guys are doing to help these patients, to protect the patients, to serve them well, and also protect your staff and it sounds like from the outside looking in, it sounds like you guys are handling it really well. So what’s one parting piece of advice. I mean, we’ve got listeners and we’ve got consulting clients and WeInfuse software customers all over the nation that are trying to figure out how to best respond to this whole situation. What’s one big parting piece of advice you would have for anybody listening to this interview?

Callie Turk: I think communication is key. I think that it doesn’t, what you do to respond to anything is important, but communicating what you’re doing to the community is just as important because if you don’t have a letter that goes out to your providers to let them know that you are still open, you are doing ABC and D to really react to the situation and implementing these things. Nobody’s going to know and you’re going to have more calls and more inquiries about, are you doing this? Are you open? So getting the word out about what you’re doing, whether that’s on LinkedIn, Instagram, Facebook, social media, or sending out, we sent out a fax to all of our referring providers to let them know, we kind of typed up what our response was and I get the emails going out as well from a lot of our vendors and that is important to let us know and communicate and just keep that line of communication open. And again, just reiterate that when patients come in, so that the comfort level for referring providers and patients is there and that they can see what you’re doing in person and then also just out in the community, see that as well. So communication on everything I think is key for these types of situations.

Dylan McCabe: Awareness is the cure all, that is that’s great. Thank you for making that point and Callie, this has been great to have you on the show. I know, like I said, at the outset, you guys were on our show about eight months ago and I know you’ve built an infusion center from the ground up. You’ve grown a successful practice there. You guys are clearly going the extra mile to take care of your patients and your staff and it’s just great to hear a success story and it’s great to hear what you guys are doing to navigate this storm and use it for good. So thank you very much for being on the show.

Callie Turk: Thank you for having me. I appreciate it. Thank you.

Dylan McCabe: All right. I hope you guys got a lot out of that show with Callie Turk. I pulled some great nuggets of information there, especially regarding what they’re doing to communicate well with their patients, what they’re doing to communicate well with their staff, their team, what they’re doing to protect everybody and again, that’s a say a successful consulting story with WeInfuse. So if you’re listening to this show and you’re thinking, I’ve been doing my research and want to start an infusion center, Callie Turk and Aaron at FlexCare infusion, they are a success story. So if you’re interested in consulting with WeInfuse, we offer two services consulting and software. So just head on over to our website weinfuse.com and you can schedule a discovery call with one of the account executives there, or if you are running an infusion practice now, and you want everybody to be unified, you want to have a streamlined process, you want to have all of the features that are included in a software tailor designed for the infusion suite. Go ahead and give WeInfuse a call or schedule a demo, just go to weinfuse.com, click that big blue button that says request a demo and you can get a demo scheduled and see how much WeInfuse can simplify your workflow, reduce financial risk, and really enable you to give the best patient care possible. All right, this is Dylan McCabe with a WeInfuse Podcast. Thanks for listening and I will catch you in the next episode.

Guest Speaker: Callie Turk, Co-Founder and COO at FlexCare Infusion Center, received her MS in Health Care Administration from MidAmerica Nazarene University. She has over 10 years of experience in the healthcare industry, holding positions such as Director of Clinical Informatics & Education, Manager of Clinical Education & Outcomes, and Clinical Training & Design Specialist.