Selected Podcast
The COVID Crisis Hits Home at a Small, Rural Hospital
How a small South Florida hospital rallied against COVID-19.
Featuring:
Mrs. Moreland was named Associate Vice President in September 2020 following a promotion to Hospital Administrator in June 2019. She was previously Lakeside Medical Center’s Director of Nursing where she oversaw the leadership and direction of nursing, case management, nurse navigation, and clinical education at the hospital. Prior to that, she served as the hospital’s Director of Quality and Patient Safety. In that role, Mrs. Moreland led successful initiatives to improve the safety, effectiveness and efficiency of the medical services Lakeside Medical Center provides to its patients. Thanks in large part to her leadership, Lakeside Medical Center was named an “A” rated, top hospital in the nation for patient safety, as recognized by Leapfrog’s Hospital Safety Grade for the fall of 2018. The hospital also received the 2018 Florida Hospital Association (FHA) Hospital Improvement Innovation Network (HIIN) Award for excellence in patient safety.
Before joining Lakeside Medical Center in August 2013, Mrs. Moreland served with the Florida Department of Health Palm Beach County for more than 25 years. She was the Health Center Administrator for the C. L. Brumback Health Center in Belle Glade where she oversaw daily operations. Other positions she held during her tenure with the Health Department include senior community health nurse, community health nursing supervisor, senior community health nursing supervisor and ARNP coordinator. Mrs. Moreland received her Master of Science in Nursing Education and Master of Science in Nursing at Florida Atlantic University in Boca Raton, Florida and is licensed as a Health Care Risk Manager. Mrs. Moreland made her home in the Glades area when she was one year old. She enjoys mentoring young adults in the community where she was raised to help them succeed in their future careers.
Janet Moreland, ARNP, MSN, LHRM
Janet Moreland has more than 35 years of experience in hospital, home health, skilled nursing, community and public health primary care environments and has served as clinical faculty. As Associate Vice President, Mrs. Moreland oversees the daily operations of the 70-bed, acute-care teaching hospital in Belle Glade.Mrs. Moreland was named Associate Vice President in September 2020 following a promotion to Hospital Administrator in June 2019. She was previously Lakeside Medical Center’s Director of Nursing where she oversaw the leadership and direction of nursing, case management, nurse navigation, and clinical education at the hospital. Prior to that, she served as the hospital’s Director of Quality and Patient Safety. In that role, Mrs. Moreland led successful initiatives to improve the safety, effectiveness and efficiency of the medical services Lakeside Medical Center provides to its patients. Thanks in large part to her leadership, Lakeside Medical Center was named an “A” rated, top hospital in the nation for patient safety, as recognized by Leapfrog’s Hospital Safety Grade for the fall of 2018. The hospital also received the 2018 Florida Hospital Association (FHA) Hospital Improvement Innovation Network (HIIN) Award for excellence in patient safety.
Before joining Lakeside Medical Center in August 2013, Mrs. Moreland served with the Florida Department of Health Palm Beach County for more than 25 years. She was the Health Center Administrator for the C. L. Brumback Health Center in Belle Glade where she oversaw daily operations. Other positions she held during her tenure with the Health Department include senior community health nurse, community health nursing supervisor, senior community health nursing supervisor and ARNP coordinator. Mrs. Moreland received her Master of Science in Nursing Education and Master of Science in Nursing at Florida Atlantic University in Boca Raton, Florida and is licensed as a Health Care Risk Manager. Mrs. Moreland made her home in the Glades area when she was one year old. She enjoys mentoring young adults in the community where she was raised to help them succeed in their future careers.
Transcription:
Robin Kish: Late this summer, the number of COVID cases started to soar in a rural south Florida community. The local public hospital there found itself in a dire situation. The intensive care unit was full and no hospitals in the county had available beds to accept the few patients who needed to be transferred for a higher level of care.
What happened next? Today, we talked to the woman who leads the hospital and also grew up in that community about how the COVID crisis hit home. Next on this edition of Here For Your Health.
Welcome to the Health Care District of Palm Beach County's podcast, Here For Your Health. I'm your host, Robin Kish.
Our guest today is Janet Moreland, Associate Vice President of Lakeside Medical Center in Belle Glade, Florida. Thanks for joining us, Janet.
Janet Moreland: Thank you for having me.
Robin Kish: Janet, for those unfamiliar with the acute care facility, Lakeside Medical Center, it's a small public teaching hospital that's owned and operated by the Health Care District of Palm Beach County. It's also the only acute care facility within approximately 30 miles. How important is this hospital to the local residents in the cities that border Lake Okeechobee?
Janet Moreland: It's critical because our 70-bed private room hospital is a safety net hospital. The Glades is a region with a higher percentage of uninsured, under-insured residents than the rest of the county. Many families in the Glades community as in any rural community struggle to make ends meet and have limited access to transportation. Farming is one of the largest industries. Thanks to our fertile soil, the glaze is one of the nation's top suppliers of sugar cane, corn and other fresh produce. Lakeside Medical Center is one of the largest employers in the region and is dedicated to providing compassionate quality care, especially during this pandemic.
Robin Kish: And I understand once the COVID crisis began, the hospital and the medical staff played an important role in the community by distributing face masks, stressing the importance of social distancing and providing free walkup COVID-19 testing and vaccinations on your hospital campus. Then this past summer, the hospital found itself in a dire situation. What happened in the community with the Delta variant? And how did that impact your hospital's staff and resources?
Janet Moreland: Our Community, Robin, was hit hard this summer by the Delta variant. Patients were flooding our emergency room with COVID symptoms and the majority were not vaccinated. Our six-bed ICU quickly filled up. So we doubled our ICU capacity to 12 beds, which was also full. For nearly a week, we were unable to transfer COVID-19 positive patients in need of other intensive care units in Palm Beach County.
It's typical for small rural hospitals like Lakeside Medical Center to be able to place patients in need of a higher level of care at another hospital in the county. But the hospital system in Palm Beach County was not functioning this way for the COVID-19 patients due to the overwhelming number of COVID-19 patient volume. We reached out to so many hospitals outside of the county, but their ICU too was very full. There was a scarcity of beds statewide. We announced that the hospital was in a dire situation.
The County Commission responded, issuing a state of an emergency. The order required all of the county hospitals to report their daily number of COVID patients and available beds that allowed us to view a daily dashboard to see what was happening in other county hospitals in real time. Fortunately, the local VA came to our rescue in a timely manner and accepted the patients we needed to transfer for a higher level of care.
Robin Kish: And we should point out that this was a specific period of time during the summer of 2021. Is this crisis over for the hospital now?
Janet Moreland: Thankfully, the situation has greatly improved and we have capacity in our ICU, but it impacted me not only professionally, but personally. In the Glades, nearly everyone knows everyone or is related. And typically, during that time and tragically, during that time, we had members of an entire family in the community lost their lives due to COVID. My cousin was one of them. It was devastating. I'm a trained nurse. I stressed to everyone I knew and love the importance of getting vaccinated, but even close relatives held off getting the shot. This experience has strengthened my resolve and became important and valuable that vaccines are so much needed in families as you go through this tragedy like this.
Robin Kish: Yes, I can imagine it's been like a rollercoaster ride for you and the staff at the hospital because you were providing care at a time when it was so needed. And you are such a powerful voice in that community, having grown up in the Glades, combined with your prior leadership at the health department locally and having that key role overseeing this rural hospital. Are the unvaccinated in the community listening to you now, do you think?
Janet Moreland: Well, the good news is vaccination continues to climb slowly in Palm Beach County. At the beginning of October, the local health department reported that 64% of residents ages 19 and older were completely vaccinated. The Florida Department of Health reported the county has an overall 71% vaccination rate as of November 18th.
Immunization rates in rural communities and rural areas, black and Latino neighborhoods, still remain low. And I am encouraged as many as 55% of residents ages 12 and older in the Glades ZIP codes reportedly received at least one vaccine dose as of August the 31st, the latest data the state department has made available. Hospitalizations for COVID-19 in Palm Beach County are also dropping to low levels and the most serious cases are declining as a result. But we still need to be vigilant and encourage our families and friends to get the vaccine to protect themselves and the community.
Robin Kish: So you've seen, you mentioned in your own ICU, that there's capacity, meaning that you have beds. You're seeing fewer patients who need to be hospitalized due to COVID-related conditions. But meanwhile, hospitals across the country are struggling to maintain medical staffing and there's a nursing shortage as many nurses experience COVID fatigue or are attracted to staffing agencies for higher compensation. Are you dealing with a nursing shortage at your rural hospital? And if so, how are you addressing it?
Janet Moreland: The COVID-19 pandemic has made it more challenging to recruit nurses here in Palm Beach County, as it is an any healthcare system across the country. The highly skilled surgical services and emergency department nurses here at Lakeside are cross-trained to support other areas within the hospital like telemetry and med-surg units. Lakeside Medical Center's dedicated nurses, including a few travel nurses, continue to meet the needs of our patients, residents and the community.
Robin Kish: Nationally, there's been a six-year decline in the number of births, and it's been reported that the pandemic has caused women to postpone their pregnancy. What are you seeing at Lakeside Medical Center?
Janet Moreland: At Lakeside, the hospital's birthing center has a 60-year tradition of delivering generations of healthy babies for residents of the Glades community. We partner with OB-GYN Specialists of the Palm Beaches. They are board-certified obstetricians and gynecologists as well as anesthesiologists to provide care 24 hours a day throughout the year. We also staff certified nursing assistants and registered nurses with over 20 years of experience who are certified in labor and delivery and newborn care.
To accommodate a family-oriented birthing experience, the birthing center at Lakeside Medical Center offers several large private postpartum suites and five large private labor suites that are adjacent to the hospital's surgical unit in the event that a C-section is needed. We have in-house board-certified pediatricians who are also available around-the-clock to attend to any newborn's needs, answer patient's questions, and ensure a newborn is ready for discharge. We also have a certified lactation specialist who is on staff to guide our new moms and their babies with breastfeeding.
Following the baby's birth, a new mom and their partner are treated to a fine dining experience to celebrate the special delivery. And members of the community are certainly invited to schedule a tour of the birthing center here at Lakeside Medical Center or ask any questions by calling (561) 829-4950 during business hours.
In 2020, Lakeside Medical Center received national goal-level recognition from the Association of Perioperative Registered Nurses for ensuring our patients and staff are safe in the operating room. Also in 2018, Lakeside Medical Center was named an A-rated top hospital in the nation for patient safety as recognized by Leapfrog Hospital Safety Grade and also was honored by the Florida Blue as a 2018 Blue Distinction Center for Maternity Care.
Robin Kish: Oh, congratulations, Janet, on those prestigious awards. We mentioned earlier that Lakeside Medical Center is also a teaching hospital. What are the benefits to patients who seek treatment at hospitals with a residency program?
Janet Moreland: There are so many benefits to having a medical resident involved in hospital care. First, you get that extra time with the physician. Unlike physicians, they are on staff. Medical residents don't hesitate to establish what is needed for the patients that they are seeing. That means residents are able to spend more time with the patients without being rushed. They spend most of the day at the hospital and can be at their site when needed. Second, you get an extra pair of eyes. Residents often work alongside teaching physicians, so a patient receives care from two doctors. Thirdly, you receive the most recent advanced care residents or doctors that are preparing to become board certified and are applying for their medical license, that calls for them to be informed about the latest in healthcare practice and treatment. It also means that their teachers, the doctors are also attending physicians at the hospital and must stay up-to-date. We've seen our former residents diagnose rare cases that stumped staff physicians at other hospitals. Fourth, you receive care at the hospital from an academic medical center. Acute care facilities like Lakeside Medical Center must work hard to meet and maintain the qualifications in order to have a medical residency program. Teaching physicians and residents are dedicated to continually advancing their medical knowledge and expertise. A recent study published in the Annals of Surgery showed that patients undergoing high risk surgery have better outcomes at teaching hospitals with lower cost. And last, by receiving treatment from a hospital resident, you are more than just a patient. We're also investing in the education, in the education, I must repeat that, of our future doctors, our future doctors.
Robin Kish: And we do need future doctors in the pipeline, that's for sure. Can you tell us about Lakeside Medical Center's residency program specifically? And share how your family medicine residents have provided support through the worst of the pandemic.
Janet Moreland: Lakeside Medical Center's Family Medicine Residency Program is a three-year program with five residency physicians each year for a total of 15 physicians. The residency program celebrated its ninth graduating class in June this year. Their rotation included emergency medicine, women's healthcare, pediatric, psychiatry, and many other specialties. We always say family medicine means we take care of our patients from the cradle to their senior year.
Residents and all of our staff are healthcare heroes. They go above and beyond to provide access to a range of quality services for our hospital and clinic patients. Many of whom have complex medical conditions and limited resources. During the pandemic, they have been invaluable for our patients and support our community education, testing and vaccination efforts.
Robin Kish: Thank you, Janet, for sharing your personal and professional experience with us. And we thank you and all of the many healthcare heroes working at Lakeside Medical Center for your dedication to the health of the Glades community in Palm Beach County, Florida.
If you find this podcast helpful, please share it on your social channel and check out our full podcast library for topics of interest to you at healthcaredistrictpodcast.org. Let us know what you think. Your review helps us reach more people just like you.
Today's podcast is brought to you by the Health Care District of Palm Beach County. The Health Care District is a unique safety net healthcare system located in South Florida and provides county residents access to primary care, skilled nursing and hospital care, registered nurses in nearly all the county's public schools and oversight of the county's trauma system, which includes operating two life-saving Trauma Hawk air ambulances.
Learn more by visiting hcdpbc.org and our hospital's website at lakesidemedical.org. For information about the hospital's birthing center, call (561) 829-4850.
Robin Kish: Late this summer, the number of COVID cases started to soar in a rural south Florida community. The local public hospital there found itself in a dire situation. The intensive care unit was full and no hospitals in the county had available beds to accept the few patients who needed to be transferred for a higher level of care.
What happened next? Today, we talked to the woman who leads the hospital and also grew up in that community about how the COVID crisis hit home. Next on this edition of Here For Your Health.
Welcome to the Health Care District of Palm Beach County's podcast, Here For Your Health. I'm your host, Robin Kish.
Our guest today is Janet Moreland, Associate Vice President of Lakeside Medical Center in Belle Glade, Florida. Thanks for joining us, Janet.
Janet Moreland: Thank you for having me.
Robin Kish: Janet, for those unfamiliar with the acute care facility, Lakeside Medical Center, it's a small public teaching hospital that's owned and operated by the Health Care District of Palm Beach County. It's also the only acute care facility within approximately 30 miles. How important is this hospital to the local residents in the cities that border Lake Okeechobee?
Janet Moreland: It's critical because our 70-bed private room hospital is a safety net hospital. The Glades is a region with a higher percentage of uninsured, under-insured residents than the rest of the county. Many families in the Glades community as in any rural community struggle to make ends meet and have limited access to transportation. Farming is one of the largest industries. Thanks to our fertile soil, the glaze is one of the nation's top suppliers of sugar cane, corn and other fresh produce. Lakeside Medical Center is one of the largest employers in the region and is dedicated to providing compassionate quality care, especially during this pandemic.
Robin Kish: And I understand once the COVID crisis began, the hospital and the medical staff played an important role in the community by distributing face masks, stressing the importance of social distancing and providing free walkup COVID-19 testing and vaccinations on your hospital campus. Then this past summer, the hospital found itself in a dire situation. What happened in the community with the Delta variant? And how did that impact your hospital's staff and resources?
Janet Moreland: Our Community, Robin, was hit hard this summer by the Delta variant. Patients were flooding our emergency room with COVID symptoms and the majority were not vaccinated. Our six-bed ICU quickly filled up. So we doubled our ICU capacity to 12 beds, which was also full. For nearly a week, we were unable to transfer COVID-19 positive patients in need of other intensive care units in Palm Beach County.
It's typical for small rural hospitals like Lakeside Medical Center to be able to place patients in need of a higher level of care at another hospital in the county. But the hospital system in Palm Beach County was not functioning this way for the COVID-19 patients due to the overwhelming number of COVID-19 patient volume. We reached out to so many hospitals outside of the county, but their ICU too was very full. There was a scarcity of beds statewide. We announced that the hospital was in a dire situation.
The County Commission responded, issuing a state of an emergency. The order required all of the county hospitals to report their daily number of COVID patients and available beds that allowed us to view a daily dashboard to see what was happening in other county hospitals in real time. Fortunately, the local VA came to our rescue in a timely manner and accepted the patients we needed to transfer for a higher level of care.
Robin Kish: And we should point out that this was a specific period of time during the summer of 2021. Is this crisis over for the hospital now?
Janet Moreland: Thankfully, the situation has greatly improved and we have capacity in our ICU, but it impacted me not only professionally, but personally. In the Glades, nearly everyone knows everyone or is related. And typically, during that time and tragically, during that time, we had members of an entire family in the community lost their lives due to COVID. My cousin was one of them. It was devastating. I'm a trained nurse. I stressed to everyone I knew and love the importance of getting vaccinated, but even close relatives held off getting the shot. This experience has strengthened my resolve and became important and valuable that vaccines are so much needed in families as you go through this tragedy like this.
Robin Kish: Yes, I can imagine it's been like a rollercoaster ride for you and the staff at the hospital because you were providing care at a time when it was so needed. And you are such a powerful voice in that community, having grown up in the Glades, combined with your prior leadership at the health department locally and having that key role overseeing this rural hospital. Are the unvaccinated in the community listening to you now, do you think?
Janet Moreland: Well, the good news is vaccination continues to climb slowly in Palm Beach County. At the beginning of October, the local health department reported that 64% of residents ages 19 and older were completely vaccinated. The Florida Department of Health reported the county has an overall 71% vaccination rate as of November 18th.
Immunization rates in rural communities and rural areas, black and Latino neighborhoods, still remain low. And I am encouraged as many as 55% of residents ages 12 and older in the Glades ZIP codes reportedly received at least one vaccine dose as of August the 31st, the latest data the state department has made available. Hospitalizations for COVID-19 in Palm Beach County are also dropping to low levels and the most serious cases are declining as a result. But we still need to be vigilant and encourage our families and friends to get the vaccine to protect themselves and the community.
Robin Kish: So you've seen, you mentioned in your own ICU, that there's capacity, meaning that you have beds. You're seeing fewer patients who need to be hospitalized due to COVID-related conditions. But meanwhile, hospitals across the country are struggling to maintain medical staffing and there's a nursing shortage as many nurses experience COVID fatigue or are attracted to staffing agencies for higher compensation. Are you dealing with a nursing shortage at your rural hospital? And if so, how are you addressing it?
Janet Moreland: The COVID-19 pandemic has made it more challenging to recruit nurses here in Palm Beach County, as it is an any healthcare system across the country. The highly skilled surgical services and emergency department nurses here at Lakeside are cross-trained to support other areas within the hospital like telemetry and med-surg units. Lakeside Medical Center's dedicated nurses, including a few travel nurses, continue to meet the needs of our patients, residents and the community.
Robin Kish: Nationally, there's been a six-year decline in the number of births, and it's been reported that the pandemic has caused women to postpone their pregnancy. What are you seeing at Lakeside Medical Center?
Janet Moreland: At Lakeside, the hospital's birthing center has a 60-year tradition of delivering generations of healthy babies for residents of the Glades community. We partner with OB-GYN Specialists of the Palm Beaches. They are board-certified obstetricians and gynecologists as well as anesthesiologists to provide care 24 hours a day throughout the year. We also staff certified nursing assistants and registered nurses with over 20 years of experience who are certified in labor and delivery and newborn care.
To accommodate a family-oriented birthing experience, the birthing center at Lakeside Medical Center offers several large private postpartum suites and five large private labor suites that are adjacent to the hospital's surgical unit in the event that a C-section is needed. We have in-house board-certified pediatricians who are also available around-the-clock to attend to any newborn's needs, answer patient's questions, and ensure a newborn is ready for discharge. We also have a certified lactation specialist who is on staff to guide our new moms and their babies with breastfeeding.
Following the baby's birth, a new mom and their partner are treated to a fine dining experience to celebrate the special delivery. And members of the community are certainly invited to schedule a tour of the birthing center here at Lakeside Medical Center or ask any questions by calling (561) 829-4950 during business hours.
In 2020, Lakeside Medical Center received national goal-level recognition from the Association of Perioperative Registered Nurses for ensuring our patients and staff are safe in the operating room. Also in 2018, Lakeside Medical Center was named an A-rated top hospital in the nation for patient safety as recognized by Leapfrog Hospital Safety Grade and also was honored by the Florida Blue as a 2018 Blue Distinction Center for Maternity Care.
Robin Kish: Oh, congratulations, Janet, on those prestigious awards. We mentioned earlier that Lakeside Medical Center is also a teaching hospital. What are the benefits to patients who seek treatment at hospitals with a residency program?
Janet Moreland: There are so many benefits to having a medical resident involved in hospital care. First, you get that extra time with the physician. Unlike physicians, they are on staff. Medical residents don't hesitate to establish what is needed for the patients that they are seeing. That means residents are able to spend more time with the patients without being rushed. They spend most of the day at the hospital and can be at their site when needed. Second, you get an extra pair of eyes. Residents often work alongside teaching physicians, so a patient receives care from two doctors. Thirdly, you receive the most recent advanced care residents or doctors that are preparing to become board certified and are applying for their medical license, that calls for them to be informed about the latest in healthcare practice and treatment. It also means that their teachers, the doctors are also attending physicians at the hospital and must stay up-to-date. We've seen our former residents diagnose rare cases that stumped staff physicians at other hospitals. Fourth, you receive care at the hospital from an academic medical center. Acute care facilities like Lakeside Medical Center must work hard to meet and maintain the qualifications in order to have a medical residency program. Teaching physicians and residents are dedicated to continually advancing their medical knowledge and expertise. A recent study published in the Annals of Surgery showed that patients undergoing high risk surgery have better outcomes at teaching hospitals with lower cost. And last, by receiving treatment from a hospital resident, you are more than just a patient. We're also investing in the education, in the education, I must repeat that, of our future doctors, our future doctors.
Robin Kish: And we do need future doctors in the pipeline, that's for sure. Can you tell us about Lakeside Medical Center's residency program specifically? And share how your family medicine residents have provided support through the worst of the pandemic.
Janet Moreland: Lakeside Medical Center's Family Medicine Residency Program is a three-year program with five residency physicians each year for a total of 15 physicians. The residency program celebrated its ninth graduating class in June this year. Their rotation included emergency medicine, women's healthcare, pediatric, psychiatry, and many other specialties. We always say family medicine means we take care of our patients from the cradle to their senior year.
Residents and all of our staff are healthcare heroes. They go above and beyond to provide access to a range of quality services for our hospital and clinic patients. Many of whom have complex medical conditions and limited resources. During the pandemic, they have been invaluable for our patients and support our community education, testing and vaccination efforts.
Robin Kish: Thank you, Janet, for sharing your personal and professional experience with us. And we thank you and all of the many healthcare heroes working at Lakeside Medical Center for your dedication to the health of the Glades community in Palm Beach County, Florida.
If you find this podcast helpful, please share it on your social channel and check out our full podcast library for topics of interest to you at healthcaredistrictpodcast.org. Let us know what you think. Your review helps us reach more people just like you.
Today's podcast is brought to you by the Health Care District of Palm Beach County. The Health Care District is a unique safety net healthcare system located in South Florida and provides county residents access to primary care, skilled nursing and hospital care, registered nurses in nearly all the county's public schools and oversight of the county's trauma system, which includes operating two life-saving Trauma Hawk air ambulances.
Learn more by visiting hcdpbc.org and our hospital's website at lakesidemedical.org. For information about the hospital's birthing center, call (561) 829-4850.