SPRINGFIELD — Bigger doesn’t always equate to better when it comes to healthcare.

Effingham Health System has been a leader in the fight against COVID-19 since the pandemic started in March.

In a recent Center for Medicare & Medicaid Services/Department of Community Health Survey, it was determined that Effingham Health System has met or exceeded all recommended COVID-19 guidelines.

“Our organization has been at the forefront of all the changes,” said Maggie Hendler, Effingham Health System’s chief nursing officer. “We were implementing ‘best practices’ well before they were saying that.”

Effingham Hospital got in front of the virus and has stayed there despite an increasing workload and constant changes to protocols established by the Center for Medicare & Medicaid Services, the Centers for Disease Control and the Department of Public Health.

“We started getting some guidance in late January or early February,” Hendler said. “That was about our (Emergency Room) process — to start screening people who came here from outside the country. I think that’s when we first started talking about (the virus).”

 In recent days, Effingham Hospital has averaged between 16 and 18 COVID-19 patients per day. It had 19 on July 15.

“We have 25 beds and our census does continue to grow — not just people with the coronavirus but patients in general,” Hendler said. “People want to stay in their community. We hear that a lot.”

During the pandemic, Effingham Health System has developed a flexibility that allows it to adapt quickly to new situations.

“It’s our new normal,” Hendler said. “In March and April, there was a change everyday and it was difficult to stay on top of them.”

COVID-19 became easier to handle after Infection Preventionists Hilary Evans and Heather Dykes were picked to lead a team. They communicated necessary changes and training needs to employees throughout Effingham Health System.

“We made our mind up to go to the top of the line so that we wouldn’t have to keep making changes and so that we are always going to be the best and make sure everyone is most protected,” Hendler said. “We are going to stay there.”

The hospital has come close to filling a few times since the start of the pandemic.

“We’ve had to create an extra space for extra patients (in case we get them),” Hendler said.

Effingham Health System has also gone to great lengths to protect the vulnerable patients in its nursing home — Effingham Care & Rehabilitation Center.

“We implemented things in the beginning,” Dykes said. “It’s not like we were playing catch-up. We were mostly already settled.

“It’s mostly making sure that we provide enough staff and have enough equipment — things like that. Keeping up with the ‘busyness’ and the upkeep is the main thing.”

The hospital and care center haven’t lacked for supplies, including masks and sanitzer. They have partnered with the Effingham County Emergency Management Agency and the Department of Public Health to get what they need.

Effingham Health System commitment to the safety of its staff is matched by the desire to protect patients.

“We aren’t down where it’s just OK. We are above that to keep our staff, patients and residents healthy,” Hendler said.

Effingham Hospital's cleaning staff is constantly at work.

“I can tell that our housekeeping team is just fabulous across the system,” Hendler said. “The National Guard offered to come in and help clean, and when we told them what our housekeeping team was doing they said, ‘You are doing way more than what we could provide to you.'"

Housekeeping is a total system effort.

“In the care center, department heads and everybody pick up and help in that, too,” said Dykes, a confessed “germophobe.” “The unit clerks are making sure the nurses’ stations are clean while housekeeping is focusing on the rooms.”

Health system staffers also try to curb the spread of COVID-19 by refraining from handshakes and hugs from staffers, patients and visitors.

“That’s one of the biggest changes — not touching,” Hendler said. “It’s different.”

The lack of intimacy creates an emotional challenge for care center residents.

“The generation that is there is the handshakers and huggers,” Dykes said. “It’s been hard on them because they don’t get that physical interaction with their families like they normally do.”

Effingham Health System moved to aid the residents through the use of iPads, iPhones and a series of apps that enabled them to see their loved ones even if they live far away.

“Now a lot of residents get to sit and talk with their families all at one time,” Dykes said. “They set up appointments.”

Care center officials also established 15-minute “curbside chats.”

Dykes said, “Of course, we have to put a partition with the Plexiglas and things to separate them to maintain social distancing but at least they get to see their families. I know at a lot of facilities you would see on the news the family would wave at the residents through the windows.

“We can’t do that because our windows are tinted.”

On May 8, staff at the center arranged family parades in which residents were able to see their families driving by in decorated vehicles. The signs on both sides were supportive and full of love.

“It was so emotional,” Dykes said. 

“That the was the highlight of my week,” Hendler said. “I didn’t miss one parade and it was amazing.”

Effingham Health System hasn’t permitted visitors at the hospital or care center since early March.

“On the in-patient side, it’s difficult whether we have a patient who is sick with the virus or a patient who is sick with something else,” Hendler said. “It’s hard for families and it's hard for families. We’ve implented this across the board — whether you are coming in for surgery or coming in to the Emergency Department — we’re not allowing visitors except in very unique situations.

“That’s tough. If someone comes into the Emergency Department, they have that need (for family contact). We have to get creative to meet that need and it’s been a challenge.”

The ramifications of COVID-19 impact Effingham Health System nurses, too. They get attached to their patients and residents.

“At the care center, honestly, I spend more time with the residents than I do with my family at home,” Dykes said. “A lot of times, I go home and talk about my residents and my husband will say, ‘Do you talk about us when you are at work?’”

It appears that Dykes will be talking about COVID-19 for a considerable period. There have been approximately 171,000 confirmed cases in Georgia and the average daily increase over the last 14 days has been 3,591.

As of Tuesday, Effingham County has had 566 cases and one death.

“I don’t think there has been a day that has gone by (during the pandemic) that we didn’t have cases,” Hendler said. “It just continues to grow and we are preparing as an organization for what happens when we do have 25 cases.

“We do have a plan for how we can handle that, what we can do through the Emergency Department and how we can expand services to make sure we are still meeting the needs of the community. 

“I hope we don’t get there. However, we have to be forward thinking expecting things to get worse.”

Hendler is confident Effingham Health System will rise to the occasion.

“I think we have some of the best staff there is,” Hendler said. “They are dedicated. They are dedicated to the health system and the community.”