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2022 Medical Director of the Year: Stand Tall – but Not Alone – in Turbulent Times

      Swati Gaur, MD, MBA, CMD, medical director of Georgia-based Horizons Lanier Park and New Horizons Limestone, may have been singled out by AMDA – The Society for Post-Acute and Long-Term Care Medicine as the 2022 Medical Director of the Year (MDOY), but she insists that she doesn’t stand in the spotlight alone. “To be effective anyplace in patient care, you need a team. It’s not just me winning this award; it’s my team working by my side,” she said.

      A Champion During Challenging Times

      From the moment COVID-19 came on the radar in long-term care, Dr. Gaur stepped up as a leader in the grueling daily fight against the virus. She established mid-morning interdisciplinary meetings to discuss issues and answer questions, promoting transparency, honesty, and the free flow of information between staff and leaders. She established a reporting and analysis structure for early identification and cohorting of COVID-19 cases, and she created standard order sets to support the residents infected with COVID-19. Dr. Gaur also developed a communication tool to establish COVID-specific goals of care, which was used by numerous organizations statewide and was later published in JAMDA.
      Communication and education are great passions of Dr. Gaur’s, and she knows the power of their role in promoting trust and infection prevention/control efforts among staff and the public alike. She recognized that it was essential for all staff in nursing homes to have equal access to the strategy, rationale, and process in a transparent manner. She hosted several town hall meetings for all staff, as well as public virtual town halls for the Gainesville, GA, community, to discuss COVID-19 preparation and changes to guidelines as they occurred.
      While she had her hands full managing the pandemic in her facility and around her community and state, Dr. Gaur also worked tirelessly to help her Society colleagues address pandemic-related challenges. She was instrumental in the development of the many COVID-related resources the Society produced during the pandemic. She also presented at numerous Society webinars, the 2020 and 2021 Annual Conferences, and the AMDA On-The-Go podcast.
      “I recognized early on that our response to the pandemic had to be a very transparent endeavor if we were to be effective and do everything possible to protect our residents and staff,” Dr. Gaur said. “Everyone needed to hear from me, and I needed to hear from them. We needed to troubleshoot this together. One person’s expertise cannot overcome a crisis.”
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      Dr. Swati Gaur, the 2022 Medical Director of the Year.
      On a personal level, she said, “I got to know everyone in the building. We’ve gone through a lot as a team, and we have come together beyond our professional roles. We have come together as human beings, we’ve gone through triumphs and grief together, and this has made us a stronger team.”

      Beyond COVID: Leadership Doesn’t Stop

      Dr. Gaur’s leadership, her colleagues stress, doesn’t start or end with the pandemic. She established an antimicrobial stewardship program that implemented the Centers for Disease Control and Prevention core elements, and she established communication protocols for the transition of patients from the hospital. She also created protocols of active surveillance for urinary tract infections, aspiration pneumonia, and gastroenteritis.
      A champion of efforts to reduce hospital readmissions, Dr. Gaur created clinical protocols to optimize the management of common reasons for readmission; and she helped enable the electronic medical record to be used as a tool to ensure safe transfers and minimize the chance of errors, gaps in communication, and adverse events.
      Reducing antipsychotic use has been an industrywide priority in recent years, and Dr. Gaur helped her facility make progress on this issue far ahead of time. In fact, she was instrumental in reducing antipsychotic and psychotropic use in her facility to below state and national averages.
      During the pandemic, recognizing the residents’ isolation and angst, and the lower transmission in outdoor spaces, Dr. Gaur championed a garden club for residents, an interdisciplinary endeavor with rehabilitation therapy, behavioral therapy, nursing, activities, and dietary and kitchen services. The residents were able to see the fruits of their labor being used in the kitchen, giving a farm-to-table feel — it was so meaningful to everyone in the team. The outdoor spaces not only decreased the threat of transmission, but interacting with nature brought joy to residents and staff alike.

      This Is Someone’s Grandfather

      That patients are family — or could be — is part of Dr. Gaur’s philosophy. “When I look at my patients, I realize they are someone’s loved ones,” she said. “I had a rich childhood with my grandparents being an important part of my life, and I’m truly blessed for that.” She further noted, “I have been very influenced by my relationship with my grandfather, who made sure his grandchildren did they best they could. I want to bring the same care, comfort, and dignity I would want for my grandfather to my patients.”
      In part because of her close relationship with her family, Dr. Gaur has always had an affinity for older people. “That is what attracted me to geriatrics.” However, she also discovered quickly that she loved the challenges of the field. She said, “When you are a geriatrician, you are hardwired to address some of the most challenging aspects of medicine. Practicing in post-acute care further adds layers to that challenge; now you also have to depend on your communications and relationships with staff and other practitioners. Every day is different, and I thrive on the challenges.”
      Looking ahead, Dr. Gaur is optimistic. “I am always a person who has a curiosity about what life will bring. I’ve always followed more of a meandering path, and I’m always open to new opportunities and challenges.” However, she said that her immediate next project is “learning more about providing fertile ground for a culture that prioritizes kindness and care for staff.”
      Whatever she does, Dr. Gaur hopes to be able to create a legacy. “My goal is to be able to leave the skills, knowledge, expertise, and lessons learned for others to use. I want to scale out some of the culture we have at my nursing home — the person-centered approach and true desire to go in as a team and to do our best every single day,” she said.

      Her AMDA Family

      Like the MDOY award recipients before her, Dr. Gaur is especially honored to win this recognition from her Society colleagues, whom she has admired and learned much from over the years. “When you get to AMDA meetings, you feel accepted for who you are. It’s a family. It sounds like a cliché, but it’s true,” she offered. Not only do her Society colleagues accept her, she stressed, but they have recognized talents and strengths in her that she may not have seen herself. “This is the Society’s superpower,” she explained, “this inbuilt culture of providing a space to learn in. Truly, my professional development is intertwined with what I do for AMDA, and this award means a great deal to both my team and myself.”
      Dr. Gaur was nominated by Kerry Smith, NNHA, executive director at Northeast Georgia Medical Center, Inc., and by Jennifer Stoeckig, RN, BSN, MBA-HC, DNS-CT, director of nursing at New Horizons Lanier Park, Northeast Georgia Health System.
      Senior contributing writer Joanne Kaldy is a freelance writer in New Orleans, LA, and a communications consultant for the Society and other organizations.
      Dr. Swati Gaur receiving the Medical Director of the Year Award from Susan Levy at the AMDA - The Society for Post-Acute and Long-Term Care Medicine Annual Conference in Baltimore, March 2022 (see article on next page).