Population Health | Quality Improvement | Blog | COVID-19 | Pharmahub
COVID-19 has providers planning for seismic operational and financial shifts, yet it’s also reminded us of how our industry looks out for one another during hard times. As industry professionals and healthcare providers break down barriers to share healthcare resources and best practices with one another, it’s inspiring to see the sacrifices these individuals are making in order to meet patient needs. In many cases, people are working outside their normal roles and duties while making efforts to keep social distancing from becoming social isolation.
For now, providers’ staffing plans need to focus on ensuring that a sufficient ratio of clinical and non-clinical staff are deployed to support an overwhelmed delivery system. While shortages of physicians, clinicians and staff are likely to occur in various subspecialties over the next few months, keeping staff healthy, both in mind and body, should be of the utmost importance.
As COVID-19 pushes across the U.S. this spring, caring for the caregiver will be more critical than ever. While physician burnout is unfortunately not new, clinicians, physicians and staff are dealing with several facets right now that risk taking burnout to the next level. Here are some of the anxieties weighing on healthcare providers’ hearts and minds.
Extreme social distancing. Clinicians who are in high-touch situations with patients, such as emergency department physicians, are isolating themselves from their families, even while at home – avoiding touching their kids, dining alone and sleeping in separate bedrooms from their significant others. They’re wholeheartedly separating their personal and professional lives to avoid potential contamination at home so that they can continue to care for, and show up for, their community members with coronavirus.
More susceptible friends. More than any other profession, they’re seeing their day-to-day “office mates” — fellow physicians, nurses, administrators and staff — contracting the virus, adding to their emotional stress.
Longer hours. As more staff get sick and more patients become infected, clinicians are also being asked to do more and stay onsite, deepening the physical and psychological strains.
Feelings of inadequacy. Clinicians are feeling stymied and frustrated in part due to the lack of supplies and tests, which inhibit them from working more proactively to identify and treat affected patients. For example, providers who were motivated about drive-thru testing as a way to keep people safe are feeling exasperated as some of these operations shut down due to a backorder of testing supplies.
Fears about long-term effects. Finally, healthcare workers may be concerned about the long-term wellbeing of their health systems and practices, as elective procedures are canceled and more patients skip non-essential appointments. Other providers who offer more elective services or procedures are not living this day in and day out – such as orthodontists, ophthalmologists and dermatologists – and are conversely seeing a dip in burden and patients, leading to questions about their long-term business viabilities and livelihoods.
Ways to Address and Prevent Physician, Clinician and Staff Burnout
Even outside of a crisis, optimizing the physician enterprise often relies on understanding barriers and enablers in key areas including workflow, staffing and skill mix, electronic health record (EHR) documentation and space utilization. Strengthening these practices routinely leads to higher patient and provider satisfaction scores, while also driving enhanced financial performance due to improved capacity and throughput.
Here are a few ways healthcare administrators and operators can leverage these domains now to help their staffs through coronavirus concerns.
Enable Technology to Ease the Burden
Create a safer environment by enabling staff to complete tasks remotely and virtually, to the extent possible. This is beneficial both physically and emotionally for clinicians and staff, who may prefer to stay closer to home. Providers can optimize the EHR to make documentation more efficient using capabilities such as templates and selection-based phrases.
Utilize virtual care options such as e-visits and telehealth. Avoiding face-to-face interactions will help combat spread of the disease and also reserves critical supplies such as gowns and gloves. The White House recently expanded telehealth services and plans to reimburse providers for virtual care at the same rate as an in-person visit. This expansion is most beneficial for seniors, who are one of the most susceptible populations to coronavirus, and may also aid in the likely event of provider shortages within a subspecialty.
Maximize Staffs’ Capabilities and Talents
While healthcare operators often talk about leveraging staff to the top of their licensure, COVID-19 may have hospital administrators directing traffic and data analysts running logistics for an employee testing clinic. So, think creatively and bring clinicians and staff into the ideation and decision-making process, whether it’s sketching out a low-touch route for patient flow through the facility or determining where to pitch tents outside for patient overflow. Staff and clinicians often bring different perspectives and ideas to the table and are much more likely to participate in new protocols if their insights are solicited early on
Some healthcare providers are facing challenges as staff, including the nurses who comprise temporary float pools, are forced to stay home with schools canceled, babysitters quarantined and daycares closed. Providers may contract with local childcare services or create a reduced-cost daycare setup so clinicians are able to come to work. Pull in employees who are available from other business units and encourage them to work in the whitespace. Healthcare professionals are driven to help, so even if their roles as business managers or marketing are not needed right now, ponder ways to leverage them; if they’re willing to help coordinate logistics for patients’ dietary orders or step into a patient transport role to do their part, encourage it.
Rethink Your Space Beyond the Four Walls
Providers have to balance creating access for high-risk populations while mitigating the health risk for their clinicians, physicians and staff. Don’t forget, screening and triaging of patients outside of the emergency department is allowed during surge demand and pandemics, so providers should be screening and triaging patients prior to their entering the emergency room.
Drive-thru tests are a great example of how providers can be creative to treat patients beyond the four walls of the hospital or practice. Another idea is to leverage mobile clinics, such as mobile mammography units, that can reach isolated or high-risk populations who cannot easily travel, such as the elderly.
Speaking of virtual care, some of Premier’s members are taking e-visits a step further and experimenting with a “virtual hospital at home” concept in which medical professionals set up remote monitoring of patients in their homes and can deploy quickly if a patient’s condition worsens. The idea is to offer at-home services to those who may need hospital-level care but not quite an ICU. Doing so protects clinicians’ health as well as the strain on beds and capacity.
During these times, it’s imperative that we monitor the time and effort that our healthcare delivery team is spending in direct patient care. Try to limit the overall volume of emails, phone calls and alerts to those who are mission critical to limit information overload, while also minimizing evening and weekend correspondence. Respect the time when providers are away, recognizing the 24/7 virtual environment that we live in, in order to help them recharge.