OPERATING IN PANDEMICS AND EMERGENCIES

Communication

 
In emergency situations, whether that emergency is a natural disaster, a viral pandemic or some other widespread event, the ability to get current information in the hands of staff is imperative. Quick, accurate and up-to-date information keeps your staff and your patients safer. When that information changes by the day – or sometimes by the hour - the challenge becomes that much greater.

The problem of communicating effectively during a pandemic or emergent situation has been known for years. There is an excellent paper on the topic titled “Risk Communication in times of an epidemic or pandemic”, that was produced as part of the 4 year ASSET research project in Europe. The research provides insight into the challenges faced with communicating during these difficult times.

One of the key points it noted was that social media, while an excellent way to disseminate information quickly and globally, is subject in inaccuracy and rumor. It is certainly not where you want your employees getting their “information”, especially as it may relate to safety protocols or regulatory compliance.

As such, organizations should operate with a robust, multi-format, centralized communication system.

Centralized communication platforms give you the ability to update staff with the latest, most current information as soon as it is in your hands. It allows you to provide everyone with factual information, rather than the rumor and guesswork frequently found on social media. Most importantly, it allows you to monitor who has and has not reviewed the information, so that you can act with confidence on how you deploy your staffing resources.

Emergency Communication Plan

In a pandemic or emergency situation, the core of your communications strategy should derive from your Emergency Communication Plan. 

While not a comprehensive list, key aspects of an Emergency Communication Plan include:

• Identify your leader. Who will be in charge of obtaining updated information? Is that same person responsible for disseminating that information to the rest of the company? Generally this individual will be the administrator and/or risk manager.
   
• Robust Information Distribution Systems. How will you share information throughout the company to ensure that everyone, including your clients, are current and updated? Email, E-blasts, text messaging are all good options, assuming the technology is working. Consider some backup communication options including walkie-talkies or other “low tech” styles.
   
• Plan For Off Hours Emergencies. What if the emergency occurs in the middle of the night? Do you have the ability to reach your staff if necessary? This is where an old-fashioned phone tree is valuable. In the event of an off-hours emergency, your communication leader should call a designated level of directors. Each director is responsible for contacting the staff members on their “tree” or list.
   
• Current Direct Contact Information. Be sure to have home phone numbers for your staff in your phone tree. Your staff will have their business phones turned off after hours, so you must have another way to reach them. It is also important this information is updated regularly.

A full emergency plan for your organization is always a good idea. If you aren’t sure how to proceed, you can check out the New York Community Health Center’s Emergency Plan. It is an excellent resource to use as an example. You may also want to have and review a copy of the FEMA Emergency Management Guide for Business and Industry.

The Agency for Healthcare Research and Quality has put together a report titled: Home Health Care During an Influenza Pandemic: Issues and Resources.  It outlines some of the challenges Home Health Care organizations face during a pandemic, some solutions and additional resources. There is a checklist to help clarify your emergency response plan in Appendix B of that report.

How to Obtain Current Information.

During an emergency situation, you must get current information into your hands or the hands of your emergency response designee. Nothing can be shared without this basic step.

In the event of a pandemic, epidemic or other infectious disease situation, the CDC is your best choice for information. Go to their website and sign up for email alerts. Once you subscribe, you can select what information you want. You can select information on your geographical area or specific disease (i.e. updates on COVID-19). There is also more generalized information available that you may want to integrate into your business. When a new email arrives, your central designee can then follow your established protocol and email or e-blast the current information straight to the appropriate staff and/or clients.

In the event of a natural emergency, like wildfire, earthquake or flood, your better resource is your local county emergency department. Each county (and many municipalities) already have emergency response teams in place. Make sure your company is on their radar. It is a good idea to offer to become a part of that emergency response team. Doing so ensures you are kept informed and updated in the event of an actual emergency situation.

Be sure to identify who in your Emergency Communication Plan is responsible for collecting information, the process by which it is reviewed for applicability to your activities, and how it will then be communicated to your workers.

Support Resources

 
Having support resources at your fingertips is invaluable during emergent times. The challenge is identifying those resources, making certain they are current and up-to-date and keeping them readily available to all staff members – whether they are in the office, or in the field.

Provide a Digital Briefcase

Have a digital copy of all of your current forms and informational, educational and instructional handouts available to your staff. These can be arranged individually or into topical groups but should be easily searchable and identifiable. Digital support resources enable easy download by staff or the ability to email or text message materials to appropriate clients, patients, vendors or colleagues. It is imperative with a digital briefcase that all old copies are replaced dynamically as new ones are uploaded.  This is significantly more effective with an embedded notification system that alerts all recipients.

If printed materials are absolutely required, equipping field staff with portable printers enables rapid generation of materials on demand without carrying binders of paperwork or forcing field staff to search out a printing facility.

Know Your Business Resources

The Department of Health and Human Services (HHS) has a vast array of technical resource information available to you online. Beyond the COVID-19 situation, they have suggestions and recommendations on other pertinent topics like workplace violence, a shooting situation, flu pandemic and other topical issues. Consult with your clinical and operational managers or leads to identify what resources your organization could import into your online platform.

Develop an Internal Library

Companies just take advantage of their own internal hive-mind of expertise by creating and developing an internal library of resources. This will allow for better refinement, correction, dissemination of various data points while eliminating traditional information bottlenecks and unnecessary managerial stress. It further allows seasoned staff to build a support library for common issues, conditions, HEPs and so forth, to help with new or on-boarding staff.

Training and Education

 
Particularly in the face of adversity, training and education must continue. It could even be argued that training and education become more important when faced with an unexpected or novel situation. How you provide that training and what type of training is delivered becomes the focus.

Online or virtual training

During emergencies, online or virtual training's are the preferred approach. The last thing you want to do is bring all of your staff members together to share in a group training and risk potential infection or delays in education while coordinating the meeting. Depending on the emergency, it may not even be physically possible to get everyone together. Having an online or virtual training program in place addresses these issues, regardless of the type of pandemic or emergency event.

Outside of pandemic/emergency scenarios, the availability of high quality on-demand online/virtual training will save your organization money. Think about how much money is spent during physical training sessions:
 

• The event is catered, or at the least some form of food/beverage is provided;
 

• All of your staff is engaged in nonproductive work for the duration of the training;
 

• There is inevitable time wasted both before and after the conclusion of the training or meeting, which is more unproductive time;
 

• If testing is required (for compliance or CEU requirements), there is the cost of the paper, the time to grade each test and the storage of all that paper.
 

Topical Training

During emergency or unexpected situations, you really want your training to focus on the issues your staff is immediately facing. The exact training content will vary based on the event type being manifested, but some of the most common topics include:
 

• How to correctly put on and discard personal protective equipment (PPE).
   
• How to sanitize your N95 mask.
   
• How to reassure your frightened patient (or one with cognitive limitations).
   
• Reducing transmission risks.
   
• Providing care in a Red Cross or emergency shelter.
   
• Safety Precautions when working in an at-risk environment.
   

There are numerous training resources available. Some are free from organizations like the HHS or CDC, while others may require purchase from content providers.

Staffing

 
In 2019, The U.S. Bureau of Labor Statistics estimated there were a 1.5 million people working in home health care services in the United States. There are an additional estimated 800,000 to 1,000,000 that work privately. Turnover is at an all time high. In 2019, the turnover rate for home healthcare aides was 25.36%. LPNs had a 22.5% rate and therapists were at 12.5%. 

This was pre-pandemic. 

You have seen the fluctuations that have occurred since the beginning of the quarantine. Staff deemed essential yet declining to work. Hospital doors closed due to low census. Emergency Rooms empty due to fear. Elective surgeries canceled, leading to reduced census in SNFs and LTACs.

Staffing is at an all-time level of liquidity. Retaining your best staff is now a critical risk all providers must manage.

There is no silver bullet to retention, but what is known is that high quality staff stay where they are wanted, supported and treated professionally. 

By providing your staff with the tools and information they need, you are showing them the value you place on their work and the respect you have for their contribution. This will lead directly to higher retention levels, and higher retention reduces operating costs.

As we’ve seen with this COVID-19 pandemic, staffing needs can change as fast as the staff themselves. The ability to remotely interview, hire, onboard and train new staff quickly and efficiently gives your organization the flexibility to rapidly grow or restructure your incumbent workforce.

Integrated Solutions.

Ideally, you want all your centralized communications, support resources, training and education, skill checks and compliance documents, reports and digital briefcase in one location. When an event, whether natural or manmade emergency, infectious disease pandemic or any other emergent situation occurs, your staff has a single solution to turn to.

Your solution needs to be online, easy to use, budget friendly and expert in providing you with valuable information and resources. You don’t need a “tech” company, you need a “healthcare tech” company. One that understands your business and the unique challenges it faces, day in and day out.