COVID-19: Q&A on how provider leaders can help care for the caregivers

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March 27, 2020

HRI spoke with PwC principals Dr. Scott Ransom and Claudia Douglass about the steps that healthcare providers should consider to protect staff through the physical and emotional toll of working through a pandemic. 

PwC Health Research Institute (HRI)

What steps should providers take organizationally to make sure plans are in place to properly protect healthcare workers? 

Claudia Douglass, PwC Principal

Creating a COVID-19 protection task force is key, one that involves crucial care team members, security and environmental services, among others. It helps formalize a cadence to focus attention on making sure that team members are protected physically while they’re working and that you are supporting them emotionally. 

It’s really important to have structure in a time that is so uncertain, to help instill some calmness and have people clearly understand what is expected and how to reach out with questions and concerns.

Dr. Scott Ransom, PwC Principal

Unless an organization has someone who wakes up in the morning to do an important job, it doesn’t generally get done very well. A leadership team focused on the safety of the healthcare workforce is critical during this time of crisis. Also during this time, the psychological and physical well-being of employees and especially clinicians is critical, so we need a team to think about supporting our people in a comprehensive way and to wake up every morning to focus on this job. 

HRI: Working in healthcare amid a pandemic obviously takes an emotional toll. What should provider leaders be thinking about to protect the emotional health of their staff?

Dr. Scott Ransom: Have team huddles at the beginning and end of the shift not only to communicate about patient issues and complete appropriate handoffs, but also to check on the well-being of your staff. How is the team? Any members of the team with particular challenges? At the ground level, you need to have a reliable support network at the unit level. How about an assigned buddy who you can look out for and who will look out for you?

Have an identifiable place where people can go to talk with clergy, psychologists and other trained professionals who can help. There’s already a lot of anxiety about the general macrostate of the world, but clinicians who work with really sick people are especially exposed to stress, and these psychological challenges are realities that many healthcare folks are going through.

Claudia Douglass: Make sure people are able to take their breaks. Maybe consider meditation and other calming apps, utilizing social services workers or even enabling staff to talk virtually with a counselor. Some organizations have stepped forward to offer virtual mental health services to caregivers.

Plenty of water and food should be available to them in the break room. In order for them to really step away to have food and drink, it’s imperative to provide coverage. 

It’s important for leadership to remain close to their staff at this time and for the staff to hear their voice. Being able to see leaders at the core of the crisis is essential to signal to staff they’re empowered and their leadership is engaged.

This emotional support is going to be a long-term need we are going to have to work on.

Dr. Scott Ransom: There will be the longtime core staff who people know, but if your institution is bringing in other volunteers and travelers, how do we support those people and help them be brought into the broader team and not isolated? Do these short-time employees know where to go for support?

And what about the loved ones of your healthcare staff, their families? Their spouses and often their children are scared. Is there anything that can be done to support your employees’ families? Free child care and grocery delivery might be a place to start.  

It’s important for leadership to remain close to their staff at this time and for the staff to hear their voice. Being able to see leaders at the core of the crisis is essential to signal to staff they’re empowered and their leadership is engaged.

HRI: How can providers organize the workplace in a way that protects staff to reduce transmission?

Dr. Scott Ransom: First, reduce the number of people coming to the hospital or clinic by encouraging telemedicine visits. Then reduce the number of unnecessary visits by staff into the room of patients admitted with symptoms of the virus. Can staff call or video into the patient’s room, even though they may be right outside the door? Of course, the staff is right there and can see the patient if needed, but it will be safer to reduce the unnecessary visits with infected patients. 

Dedicate staff to a contaminated room (those areas with infected people) or clean room. From a psychological perspective, most staff will appreciate the opportunity to be rotated from these higher to lower risk areas. But it’s highly risky to switch in between non-COVID patients and COVID patients throughout the day. 

To reduce the risk of people taking the virus home, clinicians should use scrubs or other clothing that the hospital can appropriately launder. Wear scrubs at the hospital so you know they are cleaned by people who know what they’re doing, and wear your street clothing home.

Claudia Douglass: Also consolidate activities when you need to go into a room―treatments and assessments―to minimize the exposure each time.

Some providers are looking to efforts that can make their employees feel safe outside the workplace as well, either by offering cars with drivers who are taking extra precautions and not showing signs of illness. Or, helping them get hotel rooms if they are worried about exposing their families.

HRI: Of course, PPE is crucial to protecting the healthcare workforce, and providers are reporting major shortages. What approach should providers take in managing their PPE inventory?

Claudia Douglass: This one is a challenge because some have PPE; some don’t. Some are making their own. Ensure there is a team in charge of inventory every shift. Consider if there is load balancing you can do. You may have some supplies at facilities that may not be utilized right now, such as those with elective surgeries being canceled, and some staff not working and lower acuity facilities with less volume. Some cities are pooling PPE from less used sites and redistributing to those who need it most.

Most health systems, if they have not gotten there yet, are going to have to come up with a plan for conserving or rationing their PPE. Make sure there is clear communication with expectations around PPE for team members.

It’s really important everyone is following the same procedures, and this can change on an hourly basis—so use of the task force and incident command huddles as needed or at shift change can facilitate this objective and help with problem-solving and teamwork as you care for your caregivers.

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Trine K. Tsouderos

HRI Regulatory Center Leader, PwC US

Tel: +1 (312) 241 3824

Crystal Yednak

Senior Manager, Health Research Institute, PwC US

Erin McCallister

Senior Manager, Health Research Institute, PwC US

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