Understanding the Impact of COVID-19 on Healthcare Facilities
The healthcare sector was probably one of the worst-hit by the pandemic, although not in the way that many other sectors were affected. While others counted the cost in slowing revenue and disrupted business operations, healthcare facilities found themselves overtaxed and stretched almost to a breaking point.
With the emergence of multiple vaccines and a gradual return to some semblance of normalcy in several parts of the world, the time has now come to take stock of how the vaccine affected healthcare facilities.
We know that being taxed with the frontline response to the outbreak, healthcare organizations were front and center in the global fight against COVID-19. But how dramatically did this imperative affect the operating models and capacity of these facilities, and what was their response to the pandemic? How has this affected patient care, staff welfare, and operations so far, and what lessons can we take away from the unprecedented event?
In our recent webinar titled Understanding the Impact of COVID-19 on Healthcare Facilities, Dr. Janak Patel, MD, Director at the Department of Infection Control & Healthcare Epidemiology, University of Texas Medical Branch (UTMB) Galveston, discussed these questions and more. You can also download the webinar deck here.
How did healthcare facilities respond to COVID-19?
The initial outbreak of COVID-19 was first reported as a pneumonia infection of unknown etiology in Wuhan, China on December 31, 2019. By January 21, 2020, the US had reported its first case, and in response, the US Centers for Disease Control and Prevention (CDC) issued instructions to healthcare facilities for testing and infection control practices.
In the interim, however, there was a lot of uncertainty about the coronavirus, including how patient evaluation, testing, and treatment practices should proceed. Several facilities found themselves in the unusual position of having to rapidly develop in-house response plans pending official direction from the CDC.
Dr. Patel outlined how healthcare facilities responded to the outbreak along three phases: the pre-pandemic phase, pandemic phase, and suppression phase, especially using UTMB as a case study.
The pre-pandemic phase was characterized by three major responses:
- Wishful thinking and inertia: Due to the flu-like symptoms that many patients were presenting, a section of experts and facilities theorized that COVID-19 “will be just like the flu”.
- Borrowing from old ideas: Those who anticipated a more serious problem tried to address the problem of fighting a novel pathogen with old methods.
- Cagy public health response: Government response was largely politicized in order not to scare the general public. Guidance was very slow when issued, and as a result, many facilities were forced to develop their own protocols in the interim.
At UTMB, Dr. Patel, being the head of the infectious diseases department took charge of the organization’s response. This included alerting ICU and ED staff about the virus, preparing an early response plan with public health officials, disaster preparedness officers, and clinic administrators, all before January 21. UTMB also created an initial workflow to advise staff on COVID evaluation.
With better guidance from regulators, healthcare facilities were able to develop more robust protocols for dealing with patient care during the pandemic. This included developing an expansive plan for the triage process, encompassing appointment scheduling, workflow design (spacing, testing, evaluation), and clinical pathways of evaluation.
Plans were made for sourcing, stocking, and restocking critical supplies at this point, including COVID tests and personal protective equipment (PPE). There was also significant effort to track lab results, employee infection (including contact tracing and quarantine), and community infection rates.
Throughout this period, healthcare organizations were not standing still with respect to policy and protocol development. There was frequent communication with regulators, employees, and patients, and frequent changes were implemented as more knowledge and understanding about the coronavirus became available.
Of particular note are the major innovations that were rapidly put in place during the period. These include:
- Massive uptake in telemedicine avenues and technology, especially for non-urgent visits;
- Dedicated COVID clinics for testing and evaluation;
- Recycling of PPE through use of washable gowns, washed and repackaged eyewear in sterile processing areas, and recycling of N95 respirators using biodefense research laboratory ozone vapor system in UTMB.
The suppression phase was characterized by lockdowns and travel restrictions. There was also accelerated progress in the development of vaccines, even as healthcare facilities took steps to reduce infection risks within the workplace. This included screening of visitors, limited hospital visitation, limited occupancy in closed areas, and enforced masking and social distancing. Some of the best care practices we were seeing during this period included:
- A proactive approach to planning: Organizations rely on the advice of infection control specialists.
- Respect for proven science: Misinformation was rampant during the period, and organizations had to be careful to filter proven science from fantasy.
- Designated response leader: Established a clear structure of authority by designating a team leader whose main job was the COVID response.
Lessons learned during the pandemic
All through each of the phases described above, healthcare facilities were facing terrible amounts of pressure in their role as the thin red line preventing societal collapse from the virus.
Within healthcare organizations, the impact was felt in the form of a high rate of staff infections, severe burnout, and resignations. Due to the public health dimensions of the pandemic, facilities were also seeing fewer regular (and paying) patients, leading to decreased revenue. The additional expense of PPE and difficulties with scarcity also introduced significantly higher operating expenses for these facilities.
As Dr. Patel points out, even while the pandemic was raging at its height, we were already seeing some clear lessons that organizations could hold onto and implement. These include:
- Preparation for the unknown
- Selfless leadership
- Agile and nimble organization
- Adaptable and pivot-ready outlook
Now, as many societies are approaching significant levels of vaccination, such as the US, we can look forward a little and consider the most important lessons we should keep in mind for the future:
- Lesson one: Family at work and at home matter more than we realized. Teamwork, trust, and support were critical for healthcare facilities that pulled through.
- Lesson two: We have unleashed a revolution in medicine. The innovations we have pushed forward at this time (mRNA, telemedicine) will form a foundation for significant progress in the near future.
- Lesson three: We must keep the COVID pandemic response blueprint ready for the next crisis.
- Lesson four: The tech boom we experienced during the pandemic has resulted in a paradigm shift, and there is no going back. Now, work is anywhere and anytime, even in the healthcare sector.
- Lesson five: Misinformation was more damaging than we realize. Though our trust in one another and our system has frayed, we can still recover. We must be patient to do this, but we must also verify the facts.
- Lesson six: The crowds will return, but we will gather carefully.
- Lesson seven: We can hope for stability, but we must be prepared for the opposite.
Planning for the future of your healthcare organization
With the worst of the pandemic behind many countries, how do healthcare facilities take the experiences of the past year and a half into consideration as they head into the future?
The first thing to note is that the COVID infection will most likely become endemic, although it is uncertain when this will happen. Second, we will continue to see mutations, vaccine failures, and medication failures. As a result, regular updates and boosters will be necessary. Finally, organizations must work to maintain the process they have established, including triage, testing, and stocking of PPE supplies.
Healthcare employers must also take a proactive approach to the COVID vaccination. Full vaccination is our best hope of ending the pandemic, not herd immunity. mRNA and other current vaccines have been proven highly effective (up to 99%), although vaccine hesitancy remains high (up to 40%), even amongst healthcare workers.
Organizations have to set a clear expectation for their employees to be vaccinated. They can back this up with detailed information to help guide decisions and passionate in-person appeals where necessary.
After all the things we have learned from the pandemic, one of the key takeaways is that we must have the ability to adapt to change quickly and efficiently. One of the ways to successfully prepare for the future and to stay ready for change is by going paperless and using a platform like UptimeHealth. Managing daily, weekly, monthly operations, quality control logs, and overall compliance of a facility will ensure you are ready to take on whatever comes your way.
To learn more about how UptimeHealth can help ensure your organization is ready for the next big challenge you are faced with, contact us today at firstname.lastname@example.org.
*This blog was written as a follow-up to the webinar presented by Dr. Janak Patel on Thursday, April 29th. The recording of the webinar can be found here: https://uptimehealth.com/webinars/
Want to attend the next webinar? Register here: https://bit.ly/3fb8NM2