COVID-19 Resources for Hospitals

• Activate incident command systems. In times of crisis, clear communication and the ability to implement change quickly is crucial. Every country has a different mechanism for managing this. Here are a few resources that can help:
  • NHS England: Incident Response Plan
  • U.S.: Hospital Incident Command Systems (HICS)
    
• Ensure there is an adequate supply of PPE, ventilators, and other supplies and equipment. This is not easy to do these days, as hospitals across the world are competing for the same resources. Develop a plan for rationing supplies in case you run out.
  • WHO: Rational Use of PPE During Severe Shortages
  • CDC: Strategies to Optimize the Supply of PPE and Equipment
  • PSMF Video: Running Out of Ventilators? Adapting Anesthesia Machines for Use in Critical Care 
  • The COVID Help Network
• Maintain ethical standards when allocating resources. Especially in times of strain, healthcare systems must be judicious with how they allocate resources. However, the resource allocation decisions should be founded on the utmost ethical standards to ensure equity, quality, and respect for every individual.
  • Fair Allocation of Scarce Medical Resources in the Time of Covid-19
  • Washington State Department of Health: Scarce Resource Management & Crisis Standards of Care
  • The Hastings Center Ethical Guidelines
  • The Hastings Center: Ethical Care During a Public Health Emergency
  • Health Equity During COVID-19
• Have a plan for continued surge. Calculate your expected daily census over the next 3-6 months. Convert anesthesia areas, such as ambulatory surgery centers and hospital PACUs, into critical care units.
  • PSMF Video Interview: Running Out of Ventilators? Adapting Anesthesia Machines for Use in Critical Care
  • ISQua: Patient Safety Recommendations for COVID-19 Pandemic: Lessons from the Italian Experience
  • PSMF Video Interview with Dr Kelley from the World Health Organization: Minimizing Disruption to the Healthcare System as Much as Possible
• Ensure safe staffing levels. This is likely going to be difficult to do, as hospitals are all competing for the same labor market. There are no evidence-based guidelines yet outlining a safe way to manage the severe shortages of licensed professionals as we can expect over the coming weeks. Hospitals should both continue to aggressively attract licensed help, but also to repurpose non-licensed staff with Just in Time (JIT) training to assist as appropriate.
  • CDC: Mitigate Healthcare Personnel Staffing Shortages
• Routinely analyze your facility’s risk. Especially in long term or resident care facilities, it is essential to analyze the current state of COVID-19 prevention and precaution measures with utmost frequency. Ensure that performance improvement processes do not start to slip as the situation changes and, if needed, implement new or change existing processes to optimize care. 
  • Risk Assessment and Testing Considerations for SARS-CoV-2 Transmission in Congregate Care Facilities
• Embrace continuous improvement and a culture of safety. The coronavirus pandemic has made this more important than ever, as our systems are becoming stressed beyond capacity. Creative, innovative solutions are necessary, implemented within a strategic approach to continuous improvement. The science of human factors tells us that we need to make workflows easy to get right and hard to get wrong, and healthcare systems should be doing everything they can to simplify care processes right now. Clinicians should play an active role in leading these improvement teams.
  • What Are Clinical Human Factors?
  • Key Human Factors Messages When Working Under Pressure
  • Coronavirus Blog: Knowledge Repository
  • Patient Safety Learning: A shared learning platform for emerging patient safety material
  • Antimicrobial Fighter Resistance Coalition
  • The Digital Aid Project: Putting digital solutions in everyone’s hands during COVID
• Establish safe discharge practices. As always, thorough communication within the healthcare team and with the patient and family members can create a successful discharge and minimize chance of readmission, especially for vulnerable populations, including new COVID positive mothers. In addition to clinically vulnerable populations, hospitals should pay special attention to socioeconomically disadvantaged populations upon discharge, as these populations are less likely to have access to rehabilitative care. Acknowledging and working to mitigate disparities due to social determinants upon discharge is especially relevant during the COVID pandemic to prevent worsening of existing chronic conditions, decrease chances of spreading the disease, and avoid preventable cases. 
  • AHA: CDC Updates Guidance on Discharging Patients With COVID-19
  • Michigan Government: COVID-19 Guidance For Healthcare Facilities Discharge of Residents
  • Health Affairs: How Will We Care For COVID Patients After They Leave The Hospital?
  • Kaiser Health News: COVID Patient Caught In Conflict Between Nursing Homes And Hospitals
• Ensure that proper cleaning protocols are implemented. Because the COVID-19 virus is easily spread on surfaces and after interaction with an infection person, thorough hospital cleaning protocols are essential to prevent the spread of the virus within the hospital and beyond. While there is still much to learn about the transmission and prevention, hospital cleaning protocols will play a large role. 
  • Association for the Healthcare Environment: COVID-19 Resources for EVS Professionals
  • CDC: Interim Recommendations for Cleaning of Community Facilities
  • Radiology Fighting COVID
• Continuously involve patients, family members, and members of the general public in conversations around improvement. Especially during times of uncertainty, healthcare organizations must prioritize hearing the needs and concerns of those in their immediate community. Many organizations have Patient and Family Advisory Councils (PFACs) to aid in informing targeted interventions. Ensure thorough representation, especially for seldom heard voices, including those in low income communities of color. 
  • St. Bernard’s Hospital: Community Town Hall on COVID-19 Vaccines: In January 2021, St. Bernard Hospital in Chicago held a virtual community town hall to address concerns about the COVID-19 vaccination and encourage residents to get vaccinated when they’re eligible. The event featured informative, straight-forward presentations from clinical staff and a wide-ranging question and answer session. We congratulate St. Bernard on demonstrating a high level of concern about patient safety and public education at this critical time. 
• Create a plan to resume normal operations. Surgeries and elective procedures have been suspended around the world for an undetermined amount of time. However, as we are understanding more about the virus and are working to develop strategies for treatment and prevention, these surgeries will have to resume shortly out of need and demand. Hospitals should develop a strategy to resume these services and ease their organization back into normalcy in small and safe increments. 
  • ASA Newsroom
  • American College of Surgeons: Roadmap For Resuming Elective Surgery
  • AHA: Safely Resuming Elective Surgery As COVID Curve Flattens
• Take care of your people, so they can better care for patients. This is a difficult time for everyone in healthcare and tensions are running high. It is more critical than ever that leaders establish open lines of communication with the frontline, so that concerns and barriers can be addressed real-time. Hold virtual support groups and engage pastoral care in debriefing with team members daily. Consider providing education/childcare, housing alternatives, and hazard pay.
  • Mind-Body Stress Management for Healthcare Workers
  • AMA: Caring for Our Caregivers During COVID-19
  • U.S. Department of Veteran Affairs: Managing Healthcare Workers’ Stress Associated with the COVID Outbreak
  • WHO: Mental Health and Psychosocial Considerations During the COVID-19 Outbreak
  • PSMF’s Webinar: A Way Out of Despair Into Hope
  • PSMF Video: Dr. Albert Wu
  • Death, Grief, and Funerals in the COVID Age

Not only are hospitals tasked with the immense responsibility to provide care during a global pandemic, with limited resources and ever-changing regulations and protocols, hospitals also must prioritize the well-being of their own team members. It is no secret that the COVID pandemic has compromised the well being of healthcare workers around the world. In the general sense, hospitals should do the following to promote healthcare worker safety and well-being: