“Staff are exhausted and burned out. They’re worried about family members and about bringing the virus home,” — Amber Romstad, Vizient performance improvement program director.
The magnitude of the COVID-19 pandemic is testing the health care community in unprecedented ways. The situation — as well as our understanding of the virus — is changing rapidly, creating incredible challenges for frontline workers and health care leaders.
“Early in March, we began to see chatter across Vizient’s community discussion boards — staff members from member organizations urgently seeking information about how other organizations were managing PPE, visitation policies, and triaging and treating patients,” said Cindy Abel, vice president, improvement collaboratives for Vizient. “We were also hearing from members at the early epicenters about what they were experiencing. They were sharing new protocols, policies and procedures that they had developed so we could make those resources available to all members.”
Vizient quickly assembled a team dedicated to collecting, aggregating and sharing information on COVID-19 emerging practices on an ongoing basis. The result is Vizient’s COVID-19 Compendium, a collection of resources and strategies organized across six key areas:
- Managing critical supplies
- Emerging clinical practices and evidence
- Surge capacity
- Staff impact
- Patient visitation
“The goal of the compendium is to help members easily find relevant, up-to-date information that can help them on the frontlines treating patients,” said Kelly Randall, knowledge transfer director for Vizient.
Prepare, respond, recover
Since the virus impacted members in different ways and at different times, Vizient organized the compendium’s information to show strategies by stage — prepare, respond and recover — with key strategy roadmaps developed for each. In the surge capacity section of the compendium, for example, “prepare” strategies include setting up an incident command center and assessing internal digital tools and telehealth capabilities. “Respond” strategies, meanwhile, cover repurposing spaces for testing to help divert from the emergency department and hospital, and scaling technology to screen patients and staff. “Recover” strategies include implementing emerging clinical practices as well as assessing staff well-being, strengthening staff trust and preparing physical safety readiness through workspace configuration.
Early in the pandemic, managing critical supplies emerged as a concern for members. Vizient quickly gathered resources and strategies to help members build supply resilience. Some members extended the use of their N95 masks using ultraviolet germicidal irradiation technology, hydrogen peroxide vapor, ethylene oxide and other methods. Some of the supply resources in the compendium include N95 mask conservation information and a personal protective equipment (PPE) conservation impact calculator to understand PPE burn rate. Both resources were developed by Vizient to help members make the best decisions around PPE management.
“Members were asking about the burn rate for an N95 mask and how to calculate usage on a patient level,” said Carla Stephens, performance improvement director for Vizient. “Many organizations found conserving masks on a per-patient or per-staff daily basis was a great start to conservation efforts. In addition, they were nimble and found ways to reprocess masks to ensure that they had supplies on hand to keep their staff and patients safe.”
Staff well-being is also a big focus in the COVID-19 Compendium. Resources and strategies include staff redeployment and training suggestions, addressing burnout and post-traumatic stress disorder, and communicating consistently and transparently with staff. One of the compendium resources is a comprehensive clinical workforce well-being playbook to help health care leadership support frontline clinicians through the pandemic.
“Staff are exhausted and burned out. They’re worried about family members and about bringing the virus home,” said Amber Romstad, Vizient performance improvement program director. “A lot of organizations now are wondering how to mentally support staff in the aftermath of what has happened or maybe want to strengthen trust that was lost during the crisis.”
Collaboratives and webinars offer additional support
Vizient also began offering weekly clinical webinars last spring featuring speakers from member organizations. The webinars cover a wide range of hot topics related to COVID-19, such as emerging clinical practices, surge planning and restarting elective surgery.
One webinar held early in the pandemic focused on managing the clinical care of COVID-19 patients. One member presenter discussed proning patients to increase respiratory capacity and delay intubation, which was a big turning point in the care of COVID patients.
“We were able to bring some cutting-edge, emerging topics to members in these webinars. We were hearing from members across our networks what they were seeing, hearing and learning from other members every week,” says Randall. “Some of our members were in the early epicenters of the pandemic, so really in the thick of it. We were able to share their knowledge and experiences across our membership, which really helped a lot of members prepare.”
The webinar series shifted to a monthly cadence in October but will resume a weekly schedule again in October through the end of the year. Upcoming sessions will cover supply resilience, staff resilience and virtual health. Webinar replays are available to all members on-demand.
“What we’ve seen over these past several months is our members’ incredible innovation in clinical practices as well as their transparency and willingness to share information across member hospitals so that we can all learn from each other,” adds Randall.
In addition to the COVID-19 Compendium resources, Vizient is leading a learning collaborative with 12 member organizations to focus on employee trust, communication, safety and mental support. The collaborative is looking at two metrics: nurse turnover and the percentage of staff receiving well-being assessments.
The team has collected baseline data and will remeasure this fall to see how the two metrics have changed. The results of the collaborative will be shared in December with members who are in Vizient’s networks and collaboratives programs.