Table 4 Best practices
Theme | Best practice |
|---|---|
Dynamic clinical experience with uncertainty | |
Surge staffing and sufficient workforce | Clear proactive surge plans – with next steps for scaling up/down; shared broadly Predictable plans (as much as possible) with naming conventions of services that make sense Clear role delineation Geographically based teams COVID specific teams Translator phones/tablets in every room Consider language specific teams (i.e. care team fluent in predominant language) Ensure sufficient personal protective equipment Consider shorter shift stretches |
Role delineation and ensuring appropriate training | Robust onboarding – ensuring that care teams have two main skill sets (operational knowledge, clinical skillset) Single point person for clinical trials to coordinate and help with unbiased approach to trials |
Information sharing – centralized hubs and colleagues as resources | Allow for organically formed information hubs Ensure information in stored in single site, ideally synthesized and up to date |
Importance of choice | Allow for choice in COVID care and recognize life situations may change choice Recognize all team members (those providing care for patients with COVID and those not) Follow closely the impact of types of services to try to ensure opportunities such as teaching are shared |
Importance of visible leadership with a focus on sensemaking | |
Unique dichotomy between flexibility and structure in environment | Embrace both grassroots efforts and more structured efforts Ensure more structured efforts do not inhibit communication or lead to mistrust |
Communication is key to effective operational response | Rounding on the floors regularly Ensure teams know it is ok to take a break Team lead to communicate frontline concerns and provide loop closure Help teams to understand the reasoning behind decisions Ensure sense-making when discussing financials Minimize other pressures (i.e. academic responsibilities) Standardized forms of communication Limit the quantity of communications (i.e. batch) If multiple institutions ensure congruent messaging Help with sense-making Variety of formats (zoom, email, team touchpoints) Ensure clinical liaisons for command center and single point person for frontline teams Go to the area of concern instead of going several leadership levels above When in active new situation, afternoon in person huddles where appropriate (small groups) |
Sense of mission and increased collaborations | Small tokens of gratitude such as food, notes, parking, communications expressing gratitude Build wellness into surge plans – ensuring plans are visible Address child care Small ways to connect – zoom happy hours, outreach platforms Lower administrative barriers (documentation, mask centers) |
Significant emotional toll | |
Impact on individual in the workplace | Ensure support systems such as focus groups and mental health services Send clear messaging that when you are off it is ok to be off Ensure sufficient staffing Ensure team understands that it is ok that academic endeavors may lag |
Impact on personal life/family | Ensure sufficient and safe PPE Foster access to infectious disease specialists to answer questions and provide support Prioritize predictability in scheduling as much as possible (type of work may change, but shifts, hours, duration of the day will be predictable) Offer employee benefits for caregiving duties |