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Table 4 Best practices

From: The impact of surge adaptations on hospitalist care teams during the COVID-19 pandemic utilizing a rapid qualitative analysis approach

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
  1. PPE personal protective equipment