Lessons learned: Using teamwork as a baseline to navigate COVID-19

As the COVID-19 pandemic entered our country, hospitals and clinicians faced something never seen before. We quickly and significantly altered the playbook for disaster and emergency preparedness, collaborating, innovating, utilizing and deploying every available resource to survive the crisis. A crisis, unfortunately, that many are still battling.

While COVID-19 surges continue in the midst of the influenza season, lessons learned by health systems large and small reveal the importance of teamwork, communication, flexibility, preparation and supporting the physical and mental health of all staff. Insights from hospital and clinical leader members of the American Hospital Association and American Society of Anesthesiologists, who navigated COVID-19 when it first arrived, reveal key strategies to provide the best patient care and keep front-line workers safe. In this third in a series on these lessons, we explore how flexibility is necessary for all hospitals and that there is never too much preparation.

Hospitals experiencing a surge must be flexible and make rapid decisions that may change hour to hour when needs shift or new information becomes available.   

Learning “in the moment” often is the norm and staff must be creative and collaborate to solve problems. For example, to improve personal protective equipment efficiency, one Henry Ford Health System hospital uses baby monitors in COVID-19 patients’ rooms to deliver a message or ask how the patient is feeling, reducing the risk and preventing the need to don full PPE for every communication. This is particularly helpful when PPE is in short supply.

Also, take time to prepare and continually be prepared for the worst, for things can accelerate even faster than expected.

Before the COVID-19 tsunami hit New York City, state leaders told hospitals to prepare to provide care at a level 100% over their usual capacity. Medisys Health Network prepared by dividing the need into three buckets:

• Freeing up space for COVID-19 patients by canceling elective surgeries and converting the neuro-interventional and ambulatory surgery recovery areas to intensive care units.
• Planning ahead to procure vital supplies, including ventilators, equipment, drugs and, most especially, PPE. Physician anesthesiologists converted anesthesia gas machines to provide capacity in the event ventilators were in short supply.
• Preparing to redeploy staff, e.g., redeploying physician anesthesiologists as critical care specialists. Hospitals created airway and procedure teams of physician anesthesiologists dedicated entirely to intubating patients and thus freeing up intensivists to provide overall care. Inevitably, some staff members became infected, meaning everyone had to be flexible, understanding that work schedules would change constantly.

Leadership and key staff also stayed up to date on research, watching industry webinars and gathering other insights and guidance from fellow hospitals that treated a large number of COVID-19 patients. COVID-19 has made everyone from administrators to clinicians take emergency preparedness drills more seriously than ever before.

Clinical and administrative teams that have collaborated before on projects, such as the Perioperative Surgical Home, help transform health care delivery. COVID-19 takes this partnership to a new level. The lessons learned provide hope for the promise of a brighter future, in which decision making happening in a collaborative, more agile way will be the new norm.

Additional resources are available at AHA Updates and Resources on Novel Coronavirus (COVID-19) and ASA COVID-19 Information. More resources designed to support those leading through crisis and fostering well-being across an entire organization provide free tools and real-world examples. 

Patrice Weiss, M.D., is the past chair of American Hospital Association Committee on Clinical Leadership and the executive vice president and chief medical officer at Carilion Clinic, and Beverly Philip, M.D., is president of the American Society of Anesthesiologists.