Mobilising hospital staff
What if we sent the wrong hospital staff home during the COVID-19 pandemic?
17 June 2020
This is the question being asked by Professor Jeffrey Braithwaite, Founding Director of the Australian Institute of Heath Innovation at Macquarie University, and five of his international colleagues, in light of a new paper they published in the International Journal for Quality in Health Care.
“Faced with the COVID-19 pandemic, many organisations swung quickly into action: mobilising their frontline staff, redeploying others into new roles and sending some home as non-essential staff. This is the understandable and obvious approach – but overlooks the very valuable contribution staff with quality improvement and patient safety training can make,” Professor Braithwaite said.
In many hospitals and health services such staff were not seen to be necessary to help tackle the pandemic. They were often not asked to join the pandemic management group, and thus were underutilised. But patient safety and quality staff have unique training and expertise.
Recognising the core skillset of patient safety and quality improvement staff in ensuring patients are treated safely, even under the most trying of circumstances, will benefit the health system long term.
Professor Braithwaite urges organisations not to overlook this valuable lesson of pausing in the face of a crisis to audit the full capacity of their staff.
“Thinking through exactly who you have at your disposal is a very good practice. It’s not just the obvious people – the medical services director, infectious disease staff, intensivists and emergency department staff who are useful in a crisis,” he said.
Five strategies where patient safety and quality improvement staff can contribute to supporting their patients and organisations through a pandemic are outlined in this new article.
Strengthen the system by assessing readiness, gathering evidence, setting up training, promoting staff safety and bolstering peer support. For example, quality improvement staff often have international networks they can call on for comparing and assessing an emerging situation. They can also, for example, run training simulations for putting on and taking off personal protective equipment. |
Engage with the community, patients and their families so that the solutions are jointly achieved and owned by both the healthcare providers and the people who receive care. For example, ensuring decision-making is equitable in terms of gender, class, socio-economic status and ethnicity and redresses the negative consequences of social and economic inequity. |
Work to improve care, through actions such as redesigning how the emergency department or intensive care unit is organised, providing just-in-time training and ensuring all the support clinicians need for decision making is available to them. |
Reduce harm by proactively managing risk to both COVID-19 and non-COVID-19 patients. For example, working with infectious control teams, providing ongoing audits so systems can be adjusted in real-time, spreading guidelines to help prevent pandemic associated pressure injures. |
Boost and expand the learning system, to capture improvement opportunities, adjust very rapidly and develop resilience. This is crucial as little was known about COVID-19 and its impacts on patients, staff and institutions at the start of the pandemic, although that is changing. |
Looking ahead, staff trained in quality improvement and patient safety stand ready to offer valuable input into the management of patients recovering from COVID-19 and others who’s non-COVID treatment was delayed or disrupted due to the pandemic.
Open access journal article:
COVID-19: Patient Safety and Quality Improvement Skills to Deploy during the Surge. Anthony Staines, René Amalberti, Donald M Berwick, Jeffrey Braithwaite, Peter Lachman and Charles A Vincent, (2020). International Journal for Quality in Health Care, mzaa050, https://doi.org/10.1093/intqhc/mzaa050.
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