Hospitals Need Situation Management to Adapt to COVID-19 Uncertainty

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By Terry Zysk

For survival in an uncertain financial and public health environment, U.S. health systems grapple with a new requirement: to be nimble. In this guest post, Terry Zysk, CEO at healthcare IT company, explains how some health systems and hospitals are employing situational awareness and collaboration technology to respond and adapt to unforeseen situations, including but not limited to COVID-19.

The world changed with COVID-19. Health systems went from managing a crisis once a season to managing multifaceted situations every day. Healthcare organizations needed to invent and quickly implement new approaches to workforce protection, supply chain and resource stabilization, patient flow and care protocols, and staff communication and engagement – all while dealing with a deadly respiratory pandemic, financial uncertainty, and typical seasonal emergencies, such as tornadoes. 

When elective surgeries ceased and non-COVID-19 admissions evaporated, hospitals were forced to adjust rapidly, switching to public health mode. Some health systems have experienced the value of situation management and collaboration. They tracked situations, collaborated widely, gathered information, and implemented multi-factor responses. 

Unprecedented innovation and transformation at scale

Hospital transformations require an enormous amount of creativity, communication, coordination and collaboration. Integrated delivery networks and individual hospitals quickly turned elective surgery beds into COVID ICU beds, reconfigured floors, and implemented new protocols. They scrounged and re-allocated supplies across regions and across the country. They redeployed providers to new assignments and sent home the most vulnerable providers and staff who could work remotely.

With relaxed rules and protocols, they were free to innovate and work in ways they hadn’t imagined possible before.  Their solutions operated at the intersection of clinical, environmental, and operational domains. All three need to be connected across and throughout a health system so that information could flow, and so that shared insights could be leveraged, and the response rolled out with clarity and consistency. Changes of that scale would normally take months to implement; they did it in days or hours as decision-making was streamlined.

COVID-19 situations went beyond traditional hospital emergency management, where an event is declared at a point in time, and a mass notification alerts staff, “There’s a hurricane coming. Mobilize!” Emergency management scenarios trigger well-defined command roles that undertake well-understood, pre-planned job action sheets. New information is released, as it becomes available. In less than a day or a few weeks at most, the event is over, after action reports written, and emergency preparedness plans revised. 

Using technology in new ways

In contrast, health systems need a better way to respond to situations that are not well understood, are prolonged, change over time and may even occur daily. The people facing these situations will need a different, but related, set of tools. Many types of information need to be created and shared. Multiple groups and many individuals need to be involved at different parts in a process. Expert individuals are brought in to collaborate for a while – until the stressor goes away or the organization decides how to adapt to it. 

I work with many creative hospital leaders who solved pandemic-related problems by repurposing already deployed or quick-to-deploy collaboration technology. Saving the lives of patients and protecting care providers during the COVID-19 pandemic is an unprecedented healthcare management challenge. Some technology worked better than others. Freeware got the job done for one clinical team, but painfully. Health systems using LiveProcess technology with roots in hospital emergency management were better prepared. They dynamically rebalanced business operations, shared information as widely or narrowly as needed, and collaborated in virtual command centers. 

A public health emergency response creates large-scale logistical issues that require dynamically rebalancing business operations, sharing information, and collaboration. There can be no silos. Whether called a situation center, command center or nerve center, the intent is the same: situational awareness, effective leadership, and the coordination of a creative and pragmatic response that lets the organization get ahead of a situation. 

Real-time health systems adapt and thrive in demanding situations

Real-time health systems will have an advantage. Communication, coordination and collaboration needs to occur in real-time. Dynamic ad hoc teams and static groups need to be able to form and change membership at will. Simplicity demands that protocols and processes be automated, orchestrated and connected to tackle complexity. Business intelligence and human insight are powerful and need to be sourced from throughout the organization to achieve pervasive situational awareness. With availability of information, insight, processes and the tools to make decisions and take meaningful action, a real-time health system can rapidly adapt to new and demanding situations. 

The following are three examples of healthcare organizations that realized aspects of a real-time health system (RTHS) to manage COVID-19 situations: 

One west coast health system had a seminal event with COVID19 exposure of its healthcare team. They needed a solution leveraging technology that allowed them to manage the situation over time as it evolved. With LiveProcess, they were able to reach out to hundreds of potentially exposed staff simultaneously, to track their exposure and well-being, then display the daily results on a quickly developed business intelligence dashboard.

Another health system implemented a novel process that bypassed ED triage, sending all incoming stroke patients directly to a newly-consolidated neuro unit – saving precious time. The reworked floor had seven bed types – COVID-19 and non-COVID beds, high-level and low-level care beds, negative pressure beds for patients who weren’t yet identified as COVID or non-COVID. They too required a technology platform to support their multidisciplinary communication, coordination and collaboration needs, which included managing high volumes of patients – and sending them home within three days.

A third health system needed to optimize the redistribution of staff across the health system when normal operations were discontinued in favor of COVID-19 response. Human resources specialists used LiveProcess collaboration sidebars in our emergency management solution to work together across facilities in a virtual command center, tracking staff availability and sending them where they were needed most.

Similar capabilities are required in hospitals around the country, with or without COVID-19. It’s really important to have technology to share information and flexibly collaborate on solutions. Patients present at the ED with life-threatening conditions – minutes matter. Forecasted storms disrupt elective surgeries impacting the bottom line. Staff callouts on the current shift need to be filled promptly to maintain nurse-to-patient ratios. These situations stress the healthcare environment, but all of these can be managed and addressed with coordination and collaboration technology purpose built for healthcare.  The reality of the ‘new normal’ for healthcare recovery in the age of COVID-19 is that health systems will need a strong technology infrastructure to enable resilience.  

Terry Zysk is CEO of LiveProcess, a software-as-a-service company that helps healthcare organizations know, innovate, act and thrive by dynamically rebalancing business and clinical operations for the best outcomes during routine, urgent and emergency situations. Zysk has led healthcare software companies for more than 15 years.

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