American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes


Organizational Steps to Consider Taking in Drawing Down from COVID-19 Once the Crisis Passes

This week, we explore the transition framework offered for health care leaders from the article Drawing Down From Crisis: More Lessons From a Soldier, published in the Journal of Hospital Medicine.

As hospitals and health care organizations balance COVID-19 surging in hot spot areas alongside other, less affected, areas, health care leaders have an opportunity to understand how the crisis affected their stakeholders and their organizational framework to prepare for potential future disruptions. Consider implementing the following steps in your draw-down process.

Pay attention to your personal needs and the conditions of others on your team. Health care providers are exhausted and stressed intellectually, physically, emotionally, and spiritually. Many providers experience extreme stress and post-traumatic stress. One way to address stress is by creating time for you and your team members to get an annual physical exam from a primary care physician. Taking care of physical health can lead to the space to take care of individual intellectual, emotional, and spiritual health and improved patient care.

Reflect on what you have learned during this period. Take the time to reflect on what you learned and what others might learn from your experience and create usable solutions. Consider these questions as a guide:

  • What did you experience?
  • What adaptations did you or your team make during the pandemic? What worked and what did not?
  • What do you want to sustain in your practice and what do you want to eliminate?
  • What did you learn about medical arts, or even about your Hippocratic Oath?

If you have a mentor, share these thoughts with them; if you do not have a mentor, get outside feedback.

Assess team strengths and weaknesses. Schedule a session with your team to provide feedback on their strengths and weaknesses—both people and processes. You should consider a half or full day for this type of session. Prepare your team so they can effectively communicate during this session, which may be structured as follows:

  • To assess strengths and opportunities, ask for feedback on communication, behaviors, medical knowledge, emotional intelligence, and execution of tasks
  • To assess weaknesses, ask which processes and systems either worked or didn't work, and either polish the approaches or drive change to improve systems as you get back to normal
  • Look for ways to fix what is broken and reinforce the things that worked in the crisis

Encourage completion of an organization-wide after-action review. As a leader, it is critical to discuss high-quality as well as lacking leadership and management procedures, process issues, and decision-making. Hospitals and institutions should review all aspects of teamwork, operations, and logistical preparation, as well as leader and organization procedures that need to be addressed. Start by asking the following:

  • What happened?
  • Why did it happen the way it did?
  • What needs to be fixed or adjusted in the processes, systems, or leadership approach?
  • Who is responsible for ensuring the fixes or adjustments?

Most importantly, the article says, "the facilitator (and the key leaders of the organization) must ask the right questions, must be deeply involved in getting the right people to comment on the issues, and must 'pin the rose' on someone who will be responsible for carrying through on the fixes. After the key topics are discussed with a plan for addressing each, the person in charge of the organization must publish an action plan with details for ensuring the fixes."