While it sometimes seems like the coronavirus has been with us forever, it’s worth remembering that there are still parts of the country that are only now experiencing their first big spike in cases—that’s the nature of a “patchwork” pandemic working its way across a vast country.
One of our health system members in the Midwest, with whom we recently spent time, is in just this situation: they’re seeing their highest inpatient COVID census to date, just this month. As they shared with us, there are advantages and drawbacks to being a “late follower” on the epidemic curve. The good news is that they’re ready.
Back in March, like most systems, they stood up an “incident command center”, and began preparing for a wave of COVID patients, designating a floor of the hospital as a “hot zone”, creating negative pressure rooms, cross-training staff, developing treatment protocols, stockpiling protective equipment, and securing a pipeline of critical therapeutics and testing supplies. There was a moderate but manageable number of cases across the late spring and summer, but never to an extent that stressed the system.
Eventually, recognizing that they couldn’t ask their doctors, nurses, and administrators to stay on high alert indefinitely, they “stood down” to a more normal operational tempo, only to watch with dismay as the surrounding community seemingly forgot about the virus, and lessened precautions (masking, distancing, and so forth), wanting life to return to “normal”. And now, the post-Labor Day, post-return-to-school spike has arrived.
The challenge now is getting everyone, inside and outside the system, to stop talking about COVID in the past tense, as though they’ve already “gotten through it.” The preparations they’ve made are paying off now. Hospital operations continue to run smoothly even with a high COVID census, but the workforce is exhausted, and citizens aren’t stepping outside to bang gratefully on pots every night anymore.
Asking the team to return to war footing is no easy task, given the fatigue of the past seven months. A question looms: what is the trigger to restart “incident command”? As cases begin to increase again in some of the original COVID hot spots—New York, New England, the Pacific Northwest—healthcare leaders there will need to learn from the experiences of their colleagues in the newly-hit Midwest, about how to take an already virus-weary clinical workforce back onto the battlefield.
The healthcare sector shed hundreds of thousands of jobs this spring as many providers reduced staffing during the height of the pandemic. Across the summer, healthcare has a seen a wave of rehiring, as doctors’ offices and outpatient surgery and testing centers reopened. But despite the ongoing recession and high unemployment rates, competition for talent remains fierce. In particular, hiring into lower-level clinical support roles is more difficult than before the pandemic, as potential applicants weigh the risk of being exposed to COVID.
In the past, applicants for non-degree positions were attracted by good benefits and a clear career path, but “someone looking to make $15 per hour as an entry-level phlebotomist or patient care associate is now choosing the Amazon warehouse or delivering for DoorDash,” one health executive told us recently. “They’re worried about COVID, and they see the hospital as a place where they’re more likely to get it, even though that’s probably not the case.”
A second health system leader mentioned they have posted hundreds of new job openings in the past two months. According to the COO, “these may be the most important hires we’ve made in decades.” Ensuring this new class of recruits feels safe and supported in the pandemic, and is entering a culture of pride and respect, will lay the foundation for the “post-COVID generation” of the healthcare workforce.