Sustaining Progress

Social scientist claim that it takes 3 weeks to develop or change a habit. We are now well beyond that 3 week timeframe, we are now even past 90 days in our Covid-19 response efforts. What habits have we developed or changed? Are those habits good or potentially harmful?

Initially, healthcare was preparing for being overwhelmed with patients and capacity. Now, healthcare must prepare for the continued flow of positive covid patients. As healthcare leaders plan for the future, what components are being considered in order to make progress and sustain that progress. Here are a few items to consider:

1) Outpatient services – surgery, physical medicine and rehab, cardiac care, cancer care, dialysis, home health. Moving these service lines back to routine operations takes adjustment with getting patients to return for services, building confidence in patients for visits, patient screening processes, staff screening processes, masking/other protections and billing.

2) Staffing – clinical staff and the medical staff have been over-worked in most instances. Plans need to include looking at hours worked, burn-out, stress, emotional support services, returning staff that were furloughed, cross training and maintaining staff skills or competencies.

3) Managing Infectious Patients – patient flow, housing and care management are vital internal processes to protect staff and other patients. The plans and surveillance activities should include items that look at maintaining separation between positive Covid-19 patients and all other patients (no co-mingling), staff assignments for caring for positive patients and other patients, building functions with maintaining air pressures and temperatures in modified units, proper wearing of PPE/uniforms and maintaining enhanced cleaning measures. Should hospital workers wear the uniforms/scrubs into the public before and after working or should they change?

In order to sustain what has been started with Covid-19 response efforts – organizations should now begin to review if the initial response efforts resulted in any undesired habits and attempt to identify those good habits staff developed. Even in emergency operations, performance improvement is important and all about providing the best care possible. Healthcare has made progress this year even though it is often hard to see. We all must share the good habits we have developed and continue to learn from one another as before; which has resulted in the best healthcare system in the world.

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