Less than two years before COVID-19 took off in the U . S ., we were experiencing a preview of the strain that a fast-spreading , severe respiratory infection places on our health system .”
— Gavin Harris , MD areas of the COVID-19 pandemic that holds some of the most valuable lessons to be learned . In a whitepaper , “ Evolution of Risk Mitigation in Value Analysis during the COVID-19 Pandemic ,” ECRI and AHVAP observe , “ Paradigm shifts during COVID-19 responses included healthcare service disruption ( e . g ., elective procedure shutdown ), staff furloughs , and telehealth ’ s voluminous growth . With reduced revenues still threatening , health systems combat intense pressure to ensure cost-effectiveness while struggling to address high demand for PPE ; scarce , newly approved COVID-19 medications ; and how to protect patients and staff . Technologies have emerged with promise to aid healthcare systems ( e . g ., in response to infection control ) but have also lacked definitive safety and efficacy evidence .”
The ECRI / AHVAP whitepaper continues ,
“ While a devastating experience , the COVID-19 pandemic offers critical lessons . Supply chain and value analysis activities need greater integration , with clinicians deliberately engaged in processes . Alliances and collaborations must improve between industry and healthcare providers to help make a world-class health system in which all patients have equitable access to high-quality care . Finally , assessing clinical evidence on emerging technologies and therapies is critical to achieve positive patient and health system outcomes and prevent diversion of critical resources when supplies , finances , and staff are strained .
During a recent virtual seminar , “ Elevating the Value Analysis Process ,” hosted by ECRI , value analysis and supply chain healthcare professionals responded to a poll about how COVID-19 pressures changed value analysis processes at their hospitals or health systems , indicating they have experienced more C-suite engagement ( 29 percent ) than less ( 4 percent ) and more physician engagement ( 23 percent ) than less ( 20 percent ). Discussing the results , Andrew Furman , MD , MMM , executive director of ECRI ’ s Clinical Excellence team and an emergency physician , reflected on changes wrought by the pandemic . For example , he never thought he would need to address questions about splitting ventilators for multiple patients or extended reuse of N95 respirators as he had to early in the pandemic when providers were searching for information and options in response to supply shortages .
As Furman notes , “ Greater C-suite engagement is encouraging as leadership remains invested in how to keep staff safe while caring for patients . Similar percentages of more and less physician engagement may reflect changing care processes , such as cessation and resumption of elective procedures and conversion to telehealth visits .” Remember , too , that you can capitalize on the change , according to Furman . “ Since everything has changed , it gives you the chance and the opportunity to also step back and say , ‘ What does our value analysis process look like , and what should it be ?’” he says .
As the ECRI / AHVAP whitepaper states , “ While value analysis professionals might encounter physicians who are overworked supporting patients and changes resulting from the pandemic , the poll results suggest many physicians want to be part of the
7 Critical Steps for Emergency Readiness and Crisis Response
Many healthcare organizations were not adequately prepared to respond to COVID-19 due to its uncertainty and unpredictability . Emergency preparedness depends heavily on the assessment of potential hazards and threats in advance . If risk calculations aren ’ t inclusive of all factors and lessons learned , emergency operations plans may not adequately address the needs associated with future pandemics . 1Take a rigorous approach in preparing an emergency operations plan ( EOP ). ●Perform a Hazards Vulnerability Analysis ( HVA ) to assess the potential hazards and threats of future disasters . ●Maintain awareness of capacity and be prepared to execute plans for alternate care sites . ●Perform drills regularly so that you ’ re ready for implementation of the EOP .
●Apply an “ all hazards approach ” in developing comprehensive response and recovery efforts that are relevant to a spectrum of emergency situations , including emerging infectious disease threats .
●Organize and leverage relevant subject matter experts for guidance in responding to changing requirements .
●Be nimble so that you can implement urgent changes quickly
2Maintain a list of changes during COVID-19 response and perform a thorough debrief . ●Document the review process to identify gaps and weaknesses . ●Modify the EOP according to lessons learned .
3
Plan for surge scenarios . ●Consider the four S ’ s of a surge : Staffing , Space , Supplies , and Systems : Staffing : Planning for , mobilizing , and maintaining sufficient staff levels throughout duration of the crisis scenario Space : Building , converting , or acquiring space to accommodate surge capacity while maintaining standards of care Supplies : Acquiring , stockpiling , and tracking use of equipment and goods to ensure sufficient resource availability Systems : Setting structures for command , control , and coordination to maintain continuity of operations ●Understand the specific needs presented by COVID-19 ( e . g .,
ICU beds , ventilators , PPE , medicines ).
●Determine how routinely a hospital meets capacity and identify ways to shift intake to avoid capacity issues . 4Maintain a current list of staffing needs and availability of staff members to meet demand . ●Implement a current and accurate contact database to assign and track staffing throughout the crisis .
●Anticipate possible telecommunications failures ( e . g ., unavailability of email and traditional information technology ( IT ) applications ).
●Re-allocate professionals from lower demand areas to areas experiencing a surge .
●Implement social distancing policies and talent sharing across your organization as much as possible . ●Cross-train staff to perform high-priority duties . ●Support the basic needs of staff through available community resources ( e . g ., accommodations at hotels ) when on-site resources are limited or unavailable .
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