environmental hygiene
By J. Darrel Hicks, BA, CHESP, MESRE
A Novel Crisis Requires
Essential EVS Leaders
S
ARS appeared in late 2002 and quickly spread around
the world the following year. The CDC reported that
8,098 people were infected in 26 countries, and that 774
died. SARS was called the first pandemic of the 21st century.
It would not be the last. Nor would it be the deadliest. As
of April 24, 2020, there are nearly 3 million confirmed cases
of SARS-COVID-19 in the world and nearly 200,000 deaths.
It was during that “little” pandemic in 2003, that hospitals
first started planning for the “surge” that never materialized.
Disaster preparedness became the focus of table-top drills and
dealing with the “what if” scenarios. Then disaster planning
centered around risk-assessments and contingencies that
never materialized.
Crises come in two forms: normal and novel. A “normal”
crisis would call for Hospital Incident Command System (HICS)
planning in the event of natural disasters such as hurricanes,
tornadoes, earthquakes, ice/snowstorms, floods, etc. Novel
crises are those risks that exhibit unusual frequency and impact.
Organizations typically don’t have plans for such events. Novel
crises may be a confluence of two or three events that strike
at the same time. Or they may simply be too big or unusual
to be imagined.
The wave/surge of COVID-19 patients overwhelmed some
hospitals, particularly New York City, while other hospitals
were planning for the possibility of more patients than their
ICU-bed capacity could accommodate.
A novel crisis places strains on leadership. In the EVS
department, leadership is especially important for a safe, clean
and disinfected environment for patient care. Here are some
of the essential elements for EVS leaders during these days
of staffing shortages, PPE, supply chain disruptions, isolation
room processing and high patient census.
Lead decisively: As Max De Pree noted, “the first
responsibility of a leader is to define reality.” Leaders must
wade into the mire in order to learn precisely what is hap-
pening at any given moment and to make sense of current
conditions. A leader’s visible presence during times of crisis
inspires confidence and gives others a sense of security.
Certainly, the ability of leaders to control their own emotions
is paramount during crisis. The EVS leader might be directing
a resource-challenged department but that is a hurdle they
must clear. The leader and the leadership team must be visible,
approachable and leading by example as they approach the
novel crisis head on. It’s not uncommon to make mistakes,
so it’s important to be flexible and back up, change course,
adjust and go forward again.
Continuously frame the crisis: Rather than holding fast
to the first impression and analysis of what is happening in
the ED or the ICU, be flexible to embrace new information
as it comes along. If new analysis suggests a remake of the
www.healthcarehygienemagazine.com • may 2020
original plan, remake the plan. One of the most important
things for any EVS leader is to identify what the situation on
the ground is and to constantly look at that identification
every couple of hours, days and weeks because crises can
change, and they can become multiple events. What you
thought was unimportant yesterday can become extremely
important tomorrow.
During a crisis, make it a point to withdraw from everything
momentarily to list out your top concerns. Then assemble the
core leadership team, gather their input, and amend the list
accordingly. Putting the main issues on paper helps to wrap
your mind around the crisis and to stay focused amid chaos.
Actively communicate: During a crisis, it’s important to
constantly communicate up to leaders and down to employees
and vendors. It’s also critical to keep a record of the facts
through hand-off reports required of all shift leaders. It is
extremely important to actively communicate up and down
in an organization, as well as to internal customers and
employees. Honesty and transparency are critical.
Be ready for the unexpected: Under extreme pressure,
the EVS leader should understand that individuals may act
differently than during normal circumstances, and that the
usual organizational roles may not apply during a crisis. This
can further add to the unpredictability of day-to-day, shift-
to-shift operations. Have a plan for what the operations look
like when 10 percent to 20 percent of your staff are off the
schedule due to being quarantined for 14-days because they
have been exposed to COVID-19.
Drive toward actionable intelligence: During a crisis,
leadership must often navigate confusing data and intelligence.
It’s important to cast a wide net, as crucial information can
come from a range of sources, including your professional
membership group. But those sources must be qualified,
as misinformation can be as prevalent as information. It’s
important to consider sources carefully. The CDC is an essential
resource when it comes to cleaning and disinfection.
Manage the crisis lifecycle, not just the event: The
timeliness and effectiveness of your department’s response in
a crisis often determines how it fares afterward. Front-loading
a crisis management approach with a strong emphasis on
readiness, preparation and follow-up can help departments
more effectively stay ahead of potential threats.
What’s important is to think of crisis management in terms
of a cycle—moving from preparation to response to recovery
and then around again—applying lessons learned from one
stage to the plans and processes that support the other stages.
Infection prevention and control are the essential elements of
the EVS department’s mission. EVS workers are essential to the
mission of the healthcare institution of providing state-of-the
art compassionate care to their public. But EVS leaders are
essential to both missions.
Reference:
Crisis Leadership: Five Principles for Managing the Unexpected. Wall Street
Journal. July 6, 2015. https://deloitte.wsj.com/riskandcompliance/2015/07/06/
crisis-leadership-five-principles-for-managing-the-unexpected/
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