Ebbs and Flows, Surfing the Pandemic Waves

As you plan your days and weeks ahead and continue to manage the ebbs and flows of COVID-19 infection and hospitalizations rates, consider this:

As we visit with our stroke colleagues across the country, we are reminded of the variation in how we are all experiencing the COVID-19 pandemic. Some regions experienced crushing surges in infection and death rates overwhelming the healthcare system, while others saw fewer patients. The pandemic has impacted hospitals in ways we don’t yet fully understand; while some units were overwhelmed with patient care and preparations, others were effectively shut down as elective care stopped. While some healthcare workers were in high demand, others were furloughed or re-deployed to other specialties. Meanwhile, the stroke community reported a decline in the volume of patients receiving acute stroke care, suggesting a hesitancy from patients to seek even emergent care.

As stroke leaders, you may be in an organization in the recovery phase while others are seeing surges in COVID-19 patient volumes as case counts grow. Some of our organizations have attempted to resume elective care while closely monitoring infection and hospitalization rates. Infectious disease experts have predicted that regions will see ongoing surges of COVID-19 infections, and the intensity of social distancing and shelter-in-place rules may continue to vary over the next year until a vaccine is available. Many healthcare systems are reporting very concerning financial pictures that may impact all programs in the coming months. If you play a role in stroke program leadership, It can be overwhelming to determine where and how to proceed.

As you plan your days and weeks ahead and continue to manage the ebbs and flows of COVID-19 infection and hospitalizations rates, consider the following:

• Patient first. While financial stress and pandemic fatigue weigh heavily, it’s helpful to continue to reframe conversations to include the needs of patients first. Certainly, considering the needs of multiple patient populations at the same time can be complex and require prioritization. However, reframing planning conversations to consider the needs of your patients helps establish values and priorities during times of stress.
• Systems next. In the stress of the past several months, many of our normal workflows and systems were obliterated.  As we rebuild our new normal for stroke care, can we employ systems-thinking and quality improvement tools to look for opportunities to eliminate waste and improve processes?  Rather than attempting to return all processes to pre-pandemic routines, perhaps the disruption can destroy old cultures and processes that were never serving your program well.  Look for opportunities to improve as we all rebuild.
• Self-care always. As the adrenaline of the first wave of the pandemic wears off, please remember to care for yourself. Stay vigilant with your personal protective equipment in the hospital and in the community to reduce your chance of infection. Take the necessary time to care for your own mental and physical health (link to CDC resources HERE).  To use the airline analogy, put your own face mask on before helping others.

As we all rebuild, we are planning a few webcasts to share stories from the frontlines….look for more information to come on this in the coming weeks.

Thank you for all you are doing!