Access Now: AORN COVID-19 Clinical Support

Archive COVID-19 2021

Lessons Learned From COVID-19

The pandemic has taught us plenty about running a facility during incredible circumstances.

Ann Geier

Ann Geier, RN, MS, CNOR, CASC


SAME PAGE During a crisis, facility leaders must keep staff in the loop, offer focused communications and share why changes are made.

To say the pandemic has been a struggle for outpatient surgery professionals is a massive understatement. Now that facilities are back up to speed after last year's elective surgery shutdown, I asked colleagues about what they've learned while working during the pandemic. Here's what they told me.

1. Update your risk assessment

Trying to figure out how to perform surgery during the coronavirus's first wave was new to all of us. We needed a pandemic policy, but didn't know where to start. Now we know to begin with a risk assessment — a common process the Infection Preventionist uses to identify and review potential risk factors of treatments and services provided, and the environment of care. The risks of greatest importance and urgency are identified and prioritized. Consider using your infection prevention department's risk assessment template, adding "pandemic" as one of the risks. Then convene your clinical leaders and governing body to develop a documented action plan. Next, create an action plan based on the regulations you're following. From there, create your own pandemic policy.

2. Write screening policies

One of my responsibilities is to keep my leadership team up to date on what's going on with COVID-19 screenings. It's a lot. The best thing you can do is assign a small team of clinical staff and supervisors to coordinate screening processes, write COVID-19 pandemic policies and communicate with the rest of the team. For staff screenings, conduct temperature checks according to your policy and document that they've been done. Staff must constantly monitor changes in regulations and revise the policies. Remember, COVID-19 screening and testing policies are based on your state's regulations. Speaking of compliance, outpatient facilities must follow regulations and guidelines from CMS, CDC, NIH, WHO, APIC, AORN, medical professional organizations — the list goes on and on. The information from all these sources is often contradictory. My advice: Initially, rely on a primary source, such as the CDC or CMS, as opposed to trying to incorporate information from multiple sources.

3. Take care of your people

Listen to your staff and their opinions and suggestions — and stay positive. If you act like Debbie Downer because you're stressed, what do you think happens to your staff? They'll copy your behavior. As a leader, you set the tone. In fact, a positive culture may lessen the stress of the pandemic. If you're positive and go with the flow, staff won't be as resistant to the changes COVID-19 has brought.

4. Overcommunicate

During a crisis, you must keep staff in the loop. Remember, they're not seeing the updated regulations every day. Be focused with your communication, so staff know the why behind the changes. If you tell them to do something one day and then change it the next day, give them a reason: "The CDC came down with a new recommendation," or "CMS has implemented new guidelines."

Be transparent with patients, too. They often forget visitors aren't allowed in the facility. While they may be told about the new rule on the pre-op call, they might not remember on the day of their surgery. Explain why you're limiting visitors, and why masks are required. When you're explaining why patients must wear masks until they enter the OR, review the proper way to wear them. Place large signs explaining the visitation rules in prominent entry points.

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