5 things COVID-19 taught quality experts about leading during an emergency

The COVID-19 pandemic has led health systems across the country to activate their incident command system, a federal training system that outlines an organized structure meant to help hospitals respond to an emergency.

As part of the incident command system, hospitals have had to ensure they're meeting newfound regulatory requirements that were coming in rapidly throughout the pandemic — a challenge for healthcare quality leaders responsible for these efforts. Regulatory changes typically come with advance notice, but in the case of COVID-19, hospitals had to start reporting data points such as case numbers and positivity rates with as little as a day's notice. Now, hospitals are also being asked to report vaccination data. Add all of this on top of fast changing recommendations on how to treat COVID-19. 

In an interview with Nidia Williams, PhD, president of quality and safety at Providence, R.I.-based Lifespan Health System, and Stephanie Mercado, CEO of the National Association of Healthcare Quality, the quality experts discussed the importance of quality and safety training and what the pandemic highlighted about leading during a crisis. 

Five key takeaways and quotes from the conversation:  

1. Running an effective incident command system starts with having the right people in the right roles. 

"It's completely dependent on making sure the right people are in the right roles and understand what their jobs are," Dr. Williams said. "You [first] have to have the right workforce to be able to do that." 

"Not everyone is well suited to be in an incident command role," Ms. Mercado added, noting that those who are performing exceptionally well are those who already work in quality and safety. 

The pandemic and all of the regulatory changes that came with it also revealed more people need quality and safety training, Dr. Williams and Ms. Mercado agreed.

2. The competencies and tools healthcare quality professionals need to lead during a crisis are not new. 

The best quality and safety leaders can quickly adapt to any unexpected regulatory changes, Ms. Mercado said, adding that there are specific tools quality professionals can use. Rapid cycle improvement methods, such as "Plan, do, study, act," are among such tools.

"It's a simple, quality methodology that helps people say, 'OK, we need a plan of how we're going to manage supply,' for example. We need to go ahead and execute that [plan], and then we need to study to figure out how we need to move this forward," Ms. Mercado said. 

Dr. Williams employed the method to monitor Lifespan's ongoing response to personal protective equipment shortages during earlier stages of the pandemic. She evaluated the supply day to day, balancing their warehouse's stock while also ensuring people still had access to what they needed.

3. When decisions need to be made fast, eliminate the hierarchy.

"COVID-19 showed that we can remove unnecessary layers of decision making and that we can avoid the politics of hierarchy for the good of the order," Ms. Mercado said. "When we have a common cause like supporting a pandemic, what we really need to focus on is having the right system, the right process and the right structure to make decisions."

"COVID-19 has taught us that we are able to do things faster," Dr. Williams added. "Be careful about them, but also understand that if you have to go back and if you have to refine, that's OK."

4. Health systems better understand the importance of quality leaders now. 

"In terms of healthcare quality, we've always been leaders in our areas of endeavor, which would be quality, patient safety and things like that," Dr. Williams said. "But when something of this magnitude [COVID-19] comes to the forefront, that healthcare quality workforce plays such an important role in managing the whole incident for an organization. We became organizational leaders because we have that skill set. Before, we were managing our own little worlds … but it wasn't an organizational leadership where we were leading other leaders to show them how we can use some of these different tools and skill sets to help the entire response." 

5. Don't wait to prepare for the next emergency.

"The time to prepare for the next crisis is now, and what we really need to focus on is having a stronger competency and skill set in healthcare quality so that we're ready for the next challenge ahead," Ms. Mercado said. "And that is a very doable goal because there's so much education and training in this space." 

More articles on leadership and management:
What hospitals are learning as they distribute the COVID-19 vaccine
Corner Office: Henry Ford Health System exec says she's driven by golden rule
Former hospital CEO tapped as Detroit's lead public health nurse

 

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