Healthcare’s Resilience During the COVID-19 Pandemic: Case Study of Nursing Operations Adaptation

SUMMARY & CONCLUSIONSThe spread of COVID-19 has transformed our world over, propelling individuals and organizations to adapt quickly. Often, changing directions mid-step as new information becomes available. This has subsequently evolved the concept of new knowledge learning to quantum levels.The nursing workforce is the largest profession within healthcare systems and is central to the response and prevention efforts of COVID-19. Registered Nurses (RN) are the front-line caregivers for the sickest of COVID-19 patients in the intensive care arena. Therefore, it is imperative nursing operations monitor, adapt, and function in times of constraint while exhibiting essential principles of resilience to survive under surge conditions. These principles are: Top-level Commitment, Just Culture, Learning Culture, Awareness, Preparedness, Flexibility, and Opacity. The focus of this paper is to present a case study with lessons learned on COVID-19 nursing operational initiatives within the context of the principles of resilience.The principals of resilience were demonstrated during the initial response to the pandemic through multiple operational initiatives. The Incident Command structure directed decisions and action items through an even sharper lens for driving outcomes. This was impacted by a sense of urgency in responding to social media influences, overt staff fear of the disease and potential impact to self and their families, and the evolution of incoming scientific information on disease management.Staff quickly adapted to the education while sustaining an ability to provide direct care to patients. There were 932 hospital admissions with 895 successful COVID-19 hospital discharges from March - May 2020. The remaining 114 admissions were resulting in-hospital COVID-19 related deaths. During the escalation of the COVID-19 crisis, 2845 ChristianaCare employees were tested for COVID. Five hundred and one tests came back positive for the disease. One hundred and fifty three positive tests were nursing staff that worked on the dedicated COVID-19 patient care units. Interestingly, the hypothesis in the beginning of the crisis was that the COVID patient care staff were at more risk for exposure and acquired infections. These statistics infer that the directed attention of RNs from COVID-19 units on education resulted in purposeful application too proper Personal Protective Equipment (PPE) and hand hygiene practices, along with a preparedness for working in the stressful environment. This coupled with purposeful leadership presence and responsiveness to staff feedback, resulted in better system resilience among COVID-19-unit staff versus non-COVID-19 unit staff. Opportunities have emerged to inform recovery plans in the future to include opportunities for providing acute care in the population health setting with supportive technology.