Lessons Learned as We Prepare for COVID Wave 2

August, 2020

I am a clinical executive for Vocera supporting hospitals in the northeastern United States and eastern Canada. My role is to work with and advise clinical leaders and teams of current trends, as well as to improve communication and workflow.

The COVID-19 pandemic is affecting different regions in different ways at different points in time. While some regions are still experiencing the first wave and surges of infection, others, like my region, are seeing a reduction in outbreaks. As I write this in early August, operating rooms are opening again at hospitals in my region, and more patients are starting to be admitted for elective procedures and other care.

The leaders I work with expect a second wave to hit the area in late October or early November. They are examining lessons learned from the initial onset of COVID cases, which exposed gaps in terms of patient throughput and employee safety. They’re evaluating protocols and what needs to change to support the physical, mental, and emotional care of patients, and the well-being of their staff, during COVID wave 2 and beyond. Committees overseeing capital projects are making plans. Their focus is all about communication.

In my region, many hospitals are integrated delivery networks, and they procure and deploy technology in phases. Before Coronavirus hit, we had open projects with them, which were put on hold in February and March. Now those projects are being reopened and hospitals are revisiting their initial plans, adjusting them to address communication and workflow gaps the pandemic has revealed. They are looking for rapid solutions.

We had a project open with one hospital that started with a small deployment of the Vocera Badge (our hands-free, voice-activated communication device) being used only in nursing units. Now the hospital wants to expand their Vocera deployment across the enterprise and are looking to us to be very prescriptive.

The hospital had planned to equip other departments such as Respiratory Therapy and Environmental Services (EVS) with the Badge in a second or third deployment phase. They quickly saw that because only the nurses had Badges, they could communicate instantly and directly only with each other. To reach people in other departments, they had to page them or call them on their or mobile or desk phone, possibly after donning their personal protective equipment (PPE). When the pandemic hit, paging and tracking people down was insufficient for the patient surge volume. Nurses struggled to find the people they needed.

Now, as clinical leaders are taking a step back and evaluating how workflows have changed, they’re asking me to advise them on what they need. I tell them that those team members who need to be reached must wear a Badge, and it is essential for them to have a hands-free device.

Improving Communication for Triage Tents and Makeshift Units

The communication from outside to inside the hospital has become a huge focus because so many hospitals have established triage tents to test patients. To help them prepare for COVID wave 2, we advise them on extending their wireless network into the parking lot so care team members inside and outside the hospital can easily communicate with each other over the Vocera Platform.

We also look at the workflows around the makeshift rooms and units they created. They placed patients in OR suites where there was no nurse call. They gave Badges to patients in these rooms who were awake and alert, and that’s how they communicated with them. Otherwise, they had no way to communicate.

We have a feature for use with the Vocera Badge and Smartbadge that helps restore the human connection between care teams and patients in isolation environments that lack nurse call. With this feature, nurses and doctors can communicate with a patient safely from outside the patient room, patients can easily initiate a call with their assigned nurse without leaving the bed, and nurses can bring patients and families together in a conversation through the Badge. For patients who are alone and scared, just hearing the voice of the nurse brings a sense of comfort and safety.

Breaking for Mindfulness

I think that as we go forward beyond COVID wave 2, the culture of hospitals is going to change. Nurses are now encouraged to take emotional breaks, to step away from the unit for 10 minutes – to go outside and just clear their head. We have a feature through which a Vocera user can say the command, “Play Mindfulness” to hear a pre-recorded guided mindfulness track and enjoy a brief respite.

I think stepping away and taking those little breaks is really going to help ease the cognitive burden that weighs so heavily on our care teams. What challenges or gaps in communication have you and your teams.

What challenges or gaps in communication have you and your teams experienced or solved for during this pandemic? I welcome you to connect with me on LinkedIn.