Nurses, doctors, and other healthcare team members deserve working environments that protect their physical, emotional, and psychological well-being. They also deserve equitable support and access to resources and tools to care for themselves and the patients they serve. At the heart of safety is a commitment from hospital leaders to build cultures that empower employees with essential equipment, technologies, and protocols that protect their well-being and enable them to work at the highest level of their skills.

After nearly two years, COVID-19 continues to wreak havoc on exhausted nurses, doctors, and others frontline workers. The pandemic, causing needless death and elevated stress levels, has burned out many of our caregivers. Some are retiring early, some are changing professions, and others are leaving the workforce entirely. The cognitive burden that healthcare workers are carrying, and have been carrying even before the pandemic, is extremely heavy. The emotional toll is unimaginable.

We must find ways to protect and support every care team member or we risk losing more of them too soon. The future of our healthcare system depends on what we do now.

To start, we must identify the root causes of staff shortages. Let’s call out what is harming the physical, emotional, and psychological well-being of healthcare workers. COVID-19, cognitive overload, and burnout are not the only things threatening their well-being.

Workplace violence, racial disparities, and bias are also contributing to the trauma healthcare workers must endure. While these threats existed well before the pandemic, the last 24 months have put a spotlight on the urgent need to protect the safety of our nation’s healthcare workforce who have risked so much to protect us.

Several health system CEOs from across the country have signed The Heart of Safety Declaration of Principles to redefine safety in healthcare and drive action for meaningful change. The three pillars of the Declaration highlighted below are helping galvanize support by other healthcare leaders, technology companies, policy makers, and more.

Safeguard psychological and emotional safety. We must eliminate stigmas associated with seeking mental health support and advance a culture of open communication, so people feel safe to speak up and are empowered as equal and valued members of the care team. The Dr. Lorna Breen Health Care Provider Protection Act is an excellent start.
Promote health justice by declaring equity and anti-racism core components of safety. Healthcare team members deserve to work in environments free from bias and discrimination. A recent UCLA study showed the proportion of Black physicians in the U.S. has increased by only four percentage points over the last 120 years. Focused policies and practices are needed to advance diversity, inclusion, and belonging in healthcare environments, which in turn enables more equitable care delivery.
Ensure physical safety. Healthcare workers are five times more likely to suffer a workplace violence injury than staff in other industries. Zero-harm programs must be implemented to eliminate workplace violence, both physical and verbal.
Policies, protocols, and training staff how to handle a violent situation are important, but they are not enough. Hospitals and health systems need to give nurses, doctors, and other team members the ability to easily and quickly call for help when a situation escalates.

Many hospitals have equipped employees with wearable communication devices that enable emergency communication, such as a dedicated panic button, and understand simple voice commands while wearing the device under personal protective equipment (PPE).

Intelligent communication technology can also help safeguard team members from mental and emotional distress. All day long, clinicians are overloaded with complex processes, competing priorities, and interruptions by calls, texts, and alert and alarm notifications from nurse call systems, patient monitors, ventilators, and more. These communications are often not actionable, causing clinicians to feel lost and overwhelmed, spending valuable time looking for information or a colleague to help.

A unified communication and collaboration solution can reduce distractions, noise, and stress, which have increased during the pandemic. It can eliminate loud overhead paging and help organize and prioritize notifications so they only go with contextual information to the person or team who needs them and can act. Managing alerts and alarms creates a quieter healing environment, while helping reduce the cognitive burden on the healer.

There are many ways to help protect and connect team members. Together, with more collaboration and a renewed commitment to safety, we can accelerate the adoption of these solutions to safeguard our nation’s healthcare workers for a brighter future of caring.

Amazon announced two new solutions as part of Alexa Smart Properties that will enable senior living and healthcare providers to integrate Alexa into their properties and empower residents and patients to stay connected, informed and entertained, just by asking Alexa. Designed specifically for the needs of senior living communities and healthcare facilities, Alexa Smart Properties simplifies deploying and managing Alexa-enabled devices at scale, helping properties offer customized Alexa experiences for residents and patients, and increase care team productivity and operational efficiency.

“We believe the intuitive and accessible nature of voice and Alexa has the potential to help and delight customers in many scenarios, in and outside of the home,” said Liron Torres, Head of Alexa Smart Properties, Amazon. “We’re excited to extend the experiences customers already love to senior living communities and healthcare systems, and give providers new ways to save time and personalize care for their patients and residents.”

Empowering Connection in Senior Living Communities

Alexa Smart Properties enables senior living residents to keep in touch with their loved ones, connect with their community, access community news, and more, using the Amazon Echo device in their room. Family members and friends outside the property get peace of mind knowing they can easily get in touch with residents through Alexa calling.

Administrators can offer access to tens of thousands of Alexa skills, and tailor resident experiences by customizing community information like activity schedules and meal menus. Care team members can communicate more efficiently with residents using Alexa communication features, which enable them to make Announcements, voice and video calls, or send direct audio messages to other Alexa-enabled devices throughout the property. Alexa can also help communities streamline activities like check-ins, field requests for maintenance, and administrative tasks—enabling associates to save time and increase productivity. Senior living communities like Atria and Eskaton will integrate with Alexa Smart Properties at select locations to provide a better experience for residents, while creating empowered and more connected communities.

“We’ve consistently moved to put our residents in the position to live their best lives, now,” said John A. Moore, Chairman and CEO of Atria Senior Living. “Technology has played a critical role in this effort. When you combine our resident and family app with the deployment of Alexa Smart Properties in our communities, seniors have an even greater ability to write the next chapter of their lives through easy-to-use technology that keeps them engaged and connected to their families at all times.”

Helping Hospitals Deliver Personalized Care

With Alexa Smart Properties, patients can communicate with their care staff, control devices in their room, or stay informed and entertained with news and music, just by asking Alexa. Healthcare providers can communicate with patients quickly and easily with features like calling and Drop In—without the need to enter patient rooms. This enables hospitals to increase productivity, conserve medical supplies and protective equipment, such as masks, gloves, and gowns, and free up staff time to provide more personalized care. Hospitals also can provide information customized to their facility, like notifications about schedule changes or cafeteria menus, and skill experiences like games, podcasts, and more. Health systems including Boston Children’s Hospital, Cedars-Sinai, BayCare, and Houston Methodist are adopting Alexa Smart Properties to help care for their patients more efficiently.

“Voice is intuitive for patients, regardless of age or tech savviness,” said Peachy Hain, executive director of Medical and Surgical Services at Cedars-Sinai. “Since it’s so easy to operate, patients can use Alexa to connect with their care team and stay entertained as soon as they settle in, while care providers can streamline tasks to make more time to care for those patients. It’s a total gamechanger for enhancing our hospital experience.”

Deploying Solutions at Scale with Alexa Smart Properties

In addition to support for senior living and healthcare, Alexa Smart Properties offers a set of vertical solutions that enable Alexa experiences in properties such as hotels, vacation rentals, apartments, offices, and more. Alexa Smart Properties tools and APIs make it fast and easy for solution providers to manage and service a fleet of Alexa-enabled devices quickly, remotely, and at scale. By working with solution providers like K4Connect, Lifeline Senior Living, Aiva, and Vocera, senior living and healthcare properties can use Alexa Smart Properties to easily deploy and customize large numbers of Alexa-enabled devices.

“Working with Alexa Smart Properties has enabled Aiva to bring AI voice technology that can be easily customized, managed, and deployed at enterprise scale,” said Sumeet Bhatia, founder and chief executive officer of Aiva. “Using Alexa Smart Properties, Aiva takes work off of nurses’ plates and enables them to focus on direct, high-value care, while giving patients a better, more self-directed experience.”

With the help of solution providers, administrators can build, publish and enable skills to answer property-specific questions and integrate with other property management systems, so residents and patients can request property information like, “Alexa, what time does yoga start?” and perform property-specific actions like, “Alexa, could you ask for my mail to be delivered?” Hospitals and senior living communities can also build and enable HIPAA-eligible skills, like medication tracking, to connect care providers with residents and patients in an environment designed to protect their health information.

“Voice integration has the power to transform how resident requests are made and how staff respond,” said Kim Judd, General Manager of Lifeline Senior Living. “Adding Alexa Smart Properties functionality to our CarePoint resident safety system enables residents to make hands-free help requests and receive verbal confirmation to know they’ve been heard. And staff can see the context of requests and triage more efficiently. It opens up new opportunities for better care, from simple requests to daily announcements, resident check-ins, even helping to ease social isolation, CarePoint with Alexa will be a real advantage for our customers.”

Built with Privacy in Mind

Alexa Smart Properties senior living and healthcare solutions were designed with privacy in mind. No personal information is shared with Alexa to use the device, and voice recordings are not saved. Every Amazon Echo device offers multiple layers of privacy protection, and residents and patients can disable Alexa’s ability to respond to the wake word at any time by simply pressing the mute button on top of their Echo device. Amazon implements administrative, technical, and physical safeguards for protected health information received as part of HIPAA-eligible skill interactions.

Just a few years ago, communication between BayCare’s clinical team members was effective but could be cumbersome. Many clinicians carried a pager, wireless work phone, personal cell phone and workstation on wheels for access to patients’ medical records.

So, in late 2018, Tim Thompson, BayCare’s chief information officer, began to look for secure and efficient smartphone-based communication for clinicians. After 18 months, the team deployed a pilot, assessed the results and established a solution. BayCare has more than 5,000 active PatientTouch users per day during the week and nearly 200 providers per day.

Today, that solution supports bedside clinicians across the system – most BayCare nurses and providers now carry an iPhone equipped with the PatientTouch clinical communication, collaboration and documentation platform from Vocera Edge (previously PatientSafe Solutions).

PatientTouch gives clinicians the ability to view key patient information, document patient data, administer medications and communicate directly via call or text right from their phone. Additionally, patient requests are sent immediately to the phones of the patient’s care team to expedite response.

“When we set out to provide our clinicians with a secure and efficient communications solution, we envisioned a platform that would let them communicate, collaborate and engage with medical records right from their phone,” Thompson said. “PatientTouch allows them to do exactly that. Information is power, and with this platform our clinicians have been given the power to care for patients to the absolute best of their abilities.”

While the gradual move to mobile devices at the bedside has been gaining steam within U.S. health systems, BayCare’s approach is notable for several reasons.

BayCare leadership leveraged their Innovation Team to fast-track a full hospital pilot program in only 4 months. This rapid deployment model allowed the project team to assess gaps and inform an enterprise deployment model with a high level of confidence of success.
BayCare’s commitment to resourcing the project with a dedicated cross-functional team supported shared learning and allowed the health system to implement the platform in a new hospital every 1-2 months – a pace not previously seen in the industry. Each of the system’s 14 hospitals are online with the platform.
Feedback from clinical staff has been actively solicited throughout the project and incorporated into ongoing system design, resulting in rapid and sustained adoption of the new processes and technology.
Benefits to Clinical Staff

Caring for hospital patients is a complex job, and while the widespread adoption of Electronic Medical Record (EMR) systems has had many benefits, it has also created challenges including the high percentage of time clinicians must spend at workstations to review task lists and records.

BayCare’s deployment of the PatientTouch platform has brought several innovations that reduce these burdens. PatientTouch connects with BayCare’s Cerner EMR to pull out specific task notifications and send them to the appropriate care team members immediately. Notifications to the clinician’s iPhone allows them to react quickly to time-sensitive needs. In addition to physicians and the nursing team, Pharmacy, Rehab, Laboratory, Respiratory Therapy, Care Coordination and other departments are equipped to use the technology.

Staff immediately adopted the system’s secure texting feature, streamlining communication across the patient’s care team. Nurses and nursing assistants can also now enter patient information directly into the PatientTouch application on their iPhones, which in turn feeds it to the Cerner EMR, making it much easier and more efficient to document critical patient data for BayCare’s advanced patient safety systems.

“Clinical excellence depends on seamless communication between nursing staff, physicians and patients,” said Lisa Johnson, BayCare’s chief nursing officer. “It also depends on having the right information in the right place at the right time. This new platform allows our clinicians to communicate with one another easily, stay connected with their patients and keep EMRs secure and accessible. All this allows them to provide the high-quality care BayCare is known for.”

Long-Term Vision

Initiated by the dedicated Innovation Team, BayCare’s relationship with Vocera Edge stemmed from strategy meetings with technology leaders at Apple and Cisco, and reflects a vision that extends well beyond the features deployed on the iPhones today.

With the success of the deployment, BayCare has added additional functionality within the PatientTouch application to keep improving the efficiency of their caregivers, such as notifications related to inbound patients and alarm notifications generated from patient monitoring equipment. BayCare has adopted a formal process to review requests from clinical and Information Technology staff as they learn of innovative concepts that promise value to their employees.

“At BayCare, we’re always looking for opportunities to innovate and invest in improving both the patient and staff experience,” said Craig Anderson, BayCare’s director of innovation. “Along with our deployment of voice assistant technology in patient rooms and virtual reality to benefit surgical planning, the PatientTouch project is just another example of how BayCare stays on the cutting edge of patient care.”

Lehigh Valley Health Network (LVHN) is the first health system in the U.S. to deploy the new Vocera EASE ER app that allows families to follow a loved one’s emergency room progress right on their phone from anywhere.

LVHN is also the first to integrate the secure, cloud-based app with its electronic health record system.

Opens in new tabVocera Communications, Inc., a leader in clinical communication and workflow solutions, created the technology to improve patient and family communication.

How EASE ER works
Vocera EASE ER automatically delivers secure, automated messages to patients and their loved ones based on real-time status updates from hospital electronic health records. Examples of 25 automated messages include updates on room assignments, scheduled tests and more. The app is not intended for use with seriously ill or injured patients where hospital staff is traditionally in more direct contact with patient families.

Patients must sign a consent form to participate in EASE and patients decide who will receive updates on their treatment.

The emergency department at Lehigh Valley Hospital (LVH)–Cedar Crest is the first hospital in the LVHN system to implement the app. Launched Oct. 6, more than 2,600 messages were sent in the first week of operation to loved ones in 11 states as far away as Hawaii, California and Florida. Plans include expanding the app to LVHN’s other hospitals as well as offering messaging in Spanish and other languages.

Benefits
“The app helps provide consistent communication with patients and families between in-person interactions with clinicians and staff, helping patients know when and what to expect next. That’s reassuring and provides peace of mind,” says Richard MacKenzie, MD, senior vice chair of emergency and hospital medicine at LVHN. “This enhancement of the patient experience is what our community rightly expects of its premier health care partner.”

LVHN’s EASE webpage, LVHN.org/ease-app, contains helpful information and offers links to download the app to a mobile device.

Clinical and information technology teams at LVH–Cedar Crest worked closely with the Vocera EASE professional services team to automate messages based on patient status. Messages sent from Vocera EASE ER disappear after 60 seconds of screen time, and nothing is saved on the recipients’ mobile devices, adding an extra level of security. The app, which can be used on Android and iOS devices, is free for patients and their loved ones.

Raising the bar
“We are excited to work with the Vocera EASE team to expand the ER app to emergency departments across our health network,” said Michael Minear, Senior Vice President and Chief Information Officer, LVHN. “This is another example of our focus on patients and families to deliver modern digital capability to enhance the patient experience.”

LVHN previously partnered with Vocera in 2017 when it launched the company’s EASE app to provide operating room updates to patient families. Unlike the EASE ER app, EASE messages from the operating room are generated by staff and are not automated and linked to the hospital’s electronic health records system.

Hospital leaders are grappling with multiple challenges that affect their nursing workforce. Surmounting these challenges begins with identifying where problems stem from and applying intelligent solutions.

During an October webinar hosted by Becker's Hospital Review and sponsored by Vocera, Rhonda Collins, DNP, RN, FAAN, chief nursing officer at Vocera, discussed the complex work environment nurses face and steps nurse leaders can take to protect their colleagues and the organizations in which they practice.

Three key learnings were:

1. Leaders rank staff shortages as a top risk factor for nurses' safety and well-being. Other top risks are COVID-19 and cognitive load. In an American Hospital Association survey conducted earlier this year, 55 percent of respondents pointed out that communication around changing policies and protocols, such as those that proliferated early in the pandemic, was a significant problem.

2. Burnout is a work-related injury. Two main sources of burnout are having limited control over one's work and doing work that is overly complex or urgent over an extended period of time. Both are the reality of many nurses. "What nurses really want is for their task load to be eased," Dr. Collins said. "Suggesting that people meditate or listen to a mindfulness recording is great, but if nurses take five minutes out of every hour to go collect themselves and come back to a chaotic and unsustainable work environment, that newfound serenity will be quickly lost."

3. There are proven ways to safeguard and support nurses. Dr. Collins, a sought-after speaker on the evolving role of nurses and the use of communication technology to improve care, spelled out six actions leaders can take to change the norms and expectations that lead to high-stress situations.

Equip nurses with tools they need to do the fundamentals of their job. This could mean something as obvious as making it easy to find and connect with the right people instead of them spending valuable time trying to figure out who to call using outdated call sheets or asking around during a critical situation.

Empower nurses with control over patient-family communication. Technology can be leveraged to trigger automated messages that update patients' loved ones instead of requiring nurses to frequently field anxious calls from friends and family that disrupt their workflow.

Put nurses in the driver's seat when developing plans for crisis care. "It's time for bedside nurses to sit in the seat of power and tell us how they need to be trained and the resources they need rather than us sitting in a room and coming up with a 10-year plan," Dr. Collins said.

Soften the impact of working in unfamiliar environments. During the pandemic, many nurses were deployed to different departments. Experts became novice. When nurses are asked to work in unfamiliar settings, it can make them feel insecure or unprepared. Intelligent software-enabled tools that let them set reminders and get information or help with simple voice commands can help minimize their cognitive burden..

Combat workplace violence by confronting it aggressively. Outfitting nurses with a discreet panic button is one way to counter immediate risk, but reviewing how organizational culture, policies and technology can be leveraged to prevent violence can also have a great impact.

Measure and solve for the communication task load. Hospital leaders need to minimize the threat that nurses feel from changes to their work environment as a result of staffing, protocols or regulatory requirements. In a call to action, Dr. Collins said leaders must "intentionally dismantle what causes [violence] to happen in the first place."

Hospitals and health systems expect a great deal from nurses, and nurses constantly rise to the occasion to do what is required — but the healthcare ecosystem needs to do a better job of protecting and supporting nurses.

To register for upcoming webinars, click here.

Throughout the COVID-19 pandemic, frontline healthcare workers around the globe provided exceptional patient care despite fears of infection, shortages of staff and supplies, and the frustrations of trying to treat a novel pathogen. At the same time, COVID-19 exposed deep and systemic risks to healthcare team members’ physical, psychological, and emotional safety driving burnout to crisis levels. Burnout is arising not only from the emotional toll of caring for sick and dying patients, but COVID-19 also exposed flaws in our health system and infrastructure. Systemic inequities were amplified as COVID-19 disproportionately impacted people of colour and Indigenous community members. A renewed and expanded definition of safety is needed to restore trust, recruit, and retain individuals to the healing professions, enable care to be provided with the greatest skill and humanity, and ensure the well-being of every person working in healthcare. In collaboration with CEOs of a diverse group of health systems in the United States, the author drafted a Declaration of Principles that expands the definition of safety to include safeguarding psychological and emotional well-being of team members, promoting health justice by declaring equity and anti-racism as core components of safety, and ensuring physical safety, which includes a zero-harm program to eliminate workplace violence, both physical and verbal. We invite Canadian leaders to embrace these concepts and commit to supporting team member safety and well-being as an essential foundation for public health. We must humanize healthcare and the time to act is now.

Introduction
Throughout the COVID-19 pandemic, healthcare workers around the globe exhibited courage, compassion, and resilience in the face of an invisible enemy. Frontline team members have come to work and provided care for patients despite fears of infection, shortages of staff and supplies, and the frustrations of trying to treat a novel pathogen. They have held the hands of the sick and the dying, and orchestrated video calls for final farewells between patients and their loved ones who were not allowed to visit in person. Day after day, care team members face the reality that just doing their job means they could place their own safety and the safety of their families at risk.

All of this is happening on top of a system that was already struggling with access, financial strains, and clinician burnout before the pandemic. The tug between public and private sector healthcare services, with their differences in wages, schedule flexibility, and autonomy, was already putting pressure on Canada’s critical public health sector. And differences in healthcare access and outcomes for the most vulnerable and those with historic reason to distrust government services were only heightened by COVID-19.

These and other challenges are taking a toll on frontline healthcare team members, from doctors and nurses to environmental services and food services professionals. A study conducted at the University of New Brunswick found an elevated level of depressive symptomology among Canadian healthcare workers1 substantiating other research that found healthcare professionals working in the first wave faced pandemic-related stressors including depression, anxiety, and Post-Traumatic Stress Disorder (PTSD).2-5

If Canadians do not act collectively and swiftly to redefine and restore safety and well-being for healthcare team members—at the local, provincial, and national levels—our healthcare system will be the hardest hit casualty of the COVID-19 pandemic.

Discussion
COVID-19 exposed deep and systemic risks to healthcare team members’ physical, psychological, and emotional safety driving burnout to crisis levels. In a UBC study of 302 internal medicine physicians working at Vancouver General Hospital and St. Paul’s Hospital from August to October 2020, more than two-thirds experienced burnout. Rates were highest among female physicians, younger physicians, and visible minority physicians.6 This is even higher than levels of burnout among US physicians.7

The same study exposed burnout levels among nurses and allied health professionals at levels of 78% and 73%, respectively. Issues such as forced overtime, violence, and poor working conditions are causing new nursing graduates to leave public sector positions for private sector jobs in which they have more control and better pay.8

Burnout is arising not only from the emotional toll of caring for sick and dying patients struggling against a novel pathogen for which treatment protocols are still emerging. COVID-19 also exposed flaws in our health system and infrastructure. Not only did we experience shortages of Personal Protective Equipment (PPE) and expose supply chain inadequacies, we also discovered that our definitions of PPE (gowns, gloves, and masks) failed to ensure that frontline care team members could communicate effectively with their teammates and with patients and families without risking infection. That meant more contamination risk in donning and doffing PPE that hands-free communication tools could have prevented.

We also saw broad systemic inequities exposed as COVID-19 disproportionately impacted people of colour and Indigenous community members, both from a mortality and economic perspective. These community members often fill essential work positions, live in multi-generational households, or lack access to resources such as clean water that leave them more vulnerable to infection.9,10

Action
The challenges outlined above are not unique to Canada. In the United States, my team and I are collaborating with CEOs of health systems across the country and other industry leaders to spark a movement to redefine safety in healthcare to include health justice and make psychological and emotional safety as important as the physical safety of healthcare team members around the globe.

After watching my colleagues suffer through patient surges, limited PPE, visitor restrictions, and death after death, I felt a sense of urgency to do more to protect the physical, psychological, and emotional safety of the nation’s healthcare workforce. With support from the leadership team at Vocera, we started a movement to galvanize people and organizations around this mission. I reached out to a few influential CEOs from my personal contacts. They were immediately on board and recommended other CEOs to join. I offered to put resources toward building a Coalition, creating a Declaration of Principles, and driving a plan of action. The result was 10 founding members—a diverse group of health leaders representing: clinical and operational backgrounds; a mix of genders, races, and ethnicities; institutions including academic medical centres, public safety net institutions, for-profit and non-profit organizations; and systems span urban and rural geographies.

To create the Declaration of Principles, my team and I conducted in-depth interviews with executive partners identified by the CEOs as having responsibility for team member well-being. Roles spanned medicine, nursing, quality, HR, technology, and team member experience. Some of the executive partners are still involved in frontline caregiving practice. Based on those interviews, we drafted the Declaration and then worked with the executive partners and convened the CEOs for collective feedback until all agreed on a final version.

We believe a renewed and expanded definition of safety is needed to restore trust, recruit, and retain individuals to the healing professions, enable care to be provided with the greatest skill and humanity, and ensure the well-being of every person working in healthcare.

The Declaration expands the definition of safety to include safeguarding psychological and emotional well-being of team members, promoting health justice by declaring equity and anti-racism as core components of safety, and ensuring physical safety, which includes a zero-harm program to eliminate workplace violence, both physical and verbal. This Declaration extends to all team members, from frontline clinicians to environmental services workers and back-office employees.

We are working with the Institute for Healthcare Improvement and others to turn that Declaration into action so that we can ensure that healthcare team members are safe at work. If we don’t do this, we will face an exodus of healthcare talent and compassion that will cripple our ability to care for patients.

As a physician whose career has been centred on making sure every human being has access to humane, compassionate, and competent care I invite you, my Canadian colleagues, to embrace this movement and join us to broaden the definition of workplace safety to elevate team member safety and well-being as a top strategic priority so that the lives of healthcare workers around the globe will be improved. I believe this is the most important issue that healthcare will face over the coming decade.

Getting started
Canadian leaders can get a start on protecting and connecting team members even as the delta variant brings a new surge of patients and challenges. To get started:

1. Rebuild trust. The pandemic has shaken the trust of team members—trust that they will be safe at work, and that they will get the support and resources they need. Leaders in the health services, government, and community need to focus on rebuilding that trust.

2. Redefine and recommit to team member safety. The pandemic amplified pre-existing issues such as injustice and workplace violence—and it introduced new safety concerns around infection and death. We are working on a new definition of team member safety that encompasses safeguarding team members’ emotional and psychological safety, promoting health justice, and protecting their physical safety. We need all leaders, as well as national and local governments to commit to healthcare team member safety and well-being or we will face a crisis in healthcare that will last for years if not decades to come.

3. Expand the definition of PPE to include communication tools. When team members had to adopt new infection prevention approaches to protect themselves and other patients from COVID-19, too many of them found that donning PPE left them cutoff from colleagues. They risked infection by using devices like cell phones in contaminated areas. We need to expand the definition of PPE to include communication technology so no team member has to risk contamination to communicate with their peers.

4. Embrace human-centred leadership. Put simply, human-centred leadership is leading people with humanity. More specifically, it is leadership that explicitly supports team members’ cognitive, emotional, physical, and spiritual well-being so they can maximize their human and healing potential.

5. Reimagine human connection. One of the lessons of the pandemic is that we need human connection to thrive. Never did we imagine a time when we would strip loved ones away from each other upon admission to the hospital. When in-person connection is not possible, we learned that purpose-built technology is essential to keep patients connected with their loved ones and their care teams. We need to reimagine human connection so that essential connections can happen via technology without disrupting nursing workflows or creating burdens on team members or loved ones.

Conclusion
COVID-19 is a novel virus. Early on, we needed to determine how it was transmitted requiring the adjustment of process, technologies, and physical environments to mitigate infection spread. We learned our supply chains need to be more resilient to a global crisis to ensure that we have adequate access to personal protective equipment to keep members safe and to demand communication technologies be included so team members don’t risk contamination for communication.

We initially lacked treatment protocols so care team members who professionally identify with helping others were unable to help, unable to support healing of their patients, feeling isolated, and helpless. We learned that healthcare teams need greater emotional and psychological support than we had traditionally provided because of the inherent trauma in the system heightened by the pandemic.

There are countless stories of healthcare workers being heroes during the COVID-19 pandemic. Overcoming their own fear, we have seen how their dedication to their patients meant going into COVID isolation wards over and over again not sure how much they were endangering themselves or their families.

We have heard about nurses creating video calls between dying patients and their families and even more heartbreaking stories of nurses holding and comforting their patients so that they need not die alone. Healthcare team members have carried an enormous emotional burden as they experienced unprecedented levels of death and bearing witness to the passing of patients. But all this has taken a tremendous toll on healthcare workers.

We must ensure that we never are unprepared for future pandemics. We must ensure that we not miss this opportunity to redefine healthcare safety under the three pillars: psychological and emotional safety, physical safety and health justice, and strive for meaningful change. We must humanize healthcare. If we do not, we will witness an exodus of caring, compassionate, and exhausted team members who leave their profession and their calling. The time to act is now.

Declaration of principles
We witnessed selfless acts of courage, care, and compassion from our nation’s healthcare team members during the COVID-19 pandemic. Safety is at the heart of protecting our healthcare workforce, which means being safe from physical and emotional harm and free from all forms of inequity and racial injustice. Workplace violence, burnout, and disparities existed long before the outbreak of COVID-19. The pandemic has, however, exacerbated the factors contributing to workplace violence, created an environment of unprecedented stress, and exposed the impact of systemic inequities and racial injustice on the well-being of healthcare team members.

We believe a renewed and expanded definition of safety is needed to restore trust, recruit, and retain individuals to the healing professions, enable care to be provided with the greatest skill and humanity, and ensure the well-being of every person working in healthcare. We commit to:

Safeguarding Psychological and Emotional Safety

1. Investing in processes and technologies that reduce emotional and cognitive burdens on team members and restore human connection to the healthcare experience.

2. Creating practices and policies that advance open communication between team members and leaders so people feel safe to speak up, bringing their full selves to work.

3. Providing resources to assess and support team members’ emotional, social, and spiritual health, and alleviating the stigma and deterrents to seek support.

Promoting Health Justice

1. Declaring equity and anti-racism core components of safety, requiring explicit organizational and health equity-focused policies and practices to advance diversity, inclusion, and belonging.

Ensuring Physical Safety

1. Implementing a zero-harm program for care team members to eliminate workplace violence, both physical and verbal, whether from team members, patients, families, or community members.

2. Ensuring that all healthcare organizations can procure and provide evidence-based personal protective equipment, technology, tools, and processes that healthcare team members need to do their jobs safely and care for patients.

Our ability to build trust and provide the care patients require and deserve is dependent on the physical and emotional safety and the just treatment of all those who provide or support patient care. We commit ourselves to this new definition of safety to ensure that no healthcare team member will have to sacrifice their personal safety, health, identity, or well-being to do their jobs and care for patients.

After already targeting verticals like hotels and apartment complexes, Amazon announced today it’s now rolling out new solutions for healthcare providers and senior living centers. The solutions, which are a part of Alexa Smart Properties, are designed specifically to meet the needs of deploying Alexa devices at scale and will allow the facility’s administrators to create customized experiences for their residents or patients.

In senior living centers, the residents would be able to use Alexa devices to call their family members and other loved ones, as well as keep up with the goings-on at their community and other community news. The devices could also be used to make announcements, allow the residents to communicate with each other through direct audio messages and make voice and video calls, and they can streamline other center activities — like check-ins, maintenance requests and various administrative tasks. Amazon believes this could help make facilities more efficient and productive.

Amazon says senior living communities include Atria and Eskaton will integrate with its new solution.

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The market for using Alexa in senior living communities was already being explored by third-party providers, like K4Connect, which last year closed on $21 million in Series B funding to bring newer technologies, including Alexa’s voice assistance, to older adults and those living with disabilities. Companies like K4Connect and others, including Lifeline Senior Living, Aiva and Vocera, can now tap into Alexa Smart Properties’ tools and APIs to make it easier for them to roll out their own, customized solutions and software.

Image Credits: Amazon

Meanwhile, Amazon had already piloted putting Alexa in patient rooms in a test with Cedars-Sinai, which allowed patients to use voice commands for performing basic tasks, like changing TV channels, as well as communicating with caregivers. The idea was that, by offloading some of the everyday tasks to Alexa, it could free up nurses to focus more on medical care.

With Amazon’s new solution for hospitals, patients will be able to use Alexa to communicate with care staff, control the devices in their room, and stay entertained with news and music. Healthcare providers can also communicate with their patients using Alexa features like calling and Drop-In, without having to enter the patient rooms. This could also help hospitals be more productive and conserve their medical supplies and protective equipment like gloves, masks and gowns, notes Amazon. (PPE shortages had been an ongoing issue in some locations as COVID spiked during the pandemic.)

Cedars-Sinai is among those officially rolling out the Alexa Smart Properties solution, following its pilot program, and is joined by BayCare and Houston Methodist, Amazon says.

“Voice is intuitive for patients, regardless of age or tech-savviness,” said Peachy Hain, executive director of Medical and Surgical Services at Cedars-Sinai, in a statement. “Since it’s so easy to operate, patients can use Alexa to connect with their care team and stay entertained as soon as they settle in, while care providers can streamline tasks to make more time to care for those patients. It’s a total gamechanger for enhancing our hospital experience,” Hain added.

Though Amazon has struggled with privacy issues related to its use of voice recordings and transcriptions, the healthcare and senior living center solutions will not save the voice recordings and don’t require users to share personal info with Alexa to use the device, the company explains. Users can also mute the Echo’s microphone at any time with the button on top. Amazon also claims it safeguards protected health information received through HIPAA-eligible Alexa skill interactions.

Amazon has been working to bring Alexa to healthcare facilities for some time. A report in 2018 by CNBC had said the company was building out a healthcare team with Alexa in order to make the voice assistant useful in the industry. This included working through the complex HIPAA regulations that would be required to do so. The following year, Amazon announced its first HIPAA-compliant medical skills and began piloting its devices in hospitals. Elsewhere across Amazon, the company has invested in healthcare solutions in other ways, including through solutions like Amazon Comprehend Medical, a machine learning tool that gathers information from things like doctors’ notes and patient health records, and acquisitions like online pharmacy PillPack.

Both of the new Alexa Smart Properties solutions will roll out in the U.S. starting next month, Amazon says.

Amazon on Monday unveiled a new voice offering for hospitals and health systems, representing yet another step in the Seattle tech giant's push into healthcare. That's in part through connecting to communications systems—like Vocera and Aiva Health, according to Amazon—that are already in use at an organization.

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