COVID-19 Pandemic Lessons for Hospital Preparedness

Introduction

To a large extent, the COVID-19 pandemic could be described as one of the worst pandemics the world has experienced in modern times. In addition to causing the deaths of millions of people, this pandemic was especially taxing for healthcare systems across the world. For instance, in the United States, hospitals had to continue routine medical care while simultaneously attending to the needs of those diagnosed with COVID-19. What lessons, if any, have we learned from this complex situation? What steps should we take to ensure that we are better prepared to respond to a future pandemic? These are some of the key issues highlighted in this paper.

From the outset, it is important to note that close to six million deaths have been directly or indirectly associated with COVID-19. In addition to these fatalities, the disease largely destabilized entire economic and financial systems, effectively leaving many families destitute. An argument can be made that better response measures could have blunted the impact of this global pandemic.

An assessment of response measures can be undertaken from the perspective of national public-level response and localized, hospital-level response. As part of a healthcare organization's leadership, this paper focuses on lessons of relevance at the hospital level — the level from which we can work upward to ensure that our systems are better prepared to handle a pandemic of a similar magnitude and scale as COVID-19.

Planning for Continuing Patient Care

One of the aspects of hospital operations most affected by the COVID-19 pandemic was continuing patient care. Lim et al. (2021) indicate that at both the patient and service levels, primary care was adversely affected by the pandemic. On this basis, the authors note that going forward, healthcare organizations need to formulate and deploy strategies to mitigate that impact. Hospitals ought to develop a disaster plan containing crucial elements to be operationalized during a pandemic or in situations when there is an unexpected increase in the demand for services. As Griffith and White (2019) indicate, "forecasts of demand" often underlie facility size and layout (p. 372). According to Wei, Long, and Katz (2021), a hospital disaster plan of this kind could capture aspects such as: "what areas of the hospital to expand to and in what order (e.g., recovery room first, ambulatory areas second), how to increase ability to care for incoming patients (e.g., cancel routine surgeries and appointments)" (p. 1162). Griffith and White (2019) similarly argue that healthcare organizations need to develop disaster and emergency response plans that address issues relating to increased utilization — an essential step toward ensuring no significant disruptions in continuing patient care during periods of sudden surge in demand.

The COVID-19 pandemic also underlined the relevance of telemedicine in healthcare. In basic terms, telemedicine can be defined as the use of telecommunications and information technology to enable or facilitate remote contact between patients and healthcare providers. Hospitals can deploy telemedicine solutions to contain disruptions and promote care continuity by reducing the need for physical visits — and thereby relieving additional strain on medical resources during periods of increased utilization. As Muli et al. (2021) point out, telemedicine can be perceived as one way of leveraging technology to ensure continuity of care during a pandemic. In their study examining the extent to which technological interventions such as telemedicine could be used to promote continuity of services — particularly in relation to patient follow-up — the authors found that "there is a dire need to integrate technological interventions in the provision of health care services to ensure continuity" (Muli et al., 2021, p. 41).

Supply Chain and Scheduling

Griffith and White (2019) point out that healthcare organizations often seek to avoid maintaining excess supplies in order to control costs. Furthermore, according to Wei, Long, and Katz (2021), because manufacturing consolidation reduces costs, most healthcare organizations have an incentive to source supplies from a limited list of vendors. The downsides of these approaches were exposed during the COVID-19 pandemic, particularly when most healthcare organizations experienced depletion of critical supplies. According to Wei, Long, and Katz (2021), most healthcare institutions were short of crucial equipment such as ventilators and medications.

The solution to this problem does not lie in maintaining excess supplies — a luxury that most small and medium-sized healthcare organizations cannot afford. Instead, healthcare organizations can seek to eliminate paper-heavy medical procurement processes in favor of more efficient digital processes. This would ensure swift and efficient procurement of medical equipment and medications, particularly across requisition, solicitation, awarding, and order management processes.

Kluger et al. (2020) also indicate that hospitals may need to invest in real-time data solutions for supply-chain decision-making. According to the authors, some healthcare organizations rely on supply-chain staff intuition and knowledge when making critical supply-chain decisions — an approach that proves suboptimal during an unfamiliar event such as an unexpected pandemic. In the words of the authors, during such periods, "visibility into real-time data empowers hospitals to proactively manage critical supplies by adjusting consumption, shifting to secondary suppliers, and working with manufacturers to locate more supplies" (Kluger et al., 2020, p. 116).

Conclusion

It is clear from the discussion above that the COVID-19 pandemic revealed that most healthcare institutions were ill-equipped to handle a substantial increase in the demand for services. As noted throughout this paper, more than six million lives have been lost to COVID-19. There is reason to believe that the death toll could have been significantly lower had healthcare organizations and entire healthcare systems been better equipped to handle a pandemic of this magnitude and scale. The recommendations presented above — spanning disaster planning, telemedicine adoption, supply chain reform, staffing strategies, and public-private partnerships — are particularly relevant as healthcare systems seek to ensure they are prepared to handle future pandemics.

References

Griffith, J. R., & White, K. R. (2019). The Well-Managed Healthcare Organization. American College of Health Care.

Keeley, C., Jimenez, J., Jackson, H., Boudourakis, L., Salway, R. J., Cineas, N., Villanueva, Y., ... Long, T. G. (2020). Staffing up for the surge: Expanding the New York City public hospital workforce during the COVID-19 pandemic. Health Affairs (Millwood), 39(8), 1426–1430.

Kluger, D. M., Aizenbud, Y., Jaffe, A., Parisi, F., Aizenbud, L., Minsky-Fenick, E., Kluger, J. M., ... Kluger, Y. (2020). Impact of healthcare worker shift scheduling on workforce preservation during the COVID-19 pandemic. Infection Control and Hospital Epidemiology, 20, 113–119.

Lim, J., Broughan, J., Crowley, D., O'Kelly, B., Fawsitt, R., Burke, M. C., McCombe, G., ... Cullen, W. (2021). COVID-19's impact on primary care and related mitigation strategies: A scoping review. European Journal of General Practice, 27(1), 166–175.

Muli, E., Waithanji, R., Kamita, M., Gitau, T., Obonyo, I., Mweni, S., Mutisya, F., ... Makokha, F. (2021). Leveraging technology for health services continuity in times of COVID-19 pandemic: Patient follow-up, and mitigation of worse patient outcomes. Journal of Global Health, 11, 40–48.

Wei, E. K., Long, T., & Katz, M. H. (2021). Nine lessons learned from the COVID-19 pandemic for improving hospital care and health care delivery. JAMA Internal Medicine, 181(9), 1161–1163.