Pandemic, once in a century event, is unpredictable and quite challenging to be prepared for. One such phenomenon is enough to cripple various businesses, most industries and the entire livelihood of people, forcing them to change their lifestyle. Healthcare industry has its own merits and demerits in such situations. The steady inflow of patients and increase in telemedicine being one of the very few merits but can be easily overshadowed by overcrowding in the hospitals which can occur at the peak of the pandemic, severely affecting the patient care, mainly the non-pandemic patients, as most of the medical resources are allocated for dealing with the pandemic.
A hospital is supported by two critical pillars: Clinical Management & Non-Clinical Management. Efficient management of both these departments is key to sail through this difficult time.
Clinical management of pandemic and non-pandemic patients under one roof is a herculean task. Pandemic diseases are of the infectious types and easily spread from one person to another. Clinical protocols keep changing and take time to get refined. Numerous research papers and articles create confusion as to how to treat the disease/ symptoms and prevent it from spreading. If containment fails, the exponential growth of cases can transform a public health emergency into an operational crisis. Therefore, it is imperative that your hospital has set strict clinical protocols for patient care with infection control at its core. It is also critical to identify separate areas in your hospital and assign different staff and doctors to treat pandemic and non-pandemic cases.
This, along with regular vital monitoring of all the patients, staff and doctors would help to track and check the spread of disease within the hospital premises. Regularly update yourself with the latest clinical protocols published in peer-reviewed journals or released by CDC, WHO or by the Government. At the same time, educate your staff, doctors and patients about the latest development and spread awareness to ensure everyone is on the same page. Keeping in mind the number of staff and doctors, admit only the number of patients the hospital can handle to give the best
Dr. Adit Desai
care possible. Ensure that your staff and doctors have enough resources to handle the patients. These resources may include specialized masks, PPE, a separate area to eat and take rest and in some situations, extra allowances. These will ensure that the staff is motivated and is ready to tackle any hurdle thrown in its way. Apart from clinical protocols, you must also safeguard yourself and your hospital from any legal liabilities. You must ensure all your documentation is perfect to the T. You must ensure tha your institute is safe against all legal liabilities and that all documents and reports are duly signed by the concerned authorities.
When it comes to the non-clinical department, it is a different ball-game altogether. It is a very dynamic setup where one has to be on toes 24×7. You’ll be faced with different issues and different combinations of events on a daily basis. Your decision-making skills are tested every day, and it is this skill that will help you stride forward. Staff management, infrastructure management, cost control and logistics are some of those challenges, requiring a shortterm and a long-term strategy.
Your strategy has to primarily focus on the following:
- Protecting your workforce: Efficiently managing & protecting your workforce is where your true skill lies. Optimal utilization of your workforce and their resourceful deployment will help you control your cost as well as maintain your quality of care. Motivating them and providing them with useful resources will help you retain them. A hospital is nothing without its staff members. And this realization will help you go a long way, pandemic or not.
- Managing your patients: In-patients and out- patient flow will fluctuate a lot during this time. There will be good days and bad days. But you must not deviate from your strategy. You have to designate areas for pandemic and non-pandemic patients. Divide staff accordingly. Spacing between OTs will be increased to ensure proper fumigation and deep cleaning. These measures will help you to avoid any dissatisfaction amongst patients as well as keeping the spread of the disease under control.
- Cost control: As a result of patient inflow fluctuation, there will be a stark dip in revenue. As a result, to keep your hospital afloat, cost- cutting measures becomes a necessity. The most important thing to remember is that this should not, in any way, affect the quality of patient care. Ensure judicious use of masks, PPEs, consumables, drugs, electricity and infrastructure to control costs. Avoid any luxurious service that you may be provided on any regular day. The money saved will help you ensure that your losses are kept in check.
- Logistics: Separate staff should be assigned to look after the logistics requirement of the hospital. Their main task is the procurement of various important equipment, PPEs, masks, consumables and medicines (such as antimicrobial and antiviral) and other infrastructural requirements that may arise. Providing support for patient transport, ensuring the availability of back-up resources and providing support for the maintenance of essential equipment comes under their supervision. Major epidemics can impose severe constraints on logistic functions which require continuous communication and collaboration between hospitals and various stakeholders and partners (including private- sector, other hospitals and government). This ensures there is ample amount of aforementioned items to fight against the pandemic.
- Training of staff and patients: This is a continuous process. Regularly training your staff and spreading awareness amongst patients and their relatives is what will help you to keep things under control. Training videos, visual graphics and webinars can assist you in this task. Create a team internally who will do on-job training and take sessions amongst patients’ relatives. Additionally, factual, short, and to the point, information must be provided to the citizens and quash any hoax or misinformation. A Pandemic is a difficult time for healthcare professionals. This is a time which tests not only our skills but also our patience and ethics. An overburdened and tired staff may result in an overall decrease in quality of health care provided in hospital thus it is important to implement measures to address the welfare needs of staff, such as leave and psychosocial support. As doctors, we have to lead by example. Hence, It is our moral duty to strictly follow all protocols – clinical and non-clinical. We must adhere to Government and WHO policies. We must stay home and quarantine ourselves in case of a confirmed exposure or develop mild symptoms. We must not take any unnecessary risk with ourselves or with our patients.
Keeping in mind these things, your journey through the pandemic will be a smooth one, if not a great one.