Building the ‘New Normal’ beyond COVID-19

 

Acting as a radical disruptor to the ‘normal’ way of doing things, the COVID-19 pandemic has accelerated transformations within healthcare at an unprecedented pace. Never have hospitals and healthcare organisations been forced to change so radically in such a short period of time. We have seen critical care services being run virtually using digital technologies; organisations rapidly up-skilling staff and mobilising volunteer carers at scale; the breaking-down of workplace silos to ensure patients receive integrated care; creative architectural solutions to manage flows of people in and out of hospitals as part of infection control.

 

These changes have, in many instances, incorporated a fundamental redesign of services, with profound implications for both staff and patients. Although the prime catalyst for changes has been the urgent need for COVID-19 infection control, it is notable that some of these have long been priorities for healthcare systems, on which there had been limited progress prior to the pandemic. The pandemic has provided a new context that allowed previously long-held assumptions and norms about how care should be delivered to be urgently re-examined and, if necessary, changed. To support its community to realise the benefits of these changes, the International Hospital Federation established the IHF ‘Beyond COVID-19’ Task Force.

 

Drawing directly of the experiences of Task Force members and their networks, the IHF has published a new report offering insights into how hospitals can embrace new ways of delivering healthcare, whilst responding to the evolving coronavirus pandemic: ‘Building the ‘New Normal’: Harnessing transformative practices from the COVID-19 pandemic. A selection of detailed case studies accompany this publication (listed below), offering further depth to the transformative changes included the report.

TRANSFORMATION CASE STUDIES

Click on the tabs below to view individual case studies

+ HEALTHCARE DELIVERY AND ACCESS

Electronic Intensive Care Units: an innovative model of critical care delivery

Telehealth is well-positioned to help health systems combat professional staffing shortages. Globally, the COVID-19 pandemic has exacerbated shortfalls in the healthcare workforce. Leveraging telehealth helps hospitals to optimise their clinical capacities as experienced by Apollo Hospitals (India), who implemented an electronic-ICU to overcome a nationwide shortage of critical care specialists.

Moving forward while staying at home: implementing a virtual rehabilitation model

Telehealth became an invaluable option for providing continuity in care during the coronavirus pandemic. This case study outlines how the experience of the Rehabilitation Department at Gillette Children’s Specialty Healthcare Centre (United States) in a adopting telehealth model to provide care and treatment for children and young people, who are at particular risk of COVID-19.

‘Teamwork makes the dream work’: harnessing interdisciplinary working

As demonstrated by the Hospital of St John of God (Austria) during the COVID-19 crisis, an interdisciplinary team approach presents an opportunity for on-going teamwork to enhance efficient, effective, and high-quality patient care. Such an approach is critical when dealing with complex patient cases – like coronavirus – requiring many forms of intervention across different clinical disciplines.

‘Medication at Home’: bringing healthcare services closer to the patient

Users of Pharmaceutical Services of the Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), in Portugal, are typically vulnerable or elderly patients. During the COVID-19 pandemic, many patients refused to travel to CHTMAD to collect their medication due to fears of virus transmission. Thus, a special service was set-up: delivering medicines to patients in partnership with local stakeholders.

+ SUPPLY, LOGISTICS, AND INFRASTRUCTURE

Beyond a hospital’s walls: establishing a ‘drive through pharmacy’

King Faisal Specialist Hospital & Research Center (Jeddah, Saudi Arabia) needed to minimise the risk of coronavirus transmission amongst vulnerable patients with chronic illnesses who historically had to travel to and wait for lengthy periods at the hospital to receive medication re-fills. The solution: establishing a ‘drive through pharmacy’ in a previously unused mobile unit, in the hospital’s carpark.

‘Traffic Control Building’: a model of infectious disease containment

In response to the COVID-19 pandemic, Taipei City Hospital developed the a ‘Traffic Control Building’ model to protect its healthcare workers and curtail in-hospital transmission. Implementing such a model meant that the hospital had to undergo logistical and infrastructural changes to the way that patients were screened prior to building entry, and were treated in different ‘zones of risk’ to virus transmission.

Building collaboration in sectors of supply chain management and purchasing

During the pandemic, GS1 Spain acted as the backbone of the needs and difficulties that public buyers in Spain were experiencing during COVID-19. Working collaboratively with its partners, GS1 Spain identified a lack of support for Spanish public buyers’ concerns about how to navigate the complex purchasing environment caused by the coronavirus crisis and implemented critical measures to overcome these concerns.

Adapting hospital capacity to meet changing patient demands

A key priority of Finland’s COVID-19 response was to provide sufficient medical care to patients, including sample taking, emergency department capacity and critical care provision. These activities had to take place in parallel to treating other emergency and urgent care patients. With no extra personal or bed capacity available to support COVID-19 patients, Helsinki University Hospital embarked on staff reassignments, reorganising service delivery and postponing non-urgent care to ensure sufficient medical care could be provided to their patients.

Centro Hospitalar e Universitario de Coimbra web

‘Command and Control’: managing supply chain risk and disruption in a pandemic

Coimbra Hospital and University Centre is one of the largest  hospitals in Portugal, distributed over six decentralised medical institutions and facilities, with 1,700 patient beds. One of CHUC’s challenges during the coronavirus pandemic was to successfully help assess and manage the hospital’s material needs in ‘real time’ in order to effectively purchase and allocate vital equipment, drugs, and consumables in response to an incredibly dynamic supply environment due to COVID 19.

+ PEOPLE

Making ‘virtual visiting’ a reality for critical care patients

The need for social distancing to prevent transmission of coronavirus is well understood, but a humane approach to visiting policies in hospitals need not be incompatible with an effective pandemic response. During the COVID-19 crisis, many hospitals – including a hospital trust in Cambridgeshire (United Kingdom) initiated ‘virtual visiting’ for the first time – using iPads and video conferencing applications to combat the loneliness and social isolation felt by patients by connecting them with their families and carers.

Valuing the workforce: implementing pay protection in a healthcare system

COVID-19 placed unprecedented pressure on people working in healthcare. To ensure that healthcare workers are available to meet the rapidly escalating needs of the coronavirus outbreak, it is critical that their ‘core’ needs are met. In the United States, the University of Colorado Hospital put in place a pay protection programme for their staff. By guaranteeing staff pay, UCH took a supportive, person-centred approach to ensuring its employees’ wellbeing during the pandemic.

Communicating with staff in a crisis

In response to COVID-19, Changi General Hospital (CGH) implemented infection control measures (e.g., segregated eating areas, split team arrangements, and working from home) which meant its staff could not socialise and bond as normal. This, in addition to the new stresses of an increased workload and being at risk of COVID-19 exposure, posed challenges to staff cohesion and togetherness. To manage this, CGH’s Internal Communications team implemented a three-pronged strategy to support staff through the coronavirus crisis.

Lights, Camera… Routine Appointments! Supporting patients via video consultations

Prior to COVID-19, patients at the Southport and Ormskirk Hospital NHS Trust (United Kingdom) receiving therapy as an outpatient would be seen, in-person, by a clinician. This support was restricted as part of coronavirus infection control, negatively impacting on patient adherence to treatment plans. Clinicians needed a way to in contact with their patients to support them through their outpatient journey. Thus, the Trust established a video clinic offering secure consultations for routine appointments through the digital platform.