Four Keys to Great Communication in COVID 19
Era for Post Acute Care

In these hectic times, communication becomes more important than ever. Frontline healthcare providers need both factual information and emotional support in a regular flow. Effective leaders will distinguish themselves now by providing appropriate context for communications, using best practice tactics and deploying leading edge tools. Even if you’re already “in the thick of it”, there’s time to take a deep breath and assure you are communicating well.

PROVIDE CONTEXT AND SUPPORT

Watch your language: In uncertain times, teams look to leaders to pull teams together with resolve and steadiness. Choose your words carefully using “we” instead of “I”. Show empathy and compassion for your team. Focus on forward looking actions that deliver progress. Avoid words like “struggle”, “fear”, and “worry”. When communicating a problem, use “U turn words” like “although”, “nevertheless”, “on the other hand”, “in contrast”, “yet” that demonstrate strength in the face of challenge.

Build trust to maximize communication: Remember that communication is a receiving phenomenon. What individuals receive and hear is based on their mindset and ability to process information. By following through on commitments, leaders build trust and lower the level of anxiety inherent in challenging situations. Listen for concerns and share solutions and commitments to solve problems. Invite collaborative problem solving to avoid the expectation that people wait for someone else to resolve issues. Underpromise and overdeliver.

Focus on your organization’s actions: In times when it appears things are out of our control, it’s helpful to demonstrate concrete progress. Highlight where your team is reducing risk. Share where mandates are being implemented quickly. Build a picture of step by step actions over time demonstrating progress. Make sure that the latest Covid19 best practices are being shared and fully implemented. Give a clear plan and follow through. The plan should be adjusted as new information comes communicating “here’s what we learned and here is what we are doing now”.

Provide emotional support and encouragement: Staff need to be appreciated when they are going above and beyond. A few words of gratitude and care go a long way in reinforcing their energy. Every communication should include thanks for the extra effort required to manage through the challenges of the crisis. Families are also under tremendous stress and will need regular communication to cope with the challenges.

USE BEST PRACTICE TACTICS

The Virtual Daily Update/ Standup: To keep the teams on the same page, start each day with a quick 10-30 minute huddle of relevant work groups to give everyone the relevant developments of the last 24 hours. Invite questions and idea generation that might be teed up today and followed up tomorrow or in weeks to come. These can be via conference call, Zoom, Google hangouts or other means. The 

“Daily” standup may need to be “Twice a Day” in buildings with may patients with quickly changing status.

Action Teams: If an idea for improved care or safety comes up in a Standup that requires more than a couple of minutes to think through and implement, assign an accountable person or team to follow up and share the plan following the Stand Up. It’s okay for those teams to come back and say, “We checked it out and it’s not an opportunity for now because (we don’t have the resources, we can’t do it effectively right now, etc.). We’ll revisit in the future when the situation changes.”

Virtual Town Hall Meetings: At least monthly, have the whole cross functional team together. Even while we are practicing social distancing, virtually bringing the team together matters. Make sure referral partners, front line aides, therapists, nurses and the whole team can share questions and ideas. Leadership can communicate the path forward and provide the necessary context for the team to pull together

Cascading Messages: The most credible information comes from direct supervisors who have the messages their team needs. A quick email, handout, or text letting them know the key things to share with their team helps them feel knowledgeable, aligned with their team, and on top of the plan. Supervisors may need to spend more time communicating one on one to hear staff out on fears and manage concerns.

Coordinating Patient Centered Care: Assure the complete team is in the loop on relevant patient information.

Want to share information across organization quickly?

COVER KEY COVID19 CONTENT

Department of Public Health Guidance: Make sure your team is following the latest mandates for handling Covid 19.

  • PPE requirements
  • Isolation expectations
  • Hospital capacity and positive case trends
  • Alternate care sites and transfer plans 

Reiterating the “basics” of infection control: You cannot remind people often enough how to reduce risk with fundamentals of environmental cleanliness, isolation, appropriate PPE use, and healthy behaviors like hand washing, avoiding touching the face,6+ feet social distancing and using hand sanitizer. Staff traveling from location to location should be reminded to change clothes, particularly before entering a COVID19 Naive environment. There are enough fun memes being created to keep this new daily!

Hospitalization warning signs: Covid 19 patients and PUIs need close monitoring for the following:

  • Difficulty breathing (O2 saturation<91% or a decrease of 3% or more)
  • Increased respiratory rate
  • Muscle aches, malaise, and diarrhea may be indication for increased monitoring to avoid rapid decline
  • Altered state/ cognition below baseline may also require increased monitoring
  • New Confusion or inability to arouse
  • Bluish lips or face
  • New seizure or seizures that won’t stop
  • Comorbid conditions increasing risk include Hypertension, Diabetes, chronic respiratory disease, cancer

Who is NOT eligible for hospital transfer: Reminders may also be helpful to avoid unnecessary hospitalizations when staff might be likely to over-react. Your policies may vary, but clarity such as the following is important:

  • Hospice patient flags should follow end of life wishes to avoid hospitalization
  • Anyone with advance directives inconsistent with hospitalization should remain in place
  • Testing for Covid19 alone is not a valid reason to hospitalize

DEPLOY LEADING EDGE TOOLS

While it may seem a challenging time to use new tools, it’s essential to save your team time and effort going forward. When everything changes every day, it can be a positive change to add a powerful new tool.

Telemedicine Solutions: As mentioned above, there are a variety of inexpensive ways to virtually communicate with teams. Some of the most cost effective and easy to deploy are ZoomGoogle Hangouts, and Webex.

HIPAA Compliant Messaging: As a complement to many of these best practices, HIPAA compliant text messaging can improve communication. Hucu.ai is being used effectively to support many of these practices:

  • Notifications so nothing is missed when there are updates including the ability to tag specific people or teams
  • All team channels including #resident-mgmt, #staff-mgmt. #ppe, #environment-mgmt, #visitor-mgmt, #qapi, #supplies-mgmt, and more
  • Direct messaging to individuals to offer encouragement and support
  • Hucu Honors to recognize staff for high quality behaviors
  • Patient lists prioritized based on flags, condition and communications
  • Patient centered messages including
    • Flags based on risk such as Covid-19 PUI/ Covid-19 +ive/ Covid-19 -ive, Acute Change in Condition, and more
    • Ability to upload images and files for labs, medication lists, and more
  • Ability to launch telemedicine session with a click

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