Crisis Management in Healthcare – Adapting to COVID-19

05/26/2021

From staff shortages and funding concerns to seemingly endless procedure backlogs, crisis management during the COVID-19 pandemic has been relentless. Healthcare decision-makers across the world have heroically risen to the challenge and consequently helped save many lives. However, the costs associated with managing healthcare emergencies has totaled billions of euros, and it continues to rise. With finances dwindling and thousands of elective procedures postponed over the course of the last year, how can hospital organizations be expected to manage? The pandemic has shown us that operational flexibility is key to crisis management, so can combining flexibility with digital and advanced medical technologies help clear the patient backlog – and at the right price?

Ear, Nose, Throat, General Surgery, Gastroenterology, Urology, Gynecology, Pulmonology
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The staggering scale and severity of the COVID-19 pandemic has led healthcare systems to make substantial changes to how they operate. In order to maintain a high standard of care during the pandemic, hospitals have had to make important decisions on how to optimize funding allocations, staff hiring and pay rates, and also ensure adequate PPE supplies. With healthcare professionals (HCPs) working longer hours and experiencing higher levels of stress than ever before, hospitals and clinics are also providing vital mental health support to frontline staff.

Robust crisis management strategies are crucial for hospitals to adapt to the changes brought about by the COVID-19 pandemic. Implemented by hospital organizations, these strategies involve increased usage of digital solutions for staff training and patient education, as well as adoption of advanced medical technologies that ease the significant burden placed on clinicians. By introducing greater operational flexibility and a more supportive system for staff, hospital organizations are helping HCPs to maintain a high quality of care during this unprecedented situation.

Three ways healthcare systems have adapted to the pandemic

Improved funding
To support healthcare systems in their battle against COVID-19, governments across Europe increased the amount of funding provided to critical services, developing large financial packages. These ranged from an extra €326 per person in Lithuania, to between €60 - €100 for larger economies including Spain, Italy France and the UK 1. The majority of this increased funding was distributed by hospital organizations to finance increased testing capacity, ensure sufficient PPE supply and to provide additional wellbeing services and financial support to staff.

In April 2020, the European Commission mobilized €3 billion in funding from the EU budget, channeling €2.7 billion through the ‘emergency support instrument’, which has been used to finance vaccines and treatments against COVID-19 2. Other uses of emergency support instrument funding include €2.5 million for training of a multidisciplinary pool of 15,000 HCPs in 700 hospitals to enable them to work in intensive care units, and €12 million for 200 UV disinfection robots which can sterilize patient rooms more rapidly than existing methods.

Creation of extra capacity
The surge in patient numbers seen in 2020 led healthcare systems to increase the capacity of their hospitals and in total, more than 70,000 additional intensive care unit (ICU) beds were created in Europe during the first wave of the pandemic 2. Most countries converted general purpose or other clinical wards into ICU wards, and many also opted to postpone non-urgent elective surgeries – freeing up a huge number of hospital beds. The creation of military field hospitals in countries including Estonia, France and Italy, as well as conversion of non-medical facilities into ICUs in Croatia, Ireland and Germany also helped increase capacity 2.

Rapid and flexible staff recruitment
To relieve the pressure on existing staff struggling to handle the increased number of COVID-19 patients, many European countries enacted emergency measures that enabled temporary registration of new staff 2. This included medical and nursing students, doctors in training, inactive and retired healthcare professionals and foreign healthcare workers.

The ongoing challenge of procedural backlogs

Collateral effects of COVID-19
While the large-scale operational changes implemented during the pandemic helped healthcare systems effectively handle the increased number of patients, there have also been long-term consequences on healthcare services. Staffing changes, the postponement of elective surgeries and the conversion of wards to ICUs in early 2020 created a backlog of non-urgent elective procedures – and although many countries resumed elective surgeries in mid-2020, thousands of patients across Europe are still waiting for treatment 3.

An important factor contributing to these procedural backlogs is the ongoing redeployment of staff with transferrable skills such as junior surgeons and theatre nurses. As well as transferring workers to different hospital departments to care for COVID-19 patients, staff have also been redeployed to different regions within their own countries, further exacerbating the situation 2.

Digital solutions are helping tackle the challenge of procedural backlogs
With recent developments meaning greater remote engagement, patients may require new ways to communicate with their HCPs. Digital platforms, including websites and mobile apps educate patients, and enable them to stay informed and up-to-date on important developments.

An example of one such platform is the Digital Education Solution (DES) from Olympus and Inhealthcare, developed for patients awaiting endoscopy procedures. This digital solution aims to increase NHS diagnostic capacity in the UK, where data shows that endoscopic activity fell by 95% during the peak of the COVID-19 crisis 3. This system provides personalized patient support and engaging educational materials in an accessible digital format. It helps to improve health outcomes, reduce missed appointments, support earlier diagnostics and ease the strain on overstretched hospitals.

Advanced medical technologies offer further support
There are concerns that the widespread diversion of hospital resources to fighting COVID-19 has had a negative impact on the quality of care for other diseases such as cancer. For example, UK studies suggest that the reduction in the number of colonoscopies performed between April and October 2020 resulted in 3500 fewer people being diagnosed and treated for colorectal cancer than would have been expected in that period 4.

To support clinicians in accurately diagnosing these patients, Olympus provides advanced endoscopy systems such as EVIS X1. With features like Narrow Band Imaging (NBI) and ENDO-AID CADe for computer-aided lesion detection, EVIS X1 aims to improve Adenoma Detection Rates (ADR) to help reduce the number of biopsies required. By providing an accurate and efficient tool for adenoma detection, EVIS X1 may also shorten patient hospital visits and ultimately helps to reduce the procedural backlog faced by hospital organizations.

Operational flexibility is key to effective crisis management

Procedural changes have affected care capacity
While vital to prevent disease spread, procedural changes have in some cases, had the unintended effect of reducing the volume of care that can be provided by hospital services. For example, infection prevention and control (IPC) recommendations for full PPE, patient flow and room cleaning are predicted to reduce the capacity for procedures such as endoscopy by more than 65% 5. This is a huge concern for HCPs that affects patients and in turn healthcare management.

Implementing robust COVID-19 screening procedures is one important way that hospitals can help ease the burden on HCPs, enabling them to maintain a higher volume of non-COVID related critical procedures in spite of changing infection control guidelines.

Medical solutions providers are supporting the transition to new or modified procedures

In many cases, HCPs have also had to adapt medical procedures to meet newly imposed COVID-19 measures. Through ongoing assessment of staff expertise, hospital administrators can identify where staff may need training on a new or modified procedure, and ensure a high standard of care during periods of high patient numbers, and in situations where existing staff have been redeployed.

The pandemic has highlighted the value of industry-healthcare partnerships for staff training, and medical systems providers are increasingly supporting HCPs with education and training on advanced medical procedures and the safe & effective use of products.

One example is Olympus Continuum, which is an online portal that offers a range of professional education programs and medical expert training to help HCPs broaden their clinical expertise and deliver high levels of patient care and safety.

Digital solutions can support staff training
Advances in virtual healthcare are also benefiting HCPs, with telemonitoring platforms such as MedPresence from Olympus enabling remote collaboration during surgical operations. Providing essential tools for medical training, these systems enable the secure access to external experts and maintain social distancing to reduce the risk to patients and HCPs.

Summary
While the speed and severity of the COVID-19 pandemic took the world by surprise, healthcare systems have responded by making rapid and profound changes to how they operate - saving lives and protecting key workers.

In addition to providing advanced medical equipment that increases procedural efficiency, partnerships with medical technology providers - such as Olympus - give hospital organizations much-needed support during difficult times. Whether this involves training for HCPs on new or modified procedures, or using digital solutions for patient education, these crisis management strategies can help hospital organizations decrease their procedural backlogs, and ensure that we are better protected and more prepared than ever before to tackle the spectre of infectious disease.

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References

  1. 1.How much additional money are countries allocating to health from their domestic resources? WHO Published 2020. Accessed March 24, 2021.
  2. 2.Health at a Glance: Europe 2020 State of Health in the EU Cycle. OECD and European Union OECD Publishing; 2020
  3. 3.Too long to wait: the impact of COVID-19 on elective surgery The Lancet Rheumatology Lancet Rheumatol. 2021
  4. 4.Impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England: a population-based study. Morris EJA, Goldacre R, Spata E, et al. Lancet Gastroenterol Hepatol. 2021
  5. 5.Safely restarting GI endoscopy in the era of COVID-19. Hayee B, Thoufeeq M, Rees CJ, Penman I, East J. Gut. 2020;69(12):2063-2070. doi:10.1136/gutjnl-2020-321688