Operational Considerations for Hospitals During the Coronavirus Pandemic

Harry Greenspun, MD & Charles Peck, MD

As the coronavirus pandemic continues to unfold, the essential role that hospitals and health systems play in communities nationwide has never been more apparent. While the list of needs is long, following are high-priority operational areas central to provider success during and after this or any pandemic.

Accessing government funding

Given the enormous task of responding to the pandemic, hospitals are facing unprecedented financial challenges amid new costs and lost revenue as they care for their communities.

The federal government has created several funding mechanisms to help hospitals mitigate these financial headwinds, but providers must act now to properly document and track “but for” costs – costs that would not have been incurred but for COVID-19. Examples include added security, overtime, supplies, contract workers, expanded clinical sites, and policies that caused cancellation or delay of elective procedures.

The Federal Emergency Management Agency (FEMA) funding made available through the president’s emergency declaration will reimburse qualified organizations for much of their emergency response cost – but only if their application for funding is properly structured and timely presented to their state emergency management agency. Reimbursement delays can be expected for organizations unable to present their claim in the FEMA-prescribed manner: Stafford Act-compliant and free of disallowed costs that require time-consuming review and revisions. As such, COVID-specific codes and accounting policies must be implemented to ensure maximum and timely reimbursement.

In addition, Congress authorized nearly $200 billion (with more likely to come) to address both current and future pandemic risks. We anticipate an unprecedented opportunity for organizations to make necessary changes to physical plant and technology infrastructure through additional legislative action to address current and future needs.

Providers that have engaged in comprehensive pandemic process mapping and coding engagements will be best positioned to receive maximum funding for extensive infrastructure requirements.

Protecting your cybersecurity posture

With IT staff stretched to the limit (and many quarantined), we’ve already experienced multiple coronavirus-related cyberattacks on providers and government entities. More can be expected as government guidance to the US workforce further restricts use of existing corporate operational infrastructure and compels an even greater number of employees over long periods to work remotely.

Providers must focus on protecting their most critical assets: their workforce, data and networks, and patients.

As Guidehouse’s Marianne Bailey, a former NSA and Pentagon cybersecurity executive, suggests in this interview, organizations need to “double down” on cybersecurity best practices –have disaster recovery plans and making sure there are backups of critical data. This includes focusing on such basics as ensuring software patches are up to date, utilizing effective asset management to know what devices are on a network, and enabling identity management protocols such as multifactor authentication for all end users. Moreover, providers need to aggressively communicate with employees, educating them on phishing and social engineering defense tactics.

Maintaining supply chain operations

Organizational preparedness and response have been severely hampered by supply chain disruptions. Supply chain professionals should be focused on identifying, categorizing, quantifying, and prioritizing supply chain risks and mitigation plans to minimize disruptions.

This includes:

  • Assessing existing inventory viability, availability, and immediate vulnerabilities.
  • Identifying both suppliers at risk of not fulfilling delivery obligations and alternative suppliers to support needs.
  • Allocation planning for clinical supplies, drugs, and equipment, as well as adapted management controls and decision-making support for resource assignment.

Supplier disaster recovery and pandemic management.

Also, once current conditions stabilize, providers should develop preparedness plans and contingencies for the next time a crisis arises.

Optimizing staffing, throughput, and telework

Amid rapidly changing work environments, operational leaders need to apply processes to create capacity, enhance resources, and reconfigure demand planning and workflows. For example:

  • Tracking workforce status and capacity in real-time to enhance human resource assignment to mission-critical activities as overall capacity changes daily.
  • Creating flex teams to accommodate new resource availability constraints.
  • Identifying OR schedule configurations and shifting appropriate elective cases to alternative sites.
  • Streamlining access to emergency services and throughput by revised triage protocols and reconfiguring fast-track areas/functions.
  • Unlocking unused or under-used capacity and reconfiguring to current highest and best use

For hospitals and health systems, providing optimal care to the communities they serve is always job one, and even more so during times like these. While physicians and clinicians will inevitably serve their communities first, non-clinical leadership must focus on ensuring their organizations maintain operational performance.

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