Providing a safe work environment is a baseline engagement requirement for health care employers. So organizations must continue doing all they can to secure needed PPE, testing supplies, and other materials to safeguard frontline staff. But effort alone, even successful effort, will not ensure staff feel safe amid Covid-19. We are still learning about this disease. Consequently, safety standards are evolving pretty rapidly, and providers cannot address safety concerns by meeting well established norms. Additionally, staff may not fully appreciate choices being made in pursuit of these moving safety targets.

Right now organizations must pair robust efforts to meet evolving safety standards with heightened transparency. It’s not enough for staff to have PPE today; they need to know what you’re doing to ensure they have PPE tomorrow. And it’s not enough to implement a new safety standard; staff must know why you’re implementing that particular standard instead of others.

Does every team member know how you’re handling…

…decision-making? Who is making decisions about the organization’songoing approach to safety? Why are they well qualified to do so?

…sources of evidence? Which external guidelines are you using to guide decision-making? (e.g., state guidelines, the CDC’s, and WHO’s? Another combination?) If there are areas where your organization has chosen to do more than required by minimum guidelines, make sure staff know about those instances.

…PPE procurement? What efforts are you making to ensure a sustainable supply of PPE? What does the current supply look like?

…communication? When will staff receive the next update on safety protocols? How will it be communicated? (i.e., email, start-of-shift huddle, another channel)

Lastly, addressing these questions in a dedicated meeting or communication will not be sufficient to ensure staff are and feel safe. Again, the risks created by Covid-19 are fluid. Supply constraints are changing; local virus prevalence is fluctuating; and safety standards are evolving. So what steps your organization is taking to keep your staff safe and why must be a routine focus area in your meetings and other staff communication channels.

The organizational agility shown by providers in response to Covid-19 is truly remarkable. Most health systems acknowledge they instituted changes in weeks that typically would have taken months or even years. The urgency of Covid forced health systems to dramatically streamline how they make decisions, often using principles from crisis management and process improvement. Many of these changes merit consideration for long-term adoption, as the agility shown in response to Covid will be needed to excel in a transforming market.

However, there has been a downside to such streamlining. While new incident command structures often pulled select line staff into decision-making groups for specific matters, many health systems have had to pull back on the richness of broader staff-input channels. Decision windows were simply too narrow to hear and incorporate general input, and staff often weren’t available.

We urge health care organizations to reinvigorate broader staff input channels as Covid-19 transitions from a daily, all-hands-on-deck crisis to a challenging new normal. Having meaningful input opportunities is a top engagement driver among health care workers, particularly on decisions directly impacting their workplace where there are no well established norms.

Additionally, reinvigorating such channels should not require outsized effort at most institutions. It means taking relatively small measures like: blocking chunks of town hall meetings for Q&A and feedback and not allowing other agenda items to crowd into this time; recommitting to leader rounding and asking the type of probing questions that indicate you really want to hear what staff members have to say; and proactively seeking input from employee councils on safety and other measures impacting staff and their patients.

The one area that might require new investment is “closing the loop”– putting in place resources and processes to ensure contributing employees know they’ve been heard and what action is planned, or not planned. While staff members no doubt want their guidance heeded, this isn’t always feasible. But making sure staff feel heard on matters impacting them is, and this alone will bolster engagement and often engender support for whatever decision is ultimately made.

To assess the status of your organization’s staff input channels, consider applying the two-part litmus test below. “No” to either question suggests an opportunity to strengthen feedback channels.

Health system leaders must walk a fine line between inspiring the workforce to look forward to a better future while acknowledging the brutal economic realities organizations face today. It’s tempting to tilt toward rallying the workforce around a hopeful, future vision versus dwelling on current challenges. However, this sugarcoated approach backfired during the last recession with a wide range of staff and is unlikely to bolster engagement now for the same reasons.

Most organizations face numerous tough trade-offs to sustain their own health and vitality. Staff who don’t fully appreciate the dire business realities your organization must navigate will be confused by and possibly push back against balances you strike. And staff who do appreciate these realities will worry about whether their leadership team truly ‘”gets” what their organization is up against.

A more effective narrative can and should include hope for a better future but must also directly acknowledge how challenging current financial circumstances are.

Right now in particular employees need to trust that their leaders clearly see the challenges ahead and have a compassionate vision and roadmap to overcome them. This starts with leaders and staff sharing a common perception of market realities. This doesn’t mean, however, simply sharing boardroom materials at town halls. Executives most effective at creating this shared perspective invest in crafting presentations and other materials specifically for frontline staff, which build upon their market awareness and address their personal concerns.

The fastest way to destroy trust is making a promise you can’t keep. Unfortunately, heeding this cardinal rule can be remarkably difficult for executives facing daunting challenges who care about their people. You simply want to tell them to stop worrying about more far-fetched concerns. The best way to guard against over-promising is planning how you would manage the worst-case scenario.

The most effective scenario planning considers three worsening levels and fixes responsive action steps and trackable action triggers for each.

Equipped with such a plan, leaders know what bedrock commitments you can make to the workforce. You also know when your organization is approaching the next tier of counter-measures and can ready your staff for more invasive moves in a timely fashion. Stopping short of giving staff assurances they understandably seek may feel unpopular in the moment. However, staff are far more likely to trust and follow leaders who consistently promise what they can and are realistic about uncertainties.

Media attention has rightly focused on frontline staff’s tremendous efforts to care for patients amid Covid-19. We must also acknowledge the toll on their managers and directors. They are key influencers of frontline engagement as well as the lynch pins for effecting change at most health systems.

Too many leaders at all levels are operating in an unsustainable 24/7 “sprint” mode. This crisis has no clear end. Leaders cannot keep managing their energy the way they would through an acute disaster. They must instead start operating in “marathon” mode and managing their energy in a more sustainable way.

Executives should take the lead in helping managers and directors make this shift. At a minimum, top priorities must be re-clarified for our new normal and a meaningful number of ongoing initiatives placed on a stop-doing list. To assess your room for improvement here, ask yourself these questions:

How are you helping leaders make the transition?

What have you given leaders explicit permission to de-prioritize, or stop doing altogether, to free up time and energy to lead through the pandemic?

Does every leader know you expect them to actively prioritize their own wellbeing right now? How are you confirming each leader received the message?

How are you modeling taking care of yourself?

Additionally, now is the time to invest in targeted leader development, notwithstanding economic pressures. There is no playbook for leading through this pandemic. Managers, directors, and leaders at all levels need help building their capacity to recognize maladaptive responses to stress, lead through uncertainty, discuss racial inequity, and inspire through authentic communication.