Prescription for Change

The Polyclinic expanded its staffing to see 25x as many patients—overnight. Here's how.

by Eliza Campbell

When the new coronavirus epidemic first struck, many organizations were unprepared to quickly pivot their legacy care team models to respond to an influx of Covid-19 patients. As physician executives look to the future, it's clear that change will be constant, and organizations that adopt agile approaches to staffing will be better prepared to weather future surges.

The 4 key imperatives for your Covid-19 staffing strategy

Read on to learn how The Polyclinic, an independent multispecialty group based in Seattle, has adopted a flexible staffing model in its acute respiratory clinic (ARC) to respond to future Covid-19 surges.

Scaling staff up (or down) based on Covid-19 volumes

Like many organizations, The Polyclinic dedicated a separate clinic for patients with upper respiratory symptoms, called its acute respiratory clinic (ARC). However, as the organization set up the clinic, leaders recognized the need for more agile staffing, and intentionally designed their staffing to expand and contract relative to Covid-19 volumes.

Specifically, The Polyclinic aims to staff one provider and one medical assistant (MA)  for every 20 to 30 patients in the ARC. It also staffs a few nurses in this clinic to help with infection control and hospital admissions. The Polyclinic asked primary care and acute care providers (physicians and APPs), given their existing expertise, to run the clinic, but it also pulls MAs and nurses from other specialties with lower volumes, such as surgery.

To right-size staffing, The Polyclinic's incident command center meets every morning to process the latest testing and review data from across the organization. Based on projected Covid-19 volumes, the organization scales staffing in the clinic up or down. This data also helps The Polyclinic determine where to shift providers and staff across the organization to meet evolving patient demand.

For the past two months, Covid-19 volumes have been consistently low, so The Polyclinic has shifted staff from the ARC to other specialties where visits are starting to rebound. Right now, it has allocated one to two providers to the ARC, but at its peak, The Polyclinic ramped up to see close to 200 patients per day, and was prepared to see an additional 300 patients if needed.

Equipping providers and staff to quickly redeploy

The key was proactively training as many providers and staff as possible when Covid-19 first hit so that the organization had a large, flexible staffing pool to pull from if Covid-19 volumes continued to climb.

The Polyclinic put together a centralized training program for providers and staff focused in two areas:

  • PPE and safety protocols: During the initial surge, The Polyclinic held twice daily trainings for two to three weeks to make sure that everyone working in the ARC knew how to properly put on and take off their PPE. The group's infectious disease specialist led a one-hour, in-person training to demonstrate how to properly don PPE. Anyone new to the ARC receives this training 30 minutes before his or her first shift.

  • Workflow processes and updates: The ARC's workflows are constantly evolving as The Polyclinic identifies more efficient ways to run the clinic (e.g., patient self-swabbing). To keep everyone up to date, the organization opted for virtual over in-person training. Leaders compiled an online presentation that houses the most up-to-date workflows for the ARC. It's saved in a central location alongside other tools and resources that providers and staff are expected to familiarize themselves with if they're redeployed to the ARC.

So far, The Polyclinic has trained 85 primary care and acute care providers to work in the ARC. While the organization prefers to deploy providers from primary care and acute care, it's also trained 40 specialists who are prepared to step in if Covid-19 volumes spike. To streamline re-deployment, The Polyclinic regularly updates a centralized spreadsheet that lists all the physicians and staff who have been trained and can staff the ARC if needed.

While Covid-19 volumes are low right now at The Polyclinic, the work it put into codifying its training and workflows will allow the organization to quickly scale staffing back up, if cases increase again.

Now is the time to prepare your workforce for a potential second wave

Though the future of Covid-19 may feel uncertain, there are four concrete steps that organizations can take now to build up a large pool of flexible, well-trained staff and providers to respond to future surges:

  1. Update your roster of providers and staff who are willing to redeploy if needed;

  2. Continue investing in training and proactively equip your workforce with needed skills now;

  3. Codify and update Covid-19-specific workflow protocols; and

  4. Overcommunicate with providers and staff who may need to redeploy again in the future.

Learn more: The 4 key imperatives for your Covid-19 staffing strategy

Over the past month, Advisory Board researchers have talked to dozens of clinical executives about how they're staffing for Covid-19—from those readying for a surge to organizations already on the other side of their market's apex.

Advisory Board's Lauren Rewers outlines four lessons learned that all clinical executives should keep in mind as they customize their organization's Covid-19 staffing strategy.

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