How to Achieve Hospital Resilience, Prepare for Future Health Crises

Experts have laid out how hospital resilience can help health systems be prepared for future challenges.

During the height of the COVID-19 pandemic, nearly half of US hospitals operated at more than 85 percent capacity at one point. Many hospitals were not prepared for the influx of patients and consequently struggled to maintain standards of care due to increased patient-to-staff ratios and increased demand for care.

However, not all hospitals experienced disarray when the pandemic hit. Some hospitals continued to provide quality care and were unfazed by the increased patient volumes, the JAMA Network report noted.

The traditional approach for hospital pandemic response revolved around the framework of staff, stuff, space, and systems. This required making sure there was enough healthcare professionals, obtaining necessary medications and supplies, having rooms available for patients, and having the right systems in place to integrate these resources.

Data shows that many hospitals followed this framework, but it was not enough to prepare them for the COVID-19 pandemic. Experts from the University of Pittsburgh suggested that hospitals employ organizational resilience in order to prepare for any future possible COVID-19 surges.

A hospital using organizational resilience in the face of COVID-19 would first ensure that COVID-19 patients are placed in appropriate well-staffed units to receive treatment. If no units are available, then the hospital staff should transfer the patient to another hospital that has available resources. This requires health systems to build positive working relationships with other surrounding hospitals.

Hospital resilience requires staff who will recognize that non-COVID-19 patients should still be able to access care. Hospitals should have a plan for continuing healthcare delivery for cancer care, cardiac care, trauma surgery, and elective surgeries in addition to treating COVID-19 patients.

Resilient hospitals should also prioritize their frontline workers’ physical, mental, and emotional well-being through all of this.

In order to achieve this resilience, hospitals may need to implement several operational changes.

“Well-developed, scalable clinical protocols, such as those that guide the management of patients who require mechanical ventilation, could enable evidence-based care under different staffing models or in unfamiliar care locations,” JAMA researchers wrote. “Flexible electronic health records could allow hospitals to quickly implement and iterate on new care pathways in the face of novel diseases with evolving best practices.”

Hospitals should also foster a supportive working environment where staff members feel comfortable sharing ideas and concerns under the direction of transparent leaders.

The idea of hospital resilience is not for health systems to prepare specifically for the COVID-19 pandemic, but rather to lay a stable groundwork for a hospital that can easily adapt to whatever challenges approach.

“Resilient hospitals have more degrees of freedom, allowing them to consider a range of solutions to each problem and quickly pivot when a preplanned strategy is not working,” the report explained. “The hospitals could then rapidly and effectively implement novel solutions instead of simply relying on preplanned solutions that might not fit the current problem.”

Instead of stocking up on personal protective equipment and ICU beds, hospitals should make changes that will be useful during a crisis but will also benefit them during normal day to day workflows, such as sturdy supply chains and systems for coordinating operations across hospitals.

Comprehensive hospital resilience will benefit health systems better than targeted preparedness will when it comes to facing a public health crisis, the report concluded.