Much of the attention in radiology literature during the recent COVID-19 outbreak has focused on imaging findings and infection control measures. But one group of veterans said leaders must not lose sight of the “people” aspect of their response as this situation continues to unfold.
A team of scientists from one tertiary hospital in Singapore recently detailed their learnings from both 2003’s SARS spread and the new coronavirus in 2020. Lead author Lionel Tim-Ee Cheng emphasized that radiologist managers cannot overlook the importance of their staff, including ensuring that they’re not becoming burned out during these stressful times.
“The role of radiology services during an infectious disease outbreak often focuses on identification of the infection through imaging,” Cheng, with the Department of Diagnostic Radiology at Singapore General Hospital, and colleagues wrote March 4 in the American Journal of Roentgenology. “Beyond this, radiology departments must also be nimble in implementing operational changes to ensure continued radiology services, protect patients and staff and maintain staff morale during a sustained outbreak. People are the most valuable resource during a crisis, and it takes the concerted effort of every staff member to meet the challenges of an outbreak.”
To aid in this task, Cheng et al. offered up four specific steps that radiology departments around the world can take to keep an eye on their people during response efforts:
1) Ensure rapid sharing of accurate and useful information: Aware that the hospital was “only as strong as our weakest link,” the organization made sure to quickly disseminate info to all radiology staffers at the outbreak’s start. This included meetings, emails and smartphones—with the latter providing new assistance that was not available back in 2003.
Cheng and colleagues said it’s crucial not to miss any team members, with Singapore hospital “inadvertently” overlooking a few in its initial information push, including research assistants and part-time staffers. “There is also a need to quickly address false rumors so that personnel have the correct information to work safely,” they added.
2) Confirm that infection prevention and control knowledge and practices are up to date: While many at Singapore General were already familiar with their duties because of SARS, refresher courses and videos were also provided to “bring everyone up to speed.” Thanks to that previous experience, many were already fitted for N95 masks, with a select few needing resizing. All staff members also already attended annual infection prevention and control education, they noted.
3) Create new hybrid working teams: Back in 2003, they established a shift system, used to help prevent any cross-infection between teams at different locations. With growth in the department since then, Cheng and others have updated the plan to incorporate new sites that include a mix of subspecialty expertise. Resident rotations have been halted, they added, until risk of transmission becomes clearer. And tools such as PACS and radiology information systems allow for the “remote provision of services.”
“The updated cohort plan is also applied to all other staff members including radiographers, nurses, and other health care support staff,” Cheng added. “We are also activating back-up teleradiology plans to allow radiologists who may be quarantined to report from home.”
4) Manage emotions during adversity: Beyond the more technical aspects, “radiology leadership must address the emotional response of staff,” the authors emphasized. Though many experienced SARS veterans were cool and calm, others admittedly have suffered post-traumatic stress. Newer staffers, meanwhile, have displayed emotions ranging from indifference to “near panic.”
For leaders, the advice is to share those past experiences with newer staffers. “It is reassuring to hear a SARS veteran say, ‘I know [personal protective equipment] works because I treated SARS cases while wearing PPE, and that is why I am still alive today.’”
Departments also must pay special attention to those with concerns such as pregnancy or young children at home.
“The radiology leadership mantra is not only ‘wear PPE and clean your hands’ but also ‘look out for each other,’” the authors wrote. “Beyond informal ground-level staff support initiatives, official staff welfare groups in our department and hospital are ramping up efforts to actively manage increased staff stress levels during this time.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.