EXECUTIVE SUMMARY

Healthcare workers across the care continuum are the pandemic’s unsung heroes, facing the risk of severe illness and death as they work to keep patients safe and healthy.

  • Despite exhaustion and fatigue, case managers and other healthcare workers are demonstrating resilience and a commitment to the human spirit.
  • Employers need to take care of their staff to help them remain flexible and to prevent malaise.
  • Safety is the first priority during the pandemic because safety creates confidence.

The COVID-19 pandemic has put healthcare workers in the spotlight, highlighting their heroism in the face of disease, severe illness, and death. Case managers are among the unsung heroes of the crisis, as they work to keep patients safe during transitions — sometimes in the face of daunting challenges.

“We’re seeing a lot of healthcare workers, first responders, and people on the front lines giving that extra effort, helping patients,” says J. Gerald Suarez, PhD, professor of the practice in systems thinking and design, and fellow for the Center for Leadership, Innovation, and Change at the University of Maryland.

Case managers and other healthcare workers demonstrate the resiliency and commitment of the human spirit. “But they’re feeling exhausted, chronically tired, drained, and that’s when the first part of case management begins to fall down,” Suarez says. “Being chronically fatigued is a gradual process: You begin to feel that slow, gradual sense of malaise.”

At some point, fatigue becomes explicit. That is when people can break down and make mistakes. “The integration of patient and provider satisfaction cannot be separated,” Suarez says. “Employers need to take care of their people so their people can take care of the patient.”

Individual case managers need to change continuously and become flexible so they can collaborate across functions. “The key is to maintain the constancy of purpose and the consistency of action because that will give you stability and reduce the variability in terms of the accuracy of care,” Suarez explains. “In other words, you’re changing people, and they become parts of the system you’re changing.”

Case management departments can facilitate resilience by looking at their organizations from a holistic perspective. If one part of the organization is not doing well, then the others cannot be doing well.

“This is relevant because we have too many disruptions, and the disruptions are creating tremors in every aspect of that organizational system,” Suarez says.

For example, in the emotional system related to employees and patients, hospitals and other healthcare providers are handling more medical complexities and challenges than they did before the COVID-19 crisis. “Some hospitals are over capacity,” Suarez says.

Stress can be gradual, often not obvious in its roots. “We tend to keep pushing ourselves to the point where it becomes explicit, and now we’re all in trouble,” Suarez says. “Leaders constantly reinforce their support and display authentic empathy and knowledge.”

This is a simple concept, but leaders must not be detached from what their employees are experiencing. “There is no place to hide from this pandemic; our stress is at home, and employees need a safe space where they can share their concerns without retribution,” Suarez says. “Employers need to be deliberate in offering them access to those conversations and to offer assistance so they can share.”

Employers should employ someone whose role is to take care of the healthcare providers. “Leaders must continuously ask themselves, ‘Are we exemplifying our values if we make these decisions?’” Suarez says.

Organizations commonly say they value their people, value their teams, and people are their greatest resource. “This pandemic is a moment when you say, ‘Which decisions are supporting this?’” he asks. “If you cannot find the decisions, then that is a sign that you are creating that imbalance and are not supporting what you say you value.”

Safety is the priority during the pandemic because safety creates confidence and shows staff someone has their back, Suarez says.

Transparency also is important. When managers are transparent with new policies, then their employees can process the information and relate to the challenges faced by decision-makers, he adds.

“They may contribute collectively with ideas, and I think this is presenting an opportunity to help the organization innovate,” Suarez explains. “This could be a catalyst to transform business processes and ensure greater innovation and collaboration.”

Case management leaders also can try to recognize their staff’s work, sacrifice, and commitment. “We may be in such a fast-paced environment, there may be neglect in thanking people for that commitment to providing care under incredible experiences,” Suarez says.