Interprofessional Coordination of Care for COVID-19: A CNS-Led Taskforce for Rapid Operational Change
Topic of Interest
Interprofessional Collaboration
Abstract
Significance & Background
In March of 2020, the outbreak of Novel Coronavirus happened suddenly and unexpectedly. Timely and accurate dissemination of the latest guidelines became a high priority. Early on we recognized the importance of interprofessional stakeholder involvement and engagement due to the complexity of our organization. This was a unique opportunity to harness the system leadership role that is at the core of Clinical Nurse Specialist (CNS) Practice. A CNS Leader gathered a team of inter-professional and inter-facility partners to address this rapid process improvement initiative to infuse evidence into practice, address barriers, and adapt in the face of numerous competing priorities.
Evaluation Methods
In the beginning, there was a lack of standardization and adherence to current guidelines. An intranet site was identified as a place to upload information, but it quickly became a repository for countless documents, lacking clinical influence. Utilizing Lean Methodology, there was continuous quality and process improvement via Plan, Do, Check, Act (PDCA) cycles. Gemba rounds allowed our team to see the excellent work, and some gaps in practice, in action. The interprofessional team created the content, developed an inventory of documents, and innovative tools were implemented to allow for efficient and effective access to relevant and timely updates.
Outcomes
Revamping the COVID-19 intranet site as a central source of truth led to 40,000 hits per month. Leveraging a cloud-based online project management application allowed numerous stakeholder groups to contribute to the rapid dissemination of information with consultation, clinical review and oversight; currently, 500+ documents submitted for upload. This process improvement created standard information dissemination practices across the facets of our organization when appropriate, and offered the opportunity to influence unique situations or groups. Additional Gemba Rounds indicate the guidelines and resources are now more timely, relevant, and accessible and 97% survey respondents rate the tools as acceptable or better.
Implications for practice
Historically, large acute care settings and academic medical centers struggle to engage diverse interprofessional and interdisciplinary groups to align around a shared vision. Implementation and dissemination of rapid process and practice changes need efficient and effective collaboration to minimize disruption. Leveraging the CNS role as a leader, change agent, and clinical expert allows for the success of identifying technology and process improvement tools to implement and disseminate practice changes across a complex system during the global pandemic.