Role of Non-Clinical Human Resources for COVID-19: Strategic Way Forward

Introduction

There is no doubt that the clinicians in healthcare organisations around the world are true heroes who have risked their lives to make sure other survive during the COVID-19 pandemic. The authors join the whole world in saluting the doctors, nurses and other clinicians who played a direct role under very challenging situations at times during this pandemic. Numerous cases have been written showcasing the clinicians, and they deserve to be acknowledged. This article, on the other hand, provides a deep sense of appreciation to another group of professionals who also work in healthcare organisations, not as a direct patient care provider, but as non-clinician administrators. It also provides some recommendations for leaders of healthcare organisations to plan for and/or make ‘managerial’ decisions, and it does not in any way promote interference in clinical decision-making processes. Doctors, nurses, and other direct patient care healthcare clinicians should always be regarded as the individuals who will make the most appropriate decision regarding the care and treatment of COVID-19 patients. Studies conducted on a global scale have already been published regarding establishing appropriate clinical guidelines and/or protocols for treating COVID-19 (Alhazzani et al., 2020; Li et al., 2020; Reusken et al., 2020). However, despite extensive efforts, the authors were not able to find many studies addressing the evolving roles of healthcare leaders and other non-direct patient care employees of healthcare organisations.

The healthcare executives, directors, patient advocates and other non-clinical professionals, who work in the background, have to work and provide tools, policies and procedures to assist the clinicians in providing quality healthcare to patients. COVID-19 is a very new challenge that has been thrusted upon the healthcare industry with no regard to any nations or boarders or religion or any other demographic variable.

This new challenge is so dynamic and changes so frequently that healthcare leaders are trying to catch up with new policies and procedures to get a handle on it. In many countries, there is a complete lockdown, which in turn has created new challenges for healthcare organisations to distinguish between essential and non-essential personnel. Obviously, the clinical professionals are essential personnel, but it does not mean that several non-direct patient care employees in a healthcare organisation are not.

Role of Non-Clinicians During the Covid-19 Pandemic

Though most of the reports that are broadcast or printed in the news media during the initial stages are related to clinical information, morbidity and mortality, there have been few reports regarding the critical roles played by organisational leaders, such as executives, directors, administrators and so on, who are often non-clinical healthcare management professionals. The commendable roles played by these organisational leaders, particularly in many organisations in the United States, are by individuals who have educational backgrounds in the management aspect of healthcare organisations, with graduate degrees in fields such as healthcare administration, hospital administration, business administration, public health, to name a few. On the other hand, in India, the Principal Secretary (Health), and District Magistrate, and Collector, some of who come from the Indian Administrative Services (IAS), played a key role during the COVID pandemic. Apart from these public administration officials, the police also played a key role in implementing and enforcing lockdown throughout India.

Individuals with undergraduate degrees in these or similar non-clinical fields also played critical roles in lower level positions, such as in the accounting, human resources, front office, reception and so on. Needless to say, the level of strategic planning, organisation, coordination, marketing, public relations, communication, community outreach, and other non-clinical activities that helped healthcare organisations during the COVID-19 pandemic has given greater value and credence to the field of healthcare administration. This field is still in developmental stages in most parts of the world, but fortunately it is well established in many countries whose educational programmes and values are highly regarded.

Critical Roles That the Healthcare Organisation’s Marketing Departments Play During the Pandemic

Unfortunately, the fact is that many times, the term ‘marketing’, in the healthcare field in particular, is considered unethical and with many other unflattering terms. This is far from the truth and an underappreciation of what marketing does and can do for the greater good of the stakeholders, including the patients and providers. Perhaps the most critical job for a marketing department in any healthcare organisation is to provide appropriate communication, and this is even more imperative during the COVID-19 pandemic. A brief list and examples of some of the various activities that the marketing department in a healthcare organisation during COVID-19 can do for different parties are as follows:

Develop a message or tool of communication which is not scary and fearful, but more compassionate and reassuring. This is quite done in the form of a public service announcement and delivered by the public relations officer or offices;

There is no doubt that once things settle down and clinicians have a greater control over COVID-19, there will be a tremendous amount of fatigue, burnout, and emotional impact on clinical as well as non-clinical health professionals who were day in and day out engaged in providing care to COVID-19 patients (Bromley, 2020; Hartzband & Groopman, 2020; Peinado & Anderson, 2020). The organisational leadership should pay special attention in identifying these impacts on different individuals, or even groups of individuals (such as ‘ICU nurses’) and then devise a plan to address them (Charney et al., 2020; Shen et al., 2020).

Not all individuals will need the same plan of action, but a plan of action should be ready for all. For example, ICU nurses who saw a disproportionate amount of deaths related to COVID-19 may need counselling and no matter what people say, they also do grieve (Shen et al., 2020).

Strategies for Healthcare Organisations When Getting Back to the ‘New’ Normal

The new normal in healthcare organisation definitely will have to do with ‘social distancing’. However, despite all our best intentions, it is very likely that once the pandemic numbers start going down, there will be a lack of adherence to this policy. In hospitals, some of the strategies to implement social distancing are listed below:

Protecting your own employees: COVID-19 has no doubt created fears among the healthcare organisation employees. Hospital or even standalone emergency rooms are obviously going to be the place where patients are going to be brought in particularly if they are perceived by first responders or family that they are in need for emergency care. Whether these patients are infected with COVID-19 or not, now the most common assumption is going to be that the patient is infected. Hence, these healthcare organisations should have a plan of action in place to protect the emergency room employees, both clinical and non-clinical, from getting infected (Jalili, 2020).

A Brief List of Some Future Training Programmes for ‘Non-Clinicians’ for Healthcare Organisations

Many healthcare organisations around the world already provide some sort of training to their employees. However, the issues and challenges created by the COVID-19 pandemic have also created opportunities for new topics for training in the future. Table 1 provides a brief list of topics in the form of a worksheet that can be compiled by organisations as they plan for current and future needs of their employees. Not all employees will need training in all the topics listed. It is suggested that healthcare entities use this guide. Some of the new training topics can be provided to new employees at the time they join the institution. Organisations can fill in the spaces for ‘why’, ‘who’, ‘when’, ‘where’ and ‘how’ as per their needs. Some of these training topics may be new to organisations, so they should definitely look at them from ‘cost vs benefit vs risk’ perspectives.

OPEN IN VIEWER

Table 1.

A Generic Worksheet for Training Topics.

Training Topic (What)	Why	Who	When	Where	How
Pandemic outbreak
Disaster preparedness
Outdoor screening centres
Mobile testing centres
Public relations announcements
Serving as ‘pseudo family’ for patients
Establishing social distancing protocols
Remote working tools and technology
Tech security when working remotely
Identifying duties that can be done remotely
Cross training and scheduling
Financial planning, preparedness, actions during and after a catastrophic pandemic (McGlown & Robinson, 2011)
Process improvement
Effective personnel management

Source: The authors.

Needs and Strategies for Healthcare Organisation to Play a Greater ‘Societal’ Role

Now is the time for healthcare organisations to start planning for the future, in particular how can they serve a larger community on a national or international scale, when the healthcare needs of the society at large are greater than the community that they are designed and developed to serve. These are the tasks that non-clinical and/or non-direct patient care providers in healthcare organisations should be engaged in. These are the individuals who will be looking at the organisations viability more so from the ‘business’ aspect and less from the clinical aspect. Healthcare organisation leaders will have to make critical decisions on whether they want or not want to participate in addressing such pandemics if and when they arise in the future. Despite all their good intensions, it is up to the organisations to do an honest assessment of their organisation and whether they will be able to make a contribution or not. Realistically, a majority of the healthcare entities, such as small hospitals and clinics, may not have the capacity or capability to contribute.

One of the biggest challenges was shortages of health professionals, particularly doctors and nurses, in some hard-hit cities across the globe. Many doctors and nurses in the United States left their place of employment and worked as a ‘travelling doctor or nurse’. The primary reason for this for most of these healthcare professionals had more to do with their being a healthcare professional first. At the same time, these travelling healthcare professionals, particularly nurses, were also paid decently for their services. Nurses could easily make more than $100,000 per year as a travelling nurse, and even higher during this pandemic (Walker, 2020).

This pandemic has no doubt re-emphasised that there is a greater need to have global strategic plans in place to address such an outbreak. Below are some strategies to address appropriation of health professionals in a more effective and efficient manner:

A national database of volunteer nurses and doctors: There are already several healthcare-related databases that exist for volunteers, such as for bone marrow donation. A similar volunteer database should be established in all countries where doctors and nurses are asked sign up to be volunteers in case of a pandemic. Of course not all volunteers will be able to go when a need arises, but at least there is a central database which can be quickly tapped into when the need arises. A comprehensive questionnaire should be created for volunteers so that only the appropriate health professionals are contacted. For example, during the COVID-19 crises, there is a greater need for emergency room physician or nurse as compared to a surgeon or a transplant nurse.

Conclusion

The COVID-19 pandemic is no doubt a sobering reminder to all how fragile the healthcare industry is and that the leaders in these industries need to think of all kinds of scenarios including issues of new roles for its variety of non-clinical personnel and departments. The year 2020 can also be considered as a year where employees got to learn new tools and techniques not by using simulation models but rather facing it on a real time bases. Organisations, its personnel, and leaders who did not fray away from this pandemic but instead performed more than what was expected of them should be recognised, and once this pandemic is over, should also be appreciated. It should also be a sobering reminder to entities external to healthcare organisation that these organisations should not be taken for granted and that even these organisations have their limitations of they can or cannot do. In these trying times, it is imperative that everyone shows some empathy, respect for each other, and follow the appropriate recommendations of health professionals and public health agencies who are also tackling a pandemic beyond the expectations of most the population.