Providing healthcare, especially to the home-bound patient or client, is difficult in the best of times. Staffing shortages, supply inadequacies, and the ever-growing regulatory requirements make this an industry not for the faint of heart. However, it is exactly that heart that drives healthcare providers to persevere in the face of these daily challenges.

But what happens when the unexpected occurs? We are now in the midst of the COVID-19 pandemic. We are seeing first-hand the chaos the unexpected can cause in the health care industry. In particular, basic inadequacies that could be absorbed in regular conditions are failing in many healthcare organizations in the current state of emergency

2020 has served as a turning point. There is no going back to the ?old normal? and organizations must be looking to how they can use these challenges to bring lasting improvement and innovation to their operation.


There are six fundamental areas in which healthcare providers must exhibit resiliency to meet the challenges or providing home and/or facility-based healthcare in pandemic or emergency situations:


In emergency situations, whether that emergency is a natural disaster, a viral pandemic or some other widespread event, the ability to get current information in the hands of staff is imperative. Quick, accurate and up-to-date information keeps your staff and your patients safer. When that information changes by the day – or sometimes by the hour - the challenge becomes that much greater.

The problem of communicating effectively during a pandemic or emergent situation has been known for years. There is an excellent paper on the topic titled “Risk Communication in times of an epidemic or pandemic”, that was produced as part of the 4 year ASSET research project in Europe. The research provides insight into the challenges faced with communicating during these difficult times.

One of the key points it noted was that social media, while an excellent way to disseminate information quickly and globally, is subject in inaccuracy and rumor. It is certainly not where you want your employees getting their “information”, especially as it may relate to safety protocols or regulatory compliance.

As such, organizations should operate with a robust, multi-format, centralized communication system.

Centralized communication platforms give you the ability to update staff with the latest, most current information as soon as it is in your hands. It allows you to provide everyone with factual information, rather than the rumor and guesswork frequently found on social media. Most importantly, it allows you to monitor who has and has not reviewed the information, so that you can act with confidence on how you deploy your staffing resources.

Emergency Communication Plan

In a pandemic or emergency situation, the core of your communications strategy should derive from your Emergency Communication Plan. 

While not a comprehensive list, key aspects of an Emergency Communication Plan include:

  • Identify your leader. Who will be in charge of obtaining updated information? Is that same person responsible for disseminating that information to the rest of the company? Generally this individual will be the administrator and/or risk manager.
  • Robust Information Distribution Systems. How will you share information throughout the company to ensure that everyone, including your clients, are current and updated? Email, E-blasts, text messaging are all good options, assuming the technology is working. Consider some backup communication options including walkie-talkies or other “low tech” styles.
  • Plan For Off Hours Emergencies. What if the emergency occurs in the middle of the night? Do you have the ability to reach your staff if necessary? This is where an old-fashioned phone tree is valuable. In the event of an off-hours emergency, your communication leader should call a designated level of directors. Each director is responsible for contacting the staff members on their “tree” or list.
  • Current Direct Contact Information. Be sure to have home phone numbers for your staff in your phone tree. Your staff will have their business phones turned off after hours, so you must have another way to reach them. It is also important this information is updated regularly.

A full emergency plan for your organization is always a good idea. If you aren’t sure how to proceed, you can check out the New York Community Health Center’s Emergency Plan. It is an excellent resource to use as an example. You may also want to have and review a copy of the FEMA Emergency Management Guide for Business and Industry.

The Agency for Healthcare Research and Quality has put together a report titled: Home Health Care During an Influenza Pandemic: Issues and Resources.  It outlines some of the challenges Home Health Care organizations face during a pandemic, some solutions and additional resources. There is a checklist to help clarify your emergency response plan in Appendix B of that report.

How to Obtain Current Information.

During an emergency situation, you must get current information into your hands or the hands of your emergency response designee. Nothing can be shared without this basic step.

In the event of a pandemic, epidemic or other infectious disease situation, the CDC is your best choice for information. Go to their website and sign up for email alerts. Once you subscribe, you can select what information you want. You can select information on your geographical area or specific disease (i.e. updates on COVID-19). There is also more generalized information available that you may want to integrate into your business. When a new email arrives, your central designee can then follow your established protocol and email or e-blast the current information straight to the appropriate staff and/or clients.

In the event of a natural emergency, like wildfire, earthquake or flood, your better resource is your local county emergency department. Each county (and many municipalities) already have emergency response teams in place. Make sure your company is on their radar. It is a good idea to offer to become a part of that emergency response team. Doing so ensures you are kept informed and updated in the event of an actual emergency situation.

Be sure to identify who in your Emergency Communication Plan is responsible for collecting information, the process by which it is reviewed for applicability to your activities, and how it will then be communicated to your workers.


Download the Executive Summary of this article and discover how ClinicalHQ can help you be better prepared for a remote workforce.

Download Now

Support Resources

Having support resources at your fingertips is invaluable during emergent times. The challenge is identifying those resources, making certain they are current and up-to-date and keeping them readily available to all staff members – whether they are in the office, or in the field.

Provide a Digital Briefcase

Have a digital copy of all of your current forms and informational, educational and instructional handouts available to your staff. These can be arranged individually or into topical groups but should be easily searchable and identifiable. Digital support resources enable easy download by staff or the ability to email or text message materials to appropriate clients, patients, vendors or colleagues. It is imperative with a digital briefcase that all old copies are replaced dynamically as new ones are uploaded.  This is significantly more effective with an embedded notification system that alerts all recipients.

If printed materials are absolutely required, equipping field staff with portable printers enables rapid generation of materials on demand without carrying binders of paperwork or forcing field staff to search out a printing facility.

Know Your Business Resources

The Department of Health and Human Services (HHS) has a vast array of technical resource information available to you online. Beyond the COVID-19 situation, they have suggestions and recommendations on other pertinent topics like workplace violence, a shooting situation, flu pandemic and other topical issues. Consult with your clinical and operational managers or leads to identify what resources your organization could import into your online platform.

Develop an Internal Library

Companies just take advantage of their own internal hive-mind of expertise by creating and developing an internal library of resources. This will allow for better refinement, correction, dissemination of various data points while eliminating traditional information bottlenecks and unnecessary managerial stress. It further allows seasoned staff to build a support library for common issues, conditions, HEPs and so forth, to help with new or on-boarding staff.

Contact Reduction

Particularly in the event of an infectious disease outbreak, it will be prudent to reduce some types of contact, both between staff and patient as well as staff to staff.

Staff to Patient Contact

Some contact between clinical staff and patients will be absolutely required. Regardless of situation, wounds must still be managed, therapies must still be provided, and personal care must be given. That does not mean contact cannot be reduced.

  • Reduce/eliminate non-urgent visits.  Well-check visits from staff should be provided via phone, video conferencing, Zoom meetings or other technologically based resources where possible, thereby reducing the financial burden of non-essential contact.
  • Reduce personal care visits.  Where it’s feasible, reduce the number of personal care visits. Perhaps the patient can be fully bathed twice weekly, rather than 3 times. Perhaps supplies can be provided on a weekly basis, rather than a more frequent schedule.
  • Medication management.  Make certain all patients have a minimum of 2 weeks medications on hand to reduce the risk of an “emergency” medication run or delivery.
  • Eliminate unnecessary visits.   Your client may be receiving visits 2 or 3 times weekly, but medically only needs to be seen one per week due to condition stability. Eliminate the additional scheduled visits, while making certain the patient knows that urgent visits are available, should the need arise.

Staff to Staff Contact


  • Digitization. Having your workload digitized can reduce the risk of infection between staff members by reducing the shared items they must touch. It also reduces the time staff must spend “in the office”, which in turn reduces person-to-person transmission risk.
  • Online virtual meetings. Conduct meetings and/or training's online, rather than in person. Again, you will reduce your person-to-person transmission risk while still maintaining the communication and support necessary for effective health care management.
  • Supplies. Encourage your staff members that carry personal supplies to patients to stock up before or after regular business hours. This reduces their interaction and direct contact risk with nonclinical staff. If possible, have them obtain larger than normal quantities of frequently used items to reduce their number of necessary trips to the office or warehouse.

Training and Education

Particularly in the face of adversity, training and education must continue. It could even be argued that training and education become more important when faced with an unexpected or novel situation. How you provide that training and what type of training is delivered becomes the focus.

Online or virtual training

During emergencies, online or virtual training's are the preferred approach. The last thing you want to do is bring all of your staff members together to share in a group training and risk potential infection or delays in education while coordinating the meeting. Depending on the emergency, it may not even be physically possible to get everyone together. Having an online or virtual training program in place addresses these issues, regardless of the type of pandemic or emergency event.

Outside of pandemic/emergency scenarios, the availability of high quality on-demand online/virtual training will save your organization money. Think about how much money is spent during physical training sessions:

• The event is catered, or at the least some form of food/beverage is provided;

• All of your staff is engaged in nonproductive work for the duration of the training;

• There is inevitable time wasted both before and after the conclusion of the training or meeting, which is more unproductive time;

• If testing is required (for compliance or CEU requirements), there is the cost of the paper, the time to grade each test and the storage of all that paper.

Topical Training

During emergency or unexpected situations, you really want your training to focus on the issues your staff is immediately facing. The exact training content will vary based on the event type being manifested, but some of the most common topics include:

  • How to correctly put on and discard personal protective equipment (PPE).
  • How to sanitize your N95 mask.
  • How to reassure your frightened patient (or one with cognitive limitations).
  • Reducing transmission risks.
  • Providing care in a Red Cross or emergency shelter.
  • Safety Precautions when working in an at-risk environment.

There are numerous training resources available. Some are free from organizations like the HHS or CDC, while others may require purchase from content providers.


Signup to receive our refular insights on improving productivity in the health care industry.

Skill Checks and Compliance

How do you know what training your staff wants or needs? A great way is to send out a little test or questionnaire. Have it completed by the staff and monitor the results. If you send out a short test on, How to use PPE effectively and half of your clinical staff fail to achieve a passing grade, clearly a training is in order!

While many operators are familiar with their annual skill check requirements for clinical staff, the need for short format testing of critical knowledge in pandemic or emergency situations cannot be understated. Failure to utilize knowledge checks in pandemics leaves the business open to unnecessary risks for both staff and patients.

Employee Risk Exposure

The health and safety of your staff is at risk every day. They are able to navigate those risks due to their knowledge and expertise in their field. Add in a new and rapidly changing event, and that knowledge and expertise could well be inadequate. It is your organization’s responsibility to make them aware of the risks, give them the knowledge and tools to manage those risks and evaluate their response. Failure to do so can place your staff at risk for:

  • Infection.
  • Illness.
  • Violence.
  • Litigation.

Infection and illness can occur as a direct result of using equipment improperly or failing to fully or properly sanitize that equipment.

Violence may be less obvious, but is no less real. Frightened patients or patients with cognitive challenges frequently act out in a violent fashion. A patient with Alzheimer’s for example, suddenly faced with a person they don’t “recognize”, that is wearing a mask, and trying to work with them, is liable to lash out defensively. Alternatively, should illness occur in a home, it is not uncommon for the frightened or grieving family member to blame the healthcare provider. Give your staff the training to de-escalate these types of situations.

We live in a litigious society. When something goes “wrong”, litigation frequently follows. Your staff is a prime target of that litigation. Good training, coupled with skill checks to confirm knowledge and maintaining compliance with rules and regulations, offers mitigation should a lawsuit occur. Even more importantly, by fully preparing your staff, you reduce the risk of error, thereby reducing the risk of an unfortunate event occurring in the first place.

Business Risk Exposure

Your staff is your business life blood. Their failure to follow protocols, use best evidence-based practice or failure in following regulatory or compliance requirements puts your business at risk.

  • Staffing shortages.
  • Fines or sanctions.
  • Loss of reputation.
  • Loss of revenue.
  • Litigation.
  • Insurance premium increases.
  • Potentially, loss of the business.

You must know what your staff knows; and you must identify what they don’t know. Quite literally, your business depends on it.

Testing Options

There are several different testing formats or options to choose from. The most important features you are looking for, particularly in an infectious disease environment, are:

  • Short format. Your staff is busy. Short format questions allow them to get it done and get on with their job.
  • Online. Keep your staff away from each other and from the office to reduce transmission risks.
  • Phone or PC Based. The testing needs to be conducted on tools your staff already has.
  • Updated as protocols change. In emergent situations, like the Covid-19 situation, protocols change constantly. Make sure your staff knows the most up-to-date information.


Information is invaluable. Not only for your staff, but for your business. You need reporting capabilities that give you the information your business needs at the touch of a button.  Key elements of any reporting system should include:

  • Real-time insight. At a glance, you need to know who has completed knowledge checks and who has not. You also need immediate information on the pass/fail rate of your staff members so that action can be taken to correct any knowledge gaps.
  • Segmentation capability. You need the ability to segregate information by discipline, location, and other key factors to identify common problems across the business.
  • Individual Response Data. This information allows you the opportunity to identify the exact areas requiring additional training vs. areas that do not. Targeted training is smart and profitable training, and during a pandemic situation helps to maximize the limited time resources have available.

Rapid risk identification and mitigation via additional training or 1:1 counseling is the benchmark of a successful healthcare organization in emergency or pandemic situations.


In 2019, The U.S. Bureau of Labor Statistics estimated there were a 1.5 million people working in home health care services in the United States. There are an additional estimated 800,000 to 1,000,000 that work privately. Turnover is at an all time high. In 2019, the turnover rate for home healthcare aides was 25.36%. LPNs had a 22.5% rate and therapists were at 12.5%. 

This was pre-pandemic. 

You have seen the fluctuations that have occurred since the beginning of the quarantine. Staff deemed essential yet declining to work. Hospital doors closed due to low census. Emergency Rooms empty due to fear. Elective surgeries canceled, leading to reduced census in SNFs and LTACs.

Staffing is at an all-time level of liquidity. Retaining your best staff is now a critical risk all providers must manage.

There is no silver bullet to retention, but what is known is that high quality staff stay where they are wanted, supported and treated professionally. 

By providing your staff with the tools and information they need, you are showing them the value you place on their work and the respect you have for their contribution. This will lead directly to higher retention levels, and higher retention reduces operating costs.

As we’ve seen with this COVID-19 pandemic, staffing needs can change as fast as the staff themselves. The ability to remotely interview, hire, onboard and train new staff quickly and efficiently gives your organization the flexibility to rapidly grow or restructure your incumbent workforce.

Integrated Solutions.

Ideally, you want all your centralized communications, support resources, training and education, skill checks and compliance documents, reports and digital briefcase in one location. When an event, whether natural or manmade emergency, infectious disease pandemic or any other emergent situation occurs, your staff has a single solution to turn to.

Your solution needs to be online, easy to use, budget friendly and expert in providing you with valuable information and resources. You don’t need a “tech” company, you need a “healthcare tech” company. One that understands your business and the unique challenges it faces, day in and day out.


Download the Executive Summary of this article and discover how ClinicalHQ can help you be better prepared for a remote workforce.

Download Now

Key Takeaways

Emergency situations happen. To be a successful healthcare business in our modern times requires the ability to can adapt quickly and effectively. Organizations looking to operate with best-in-class practices regarding pandemic and emergency situations should ensure they are prepared with the following:

In order to not only survive in this pivotal time, but thrive in the face of adversity, your organization must find solutions to these, and other business issues. For those solutions to be effective, they should be online, digital, integrated into existing systems, and budget friendly. They should also be easy to use, configurable to your needs, and able to be updated in real time.

ClinicalHQ provides free, no-obligation, strategy sessions to assess the needs of any healthcare business for pandemic and emergency readiness. Contact us to schedule a session today.