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Improving Local VA COVID-19 Crisis Response through Mobilized Teleworking Staff

During a pandemic teleworking by non-clinical staff reduces burden on medical settings by decreasing the use of personal protective equipment (PPE), screening demand and potential infection spread both in the medical setting and community. COVID-19 has presented significant challenges to the onsite reassignment of non-frontline staff, and a significant number of employees are now working from home (i.e., teleworking). Given the uncertainty and rapidly changing information around the virus, many have been understandably reluctant to join employee onsite labor pools. Further, anecdotal evidence indicates teleworking mobilization team efforts have been hampered by critical gaps in the mobilization and reassignment process: lack of pre-crisis planning and policies; a focus entirely on onsite efforts (e.g., mask distribution) within medical center crisis management teams; and a lack of existing systems for collaborating across these teams. As the trend toward VA telework continues, medical systems need to understand and prepare to effectively deploy teleworking staff as an integral part of crisis response.

EMPIRIC QUERI Partners to Evaluate Telework Mobilization During Pandemic

Partnering with local VA sites, investigators with QUERI’s EHRM Partnership Integrating Rapid Cycle Evaluation to Improve Cerner Implementation (EMPIRIC) initiative sought to evaluate and describe local sites’ efforts to mobilize and reassign teleworking staff to improve local medical systems’ crisis response. They also worked to understand the challenges and facilitators to mobilizing and reassigning teleworking staff in remote support – and to identify remote emergency reassignment strategies. Investigators interviewed 19 study participants between July and September 2020, including:

• Local HSR&D leadership and staff facilitating teleworking mobilization teams;
• HSR&D staff deployed to teleworking mobilization teams; and
• Frontline clinicians who received remoted support from teleworking mobilization teams.

Investigators included questions regarding working from home, efforts to be involved with response efforts, and the success or failure of those efforts. The three sites in this study had similar research workflow changes due to the pandemic, including total stoppages and being on hold while waiting for guidance from others. Most research staff had already done remote work prior to the pandemic and so were set up to work from home; however, some staff needed to get permission to work remotely. Some staff also needed to learn how to access their remote desktop, and so on.

Findings and Study Participants’ Feedback

Staff across sites showed an “outpouring of interest” in volunteering for response efforts. Many staff members independently reached out to leadership asking about how they could help. Their reasons for wanting to volunteer were many and varied. Staff expressed an interest in helping to be part of a solution to the pandemic, to stay connected to the VA’s mission of serving Veterans, to feel like they had an outlet for the many emotions they were feeling, to have work while certain projects were on hold, and to feel connected to something greater than themselves.

I think there was instantaneous enthusiasm for engaging in a shared task, a shared sacrifice, a shared need. It’s a testament to the people who work for HSR&D. I think it’s a testament to human beings, in general, that wanted to help. —HSR&D Mobilizing Team (Site A)

This was pure volunteerism and willingness to take on something for the greater good, and to me it’s really striking. —HSR&D Mobilizing Team (Site B)

For those teleworking staff who were successfully mobilized, the ability to volunteer with response efforts left a notable impact on their morale during this time. Some staff got to use skills they had learned in previous clinical roles, while others got to be directly involved in clinical care in a way they never had envisioned.

I found it really fulfilling, because, and this is what I heard from the other individuals, I think for those of us that weren’t at the hospital helping out, or not a clinician, it was a way to be like, “I’m helping with this effort.” I mean, I’m Public Health trained, so I want to be out helping, [but] I also want to protect my family. We could do this virtually; we could help some of the providers at the hospital that we knew were going to be more overwhelmed and working really hard. So, it was very fulfilling. —HSR&D Mobilizing Team (Site B)

The ability of VA sites to organize telehealth with remote staff was mixed, which, in turn, led to varied levels of success. No matter how successful they were in organizing, however, there was a disconnect between staff who could help onsite and those who could provide remote help. Having awareness of teleworking resources and protocols for mobilizing these staff to support critical pandemic responses could provide a much-needed resource for clinical and other frontline staff efforts to care for patients.

For more information about this study, contact George Sayre, PsyD, at George.Sayre@va.gov . Dr. Sayre is a core investigator with HSR&D’s Denver/Seattle Center of Innovation for Veteran-Centered & Value Driven Care and co-leads EMPIRIC QUERI with Seppo Rinne, MD, PhD.