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The Common Threads of Crisis Management – Finding Certainty in Uncertain Times

Key Takeaways from an Assisted Living Facility Owner

In the early days of the COVID-19 pandemic, we were shrouded in the darkness that utter uncertainty inevitably brings. As an assisted living facility operator during a global pandemic that affected residents in Florida facilities to the tune of 35% of all Florida deaths, more was unknown than known. And while state government offered little transparency in a way that would yield the sort of guidance needed to navigate the pitfalls of a public health crisis, I made the conscious decision to take action.

Being Proactive, Rather than Reactive

I had started following the COVID-19 news in January of 2020, when few had even heard of it, and with increasing urgency in February. We conducted refresher trainings with our staff during this time, and began stocking up on PPE supplies and tracking back-orders.

As I evaluated the risk profile explained by the CDC and the definition of community spread (even though our Governor would not publicly acknowledge that Florida was experiencing community spread), it was obvious we were living through it. I felt a responsibility to read the signs and take continued action, regardless of government inaction.  Before we were required, I began screening visitors and vendors for possible exposure.  In doing so I ensured open and honest communications with our residents and families, so they would understand that we were being proactive. “Better safe than sorry” became a motto used often during that time. Now, I look back with appreciation for the support of our families, who understood these efforts and adjusted quickly to the new means of communication. We proactively scheduled Facetime video calls with each of our families using our in-house I-Pad.

In March, we cross-trained staff to have the ability to act in various roles in the event we would encounter a shortage of staff due to sickness. We also updated our emergency plan for creating a self-contained wing, should we need to care for known COVID-19 infected residents who could not be discharged to a hospital due to lack of available beds. This included creating our own version of “negative pressure” rooms. We scheduled “shopping runs” for our residents to place their “personal shopping orders” with a designated staff member who was prepared to carefully minimize their exposure while conducting these shopping trips on their behalf.

As always, I remembered that knowledge is power. And as such, we maintained regular open and honest conversations with our staff, establishing trust and commitment. Each person committed to maintaining a “bubble-like” lifestyle to help shield us from exposure that would eventually bring the virus into the workplace. I also invested in hardship stipends so that each staff member would be able to “stock-up” at home with the supplies to keep themselves and their families safe.

By the first week in March, we had closed our doors to guests and all but essential vendors, before the State mandated such actions.

Facing Uncertainty with Stress Management, Information, and Communication

It became obvious to us by May that this emergency was unlike anything we had been accustomed to in the past in preparing for, and managing, emergencies caused by hurricanes (a fairly common occurrence in the state of Florida). Unlike past storms, this was not like a period of preparation, experiencing the storm, and responding to the aftermath within a period of a month or two. It was clear our periods of preparation, experience, and response to COVID-19 each had no real end in sight. We also saw with abundant clarity that we were not dealing with the geographical, relatively limited path of a hurricane, and that this worldwide global pandemic would require far more resources for recovery.

We understood that this uncertainty would lead to stress and fear not only among our residents, but also among our staff. As a consequence, in addition to cross training our staff, we began coaching them on various coping skills to manage stress more effectively. We routinely asked not only how they were doing, but also how their families were navigating the incredible amount of stress that was building in us all. We sought to help them balance those challenges in the face of our commitment to live in a “bubble” in the interests of protecting each other and our residents. 

Further, I continued to maintain a rigorous data and information evaluation schedule that entailed daily reviews of several primary information sources, such as the CDC and the Florida Department of Health, as well as disseminators, such as the Health Care Association and the Florida Assisted Living Association.  Often, this resulted in an exercise in “information overload” that left me completely exhausted, but ultimately, better informed than if I waited for other, largely unreliable, sources to provide information. I needed the ability to make adjustments to our operating protocols in a moment’s notice, and needed reliable, accurate information to do so.  I was also able to use this information in my ongoing communications with our residents and their families, so that they could make the most informed decisions, and trust the fact that we were doing the same.

The Common Threads of Crisis Management

As we tentatively approach the other side of this life-altering event, I can say with humility and fulfillment that I was able to lead through the uncertainty of that first surge with no infections and no deaths from COVID-19 in our staff or residents. With gratitude, I thought about the common threads in the actions we took: 

  • Leading with my heart, as if my mom was living in my ALF, through this and with my mind, by following facts-based guidance.
  • Detailed attention not only to the problem, but also to the management and resolution,
  • Reliable, accurate information gathering and dissemination by vetting sources,
  • Proper training and communications,
  • Early investment in resolutions (PPE, hardship stipends), and
  • Thorough coordination among all the key stakeholders.

When I examined these common threads, I realized that we did, and still do, have some certainty after all. These are no different from navigating any crisis, whether it has a foundation in health, finance, business, education, natural disaster, or career. It reminded me that we have the resilience not only to manage a crisis, but to educate ourselves through the process. This is one of the key takeaways I will choose to remember from an unforgettable time.

Until next time, stay safe and, please stay educated – lives depend on it!