Innovation in health services and new forms of collaboration are some of the lesser-known spinoffs of the pandemic in Victoria, according to Tom Symondson, Chief Executive of the Victorian Healthcare Association (VHA), the state’s peak body for public hospitals and community health services.
The VHA has been running an ‘Ideas, Innovations and Insights’ campaign, to enable the health sector to share lessons from the pandemic response.
Tom Symondson writes:
The pandemic has undoubtedly provided a unique impetus for change.
Much attention has been given to telehealth, as one of the most obvious hallmarks of the pandemic’s impact on face to face service provision. And it’s true that the rapid move to virtual or phone-based settings will have long-lasting positive effects on our system. It allowed vital care to continue during lockdown and undoubtedly reduced the spread of the virus. In a modern system people should be able to receive services however they choose, as long as it is clinically effective.
However, countless other examples of innovation have received far less attention.
The health system has undergone an unprecedented shift in mindset, moving to embrace innovation and change. Innovations have emerged from a truly collaborative approach across our sector and beyond, breaking down historic boundaries to ensure rapid implementation.
These have included the use of data by community health services to proactively identify vulnerable people and understand the levels of supressed or delayed demand ahead. One community health service has created a dashboard to track client cancellations associated with COVID-19. While they knew anecdotally that service delivery had been suspended, seeing it in ‘dashboard mode’ allowed them to identify, analyse and prioritise specific services and needs of vulnerable groups.
Another example has been adapting remote monitoring developed for aged care settings to observe the condition of COVID-19 positive patients. A collaborative model of care between community, primary and tertiary health services gives non-critical patients the opportunity to receive care where they feel most comfortable, at home, with immediate transfer to acute services available as necessary. This model demonstrates the potential for integrated partnerships to deliver efficient community-based care in a post-pandemic context.
Transformation of the way services operate has also led to patient-centred initiatives such as remote visitor ‘cafes’ in aged care services using social media platforms to keep patients connected to their loved ones. New friendships have also formed between aged care residents and our youngest community members. Exploring innovative ways to retain and form new social connections has had a profoundly positive effect on the psychological wellbeing of aged care residents and staff at this challenging time.
Sadly, there is still a ‘but’.
While the sector has made great strides in demonstrating what is possible during a pandemic, where rapid action is the order of the day and red tape can be more easily pushed aside, investment will be needed to retain, scale and replicate these changes, to embed and grow the transformation, and to avoid a return to ‘business as usual’.
The intense media spotlight means the public have been getting to know the humans behind the masks in the fight against COVID-19. Healthcare professionals are becoming media stars and taking the public inside their daily operations, highlighting the important work of the sector and calling on all Victorians to play their part.
But it comes at a great cost, which we are only starting to fully understand.
Despite rising to the challenge of not just one but two waves of COVID-19, our workforce is fighting on multiple fronts. Not just against the virus, but the fatigue brought about by long hours worked under the threat of infection, and the emotional strain of self-isolating from their loved ones to keep them safe.
The constant pressure of working in a crisis is even worse in parts of the state that had only just emerged from the worst bushfires in living memory to find themselves in a pandemic. Some have worked under the shadow of crisis for almost a year and, remarkably, are already turning their attention to the next bushfire season. Yet still they turn up. Every day. To keep us safe.
As with any infectious disease, services are incredibly concerned about healthcare workers contracting COVID-19, be it from community transmission or at work. While we have learnt a lot about infection control from this pandemic, infections still happen, despite all of our best efforts.
While there has been a great deal of attention on aged care, the health sector has not escaped. And for those whom it impacts, the cost can be considerable. The sector is witnessing increased incidence of fatigue, burnout and mental ill-health within its workforce.
Collaboration the winner
Health services across the state report drastically increased levels of collaboration and information sharing across services, public and private, and into local communities through councils, community groups and businesses.
What once might have been seen as threatening has become a core component of our system: data and information freely shared between organisations and sectors to strengthen crisis planning and build true partnerships.
A cluster-based approach to collaboration between our hospitals, an early response to the pandemic, is also paying dividends; reducing the feeling of isolation among health services and enabling an integrated regional approach.
Shining a light on community health
Although community health has long been a crucial part of our system, it has rarely received the attention it deserves.
The past few months have proven the vital role these services play in delivering targeted and tailored grass roots care to the State’s most vulnerable people, with the Minister of Health herself calling out their incredible contribution.
Not only have community health services successfully ‘gone virtual’, adapting their traditionally face-to-face service delivery to ensure their clients keep receiving services no matter what, they have taken up the Government’s call to deliver a range of highly successful pandemic responses.
Most notable of these was the establishment of testing centres in a matter of weeks (and in some cases days) in the early part of the pandemic as the Government sought to turbo charge the testing regime and take pressure off hospital-based centres. There is no question that the truly fundamental role of community health in our system has been laid out for all to see.
Preparing for the challenges ahead
After months of responding to COVID-19, we can only hope the recovery phase is not too far away. Healthcare leaders are preparing for the challenges that lie ahead, on top of maintaining the momentum of the current response.
Key issues are likely to require our attention, not least the need to invest in the health and community health workforce.
Beyond the many workforce issues we were contending with before the pandemic, there is a real fear that COVID-19 might lead to a greater attrition rate among healthcare workers not to mention increased rates of mental and physical illness related to stress and fatigue; things which could devastate an already constrained system.
The time is now to care for our carers by investing in the rapid evaluation and expansion of existing evidence-based workforce mental health and wellbeing programs.
And then there is the system’s physical and technological infrastructure, which has struggled in some cases to keep up with the demands of the pandemic, particularly the many older buildings and systems crying out for replacement to bring them up to 21st century standards.
But, in one thing, you should have no doubt. Our system has been fundamentally changed by this virus. And while I remain hopeful that we will eventually beat COVID-19, it is crucial we take time to reflect and learn from this experience to build a more resilient and sustainable health system in the long term.
Tom Symondson is Chief Executive of the Victorian Healthcare Association