ECRI Blog

The COVID-19 pandemic has focused attention on healthcare emergency preparedness and response demonstrating real-time, the correlation between emergency preparedness and the safety and quality of care and services. But emergency preparedness did not begin with the pandemic—nor do the lessons stop there. The pandemic provided sobering evidence that these correlations exist beyond acute care, as demonstrated in other settings such as ambulatory and especially aging care.

Other highly-disruptive forces have increased the urgency for more robust emergency planning and response across the all care settings. An increasing frequency of threats from potentially life-threatening emergencies such as hurricanes, tornados, wildfires, severe flooding, and even cyberattacks now need consideration in every provider organization’s emergency preparedness and response efforts.

Any of these emergencies and related hazards require organizations to move from routine to non-routine operating environments. The ensuing disruption of continuity of care and services leads to a myriad of risks and opportunities for harm.

A critical area of operations which is often overlooked until an emergency occurs is purchasing and supply chain management—and when an emergency occurs it’s too late to effectively respond. Not having the right types and amounts of medications, supplies, and equipment available when needed creates real harm for not only persons served, but also the workforce who shoulders the burden of delivering the care and services throughout an emergency. Additionally, these risks extend enterprisewide, opening up an organization to real financial and reputational harm.

All who have cared for our nation’s older adults through the COVID-19 pandemic have given so much; the toll in lives lost, illness, and financial and economic impacts have been great for those we serve, all aspects of the workforce, and provider organizations alike. But the care-critical work is not over.

As the COVID-19 pandemic response and recovery efforts continue worldwide, in our nation, and specifically in the aging services sector it is more important than ever that providers continue efforts to prevent harm to residents, staff, and healthcare partners who care for older adults, and their families and loved ones.

Data from Pennsylvania’s COVID-19 Vaccine Needs Assessment Survey, as shared by the Pennsylvania Department of Health on April 1, 2021, indicates the same trends that other U.S. studies also suggest: a statistically significant lag in COVID-19 vaccination acceptance rates in staff and contractors working in the aging services sector compared to the vaccination acceptance rates of the residents they serve and care for.

With several vaccines against COVID-19 already available through emergency use authorization (EUA), others potentially on the way, and a nationwide vaccination campaign to administer the vaccine to as many people as quickly possible, the COVID-19 pandemic continues to transition to new phases. And yet with new hope comes new challenges and emerging risks as organizations work to safely care for older adults.

According to the Centers for Disease Control and Prevention (CDC), skilled nursing facilities that conducted at least one vaccine clinic during the first month of roll-out administered a first shot to a median of 77.8% of their residents and 37.5% of their staff. As the agency points out, the moderately high coverage among residents is counterbalanced by relatively low coverage among staff.

The stakes are high in medicine and healthcare – they pertain to life and death, as the current pandemic has reminded us on an hourly basis. This is especially true when it comes to those who care for our older adults, given their high vulnerability to COVID-19. For many older adults, this illness has proven deadly.

Rightfully, given the potential for harm, aging services providers are held to high standards and expectations. We are taught to focus on what went wrong and fix it; every aspect of quality assurance in our industry is built on a platform that looks for “deficiencies” in care and service delivery, investigates them, and demands correction. Yet that is only part of an effective process that builds communities conducive to providing quality care that promotes health and well-being.

Decisions made and actions taken in the first minutes and hours after an incident occurs in an aging services organization set the stage for everything else that follows. For instance, consider this hypothetical scenario:

A resident falls out of a lift, breaking a hip, but it is unclear what caused the fall. The lift is briefly checked by the staff involved, and they see nothing wrong, so the lift is not removed from service while the incident is investigated further. The next day, another resident falls from the same lift in a similar manner.