Addressing the Challenge of COVID-19: One Health Care Site's Leadership Response to the Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic created an extremely disruptive challenge for health care leaders that required a rapid, dynamic, and innovative response. The purpose of this manuscript is to share the leadership actions and decisions at Mayo Clinic in Florida during the first 6 months of the pandemic (February to July 2020). We note 4 strategies that contributed to an effective response: (1) leverage experience with disaster preparedness and mobilize regional and national networks; (2) use surge models to anticipate and to address supply chain issues as well as practical and financial effects of the pandemic; (3) adapt creatively to establish new safety and procedural protocols in various areas for various populations; and (4) communicate timely information effectively and be the common source of truth. Mayo Clinic in Florida was able to address the surges of patients with COVID-19, to provide ongoing tertiary care, and to restore function within the first 6 months with new, strengthened practices and protocols.

Using a Potentially Aggressive/Violent Patient Huddle to Improve Health Care Safety.

BACKGROUND: Unexpected situations of workplace violence are occurring in the United States at increasing rates in health care environments, warranting increased attention to processes supporting safety for health care workers. At a large, academic hospital, two patient safety incidents had occurred in a two-year period in which a patient had become violent at the time of admission from the emergency department (ED) to the medical unit. METHODS: A multidisciplinary quality improvement (QI) team was formed to address the risk of violent patient events. Using two iterative Plan-Do-Study-Act (PDSA) cycles, the QI team designed and tested a huddle handoff communication tool, the Potentially Aggressive/Violent Huddle Form. An ED nurse would initiate the huddle process by informing the admitting unit that a patient at risk for violence was being admitted. The admitting care team would then call the ED team so that both teams participated in the handoff call together. The huddle process occurred for 21 transfers in the first PDSA cycle and for 18 transfers in the second. RESULTS: RNs from the ED and the six medical units reported feeling safe during the transfer process 100% of the time during both tests of change PDSAs (vs. 54.7% at baseline). In the ED, from the first test of change to the second test of change, satisfaction with the process improved from 53.3% to 75.0%. CONCLUSION: The huddle handoff communication tool and other methods to facilitate the transfer of potentially violent patients have the potential to decrease the number and severity of violent incidents in the health care workplace.