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KSB Hospital implements clinical cross-training of health care workers during COVID-19 crisis

Academic and government researchers predict that the State of Illinois will reach its peak in COVID-19 cases in mid-May. In the event that peak occurs, the numbers of acutely ill virus patients requiring hospital care could be much higher than what a local hospital normally handles. To accommodate the increase in virus patients, additional clinical staff will be needed to assist in their care.

Planning for the potential need for increased hospital staff during the pandemic is well underway as healthcare leaders at Katherine Shaw Bethea Hospital (KSB) in Dixon, IL have prepared and are implementing its clinical cross-training plan.

Kim Hudson, Director of Clinical Operations for KSB Medical Group, and Sandy Dennis, KSB’s Senior Director of Nursing Operations, were two of the healthcare professionals called in to help organize and set up the cross-training program.

Hudson oversees physician practices and KSB clinics in Polo, Amboy, Mt. Morris, Ashton, and Oregon as well as the Dixon clinics, Towne Square Center and Commerce Towers. Dennis worked with Kim Hudson in coordinating the cross-training process from the hospital side.

“We saw that we needed to mobilize and figure out how we could utilize our staff most effectively,” said Hudson. “We had to look at the talents and experiences of our staff. Many of our clinic staff have worked in the hospital, Home Health Care (HHC), and the emergency department (ED), previously in their careers.”

Once all clinic personnel were identified for the cross-training process, Hudson and Dennis worked together in determining which department they would be working in at the hospital. A two-day orientation was developed for each department in need of extra staff. Each two-day training was geared specifically towards either inpatient care, pharmacy, ED, respiratory therapy, and other areas within the hospital.

“We’re complementing the existing staff at the hospital as volumes grow,” said Hudson.

If a surge occurs, KSB is already able to react quickly to the increased need for hospital staff by using the identified clinic personnel. Cross-trained staff will be put into action as per the staffing needs of the different stages in KSB’s surge plan. As demand for hospital workers becomes higher, clinic work will be minimized to enable pulling their staff over to the hospital.

Two LPNs were selected to learn the role of the pharmacy tech. Each of them spent their training session learning these roles. This included stocking and restocking medications in the automated medication dispensing system, taking medication history from patients, assisting the pharmacists in preparing medication for patients in the nursing units, and learning the pharmacy computer system.

For a certified medical assistant (CMA) to work in the emergency room (ER) as an ER tech, they would need to be prepared to participate in chaotic or emergency situations. Skills such as helping with chest compressions, applying pressure to a wound, getting vital signs, transporting patients to Medical Imaging are tasks they would be able to assist with during a surge situation.

In the clinic, the CMA role includes settling the patient in an exam room, taking vital signs and charting them, assisting the physician or nurse as requested, and restocking supplies. There are overlaps in what they would do in both roles–the difference is the environment. The office setting is normally controlled while in the ER, you have to be prepared to help with everything from a gunshot to childbirth.

For the clinic staff that didn’t have a background in any particular hospital department, they were trained as runners. Runners handle many duties inside the hospital that include patient transporting to X Ray or CAT SCAN, assisting with drive-through testing, and many other areas.

Cross-training has been completed on the clinic side within KSB’s medical-surgical area, pharmacy technicians, and Home Health Care service, just to name a few.

On the hospital side, cross-training is still in process. An example is that all non-essential surgeries were canceled to preserve the personal protection equipment (PPE) needed for staff working with COVID-19 patients. Dennis remarked that this was the first group the taskforce started working with on cross-training. “We looked at who’s worked with someone else in the hospital in order to find people who already have some skills, knowledge, and an affinity for another unit,” she said.

“Along with working with Kim, I worked internally with KSB’s individual nursing departments’ directors and supervisors,” said Dennis. “These individual directors have been instrumental in making sure their staff are sent to different areas in need and knowing which staff are available when.”

KSB is paying close attention to what’s happening in the current COVID-19 hot spots of New York, New Jersey, and Chicago. The knowledge taken from these medical institutions’ experiences and developments will guide KSB towards what they may be required to do.

Cross-training will be put into action by the taskforce team looking at the KSB surge plan. KSB’s chief nursing officer, Linda Clemens, has been instrumental in assisting the taskforce. She will provide the input for scaling up staffing when it becomes necessary.

Kim Hudson knows the value of KSB’s work in this time of crisis, especially for a rural community. “I’ve worked in a lot of larger organizations. It is so impressive how KSB has developed and utilized our limited resources so effectively.”