The Covid Crisitunity
Let me start this post with a big asterisk, *the pandemic was/is a bad thing, people have lost loved ones, been isolated from their families, seen the economy devastated, and like everyone else, I wish it could have been avoided.
That said, the purpose of this blog is not to dwell on the negatives, there is far too much of that going on elsewhere. Instead, my intention is to highlight some of the positives that have happened over the last year and offer a different point of view. I want to talk about some of the opportunities that have come out of this crisis, the “Crisitunities” as Homer Simpson would say.
To try to put a positive spin on the events, this crisis has been a golden opportunity for organisations to look at their ways of working and make sure they are as effective as they can be. Whether it is in health and social care, retail or the hospitality sector, frontline workers’ time is at a premium and so it is up to management to ensure there are no processes that are unnecessary or that waste time. It could be as simple as changing where equipment is stored to make it more accessible, being flexible about shift patterns and start times or delegating tasks differently. For us it was about structuring our day so that tasks such as activities, supervision and health and safety checks are planned out in advance and included on the relevant handover sheet.
And it didn’t stop there, here are some other ways the pandemic helped us to improve our ways of working.
Taking Our Medicine
Compared to other care homes, our residents’ medication requirements are fairly simple, with the majority being tablets and capsules. There is the occasional cream or inhaler, but that’s as complicated as it usually gets. To makes things even easier, prior to the pandemic, they were mostly delivered in an MDS from the pharmacist.
For those who don’t already know, MDS stands for Monitored Dosage System and refers to device or package in which a patient’s tablets have been dispensed into individual doses that are arranged by day and time. This makes it easy to see what tablets an individual takes at a specific time and, in our minds at least, they saved so much time when administering medicines.
I had always heard rumours that MDS were frowned upon and at some point, the pharmacists would stop supplying tablets in this manner. That idea filled me with dread – it would turn a simple and relatively risk-free procedure into overly complicated logistic nightmare! Administering every tablet from its original box with only a little label on the front to tell you the names, dose, time etc would not only increase the time it took but also introduce so much more risk that it wasn’t worth thinking about. Thank goodness it wasn’t happening any time soon.
Trust Covid to bring about this dreaded change.
Not long into the pandemic, our pharmacist told us they would no longer be using the MDS racks and would supply the tablets in original boxes. When the first four-week delivery came, I was ready for pure chaos to erupt. Instead, after booking them all in, I couldn’t help noticing how much easier it was to go through the small boxes rather than the big metal racks. Even so, I had made sure all the staff were prepared for the new way of working, and that we had all done an online refresher and were allowing for extra time. But almost from day one it was noticeable just how much more straightforward the task was, and we all started to wonder why we ever used the racks in the first place.
And it wasn’t just how easy it was that we noticed. We were all becoming more familiar with who was prescribed what. Before, the names of the medications had all blended into a levoprariprazolic mush of incomprehensible words, but now we were looking at each individual label when administering medicine, and we all know and can pronounce the names of all the medicines prescribed to our residents. During a round of supervisions (see part 2) all the staff mentioned they would like more information about what the different medicines are prescribed for. I decided we should all individually go through the information leaflets that come with tablets and write out what they are prescribed for. This exercise really improved our group understanding of the medications our residents are prescribed.
Something we had thought was saving us time and helping eliminate risk was removed, and instead of it causing problems, it not only made our lives easier, but it also improved the care our residents received. Covid had forced us to abandon our safe established way of doing things and find a better way.
And this isn’t the only example of this phenomena.
Putting Food on the Table
For years we had an “as-and-when” approach to ordering food from the supermarket as it was so easy to log on and book a delivery slot for the next day to get what we needed. This meant meal planning didn’t need to be that organised either, so long as we kept the freezers well stocked so that if there was nothing planned, staff could just improvise on the day. On other days, staff could sit down with the residents and a cookbook and pick some healthy meals that everyone would like and the next day all the ingredients would arrive in time for them to start cooking. I thought this was a great system, as it meant we could be flexible with the meals we provided and responsive to our residents’ wishes. Yes, it meant there was often a lot wasted when I miscalculated how much we needed when stocking up (many a good onion lived and died in our vegetable rack), and sometimes the staff were unprepared for a delivery turning up at 3pm just as they were about to start cooking. However, this was the price we had to pay for offering quality meals, wasn’t it?
And then it all changed.
Suddenly, delivery slots started to disappear fast, and I was no longer able to guarantee a delivery the next day, or even that week. When I was able to book a slot, I was limited to 80 items in an order, which by no means covered a week’s worth of food. It wasn’t long before I was waiting till midnight when the new slots became available to grab them straight away like I was buying tickets to see the Rolling Stones (or, for the younger readers, a limited-edition Nintendo Switch). But before long, my clicking wasn’t quick enough, and I couldn’t get any deliveries at all.
At this point I started to worry.
But between the corner shop, staff queuing up outside supermarkets and a catering supplier we made use of, we made sure the residents didn’t miss a meal. Another round of applause for my magnificent staff team.
Then, many months later, I was logging on to the supermarket’s website and to my amazement, there were slots available, and not just one or two but a full week’s worth. I don’t know what brought about this change but I had never been so happy to buy groceries online! Terrified this would be a passing trend, I booked slots in advance at 10am every Monday and Friday. I put an expensive bottle of whisky into the basket to meet the minimum cost and then I could edit the basket the day before with an up-to-date shopping list to make sure we got everything we needed (I would hopefully remember to take the whisky out the basket before checking out). The number of items was still limited so I would have to be ruthless with what I ordered, and the days of “stocking up” were gone. I could buy what we needed and nothing else.
As time went on, slots became easier to book to the point where I could have easily returned to the as-and-when approach I had before, which is what I had always assumed I would do. However, that’s not what I did, and to this day I still book 10am slots on Monday and Friday in advance (still using my whisky technique and almost always remembering to take the whisky out before I submit the order!). Knowing that these are the times when we have food deliveries means the staff are prepared when they arrive, and they know to tell me about anything we have run out of by Thursday or Sunday so it can be included in the next shop. We began planning meals in advance, and on a Sunday we have the following week’s menu planned with the ingredients spread between the two shopping orders. There is so much less waste and confusion that I can’t understand why I ever did it any other way. I think the flexibility of unlimited deliveries gave a false sense of security with ordering food, much like the MDS racks did with the medication. It wasn’t until that was taken away from me that I could see a better way of doing things.