Health System Resiliency and the COVID-19 Pandemic: A Case Study of a New Nationwide Contingency Staffing Program

Abstract

When COVID-19 emerged, the U.S. Veterans Health Administration (VA) was in the process of implementing a national contingency staffing program called Clinical Resource Hubs (CRHs). CRHs were intended to provide regional contingency staffing for primary and mental health clinics experiencing staffing shortages primarily through telehealth. Long-term plans (year 2) included emergency management support. Early in the implementation, we conducted semi-structured interviews with CRH directors and national program leaders (n = 26) and used a rapid analysis approach to identify actions taken by CRHs to support the resiliency of the VA healthcare system during the pandemic. We found that the CRH program was flexible and nimble enough to allow VA to leverage providers at hubs to better respond to the demands of COVID-19. Actions taken at hubs to sustain patient access and staff resiliency during the pandemic included supporting call centers and training VA providers on virtual care delivery. Factors that facilitated CRH’s emergency response included hub staff expertise in telehealth and the increased acceptability of virtual care among key stakeholders. We conclude that hub providers serving as contingency staff, as well as specialization in delivering virtual outpatient and inpatient care, enabled VA health system resiliency and recovery during the COVID-19 pandemic.

SITE selection and optimization for urban epidemic prevention material distribution points

“…Section 3 presents the experimental process and results, and finally, the conclusions are discussed in Section 4. The establishment of detailed contingency plans to ensure the supply of daily necessities to residents during special periods through scientific methods will greatly enhance the ability to respond to emergencies in the future [4] . Therefore, next, we have constructed an organized network graph for the supply of daily necessities to residents.…”

Rates of Primary Care and Integrated Mental Health Telemedicine Visits Between Rural and Urban Veterans Affairs Beneficiaries Before and After the Onset of the COVID-19 Pandemic

“…14 In 2019, a national VHA initiative created 18 regional hubs to provide telemedicine visits for understaffed clinics. 15 Although the Veterans Affairs (VA) telemedicine infrastructure had been solidly in place for years, telemedicine use markedly increased in the VA health care system 12 and other health care systems 16 when the COVID-19 pandemic began. This public health emergency affords us an opportunity to close evidence gaps about telemedicine delivery within primary care settings.…”

“…In 2018, Congress passed the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act and legalized cross-state telemedicine delivery . In 2019, a national VHA initiative created 18 regional hubs to provide telemedicine visits for understaffed clinics . Although the Veterans Affairs (VA) telemedicine infrastructure had been solidly in place for years, telemedicine use markedly increased in the VA health care system and other health care systems when the COVID-19 pandemic began.…”

Hospital Staffing during the COVID-19 Pandemic in Sweden

“…However, resilience includes a system’s ability to continuously learn from past experiences of crisis management and improve the ability to manage future crises [ 13 , 14 ]. According to Kruk et al [ 15 ] and Cannedy et al [ 16 ], a resilient healthcare system will safeguard human life and produce good health outcomes during a crisis, and it will revert to its routine of delivering everyday healthcare post-crisis. Sinha and Ola [ 14 ] reported the differences between reactive and proactive responses in an organization during crises.…”