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Getting Practical

Supporting Organizational Workflow in Times of Crisis

Remley, Karen MD, MPH; Valdes Lupi, Monica JD, MPH; Haskins, Julia BSJ

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Journal of Public Health Management and Practice: July/August 2020 - Volume 26 - Issue 4 - p 387-388
doi: 10.1097/PHH.0000000000001198
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Throughout the COVID-19 pandemic, local and state governmental public health employees have risen to the challenge. They are putting community needs first, looking out for vulnerable populations, adjusting to the need to work remotely, and keeping staff informed and motivated.

Public health workers prepare for emergencies of all kinds, but the reality of the COVID-19 pandemic has far exceeded any tabletop exercise. Strong leadership in health departments is critical. While agency leaders juggle multiple response efforts in their communities, their responsibility to staff is greater than ever.

Having led public health agencies at the local and state levels through numerous emergencies, we understand the importance of supporting organizational workflow in challenging times. We offer the following advice for agency leadership to help staff be as productive, connected, and energized as possible amid an unprecedented crisis.

Streamline and Tailor Communications

Rapid, consistent communication is needed to keep staff informed, but communications must also be accurate and carried out efficiently.

Public health agency leaders need to determine the most effective ways to get in touch with staff and for what purpose. Create communication guidelines to decide when to have a discussion over videoconference, e-mail, phone, or text message. While many conversations can happen over a brief phone call, more in-depth discussions may be better held face to face on video. Also maintain a list of all employees' various contact information and how to quickly get in touch with them based on their preferences.

Many health departments begin and end each day with a situational awareness briefing with preparedness staff and key members of the public health emergency operations center. Agency leaders can highlight essential points from these briefings and other valuable information in a daily message sent to all employees, helping them stay informed and connected to one another.

Reduce Burnout

Be aware of the physical and mental limitations of crisis response. Many of us who have led in local and state public health departments are used to working long hours, but an emergency on the scale of COVID-19 has significantly increased the potential for burnout. Agency leaders need to pay attention to signs of burnout in themselves and among staff members—and intervene.

Make sure that staff are being consistently rotated in and out of tasks so that they can take breaks when needed. While an emergency situation will force employees to occasionally take on responsibilities outside their normal roles, agency leaders should strive to leverage transferable skills of employees when developing assignments that fall outside of their usual duties. Staff who are given assignments that are somewhat related to their expertise will likely feel more comfortable in a new situation and may be at a lower risk of experiencing burnout.

Some staff members may jump at every opportunity to take on a new assignment or volunteer to be part of the emergency operations center, but their well-being comes first. Encourage staff to be strategic about attending nonurgent activities, such as press briefings, especially when they do not have a speaking role.

In addition, provide clear rules for taking time off and underscore the importance of being fully disconnected during periods away from work. Responding to messages while taking time off not only defeats the purpose of recuperating but also causes confusion for line staff.

Champion Operational Staff

Operational employees, such as human resources and information technology staff, are essential to the continuity of activities, especially during crises.

Agency executives can advocate for these employees by being transparent with board members, elected officials, and other leaders who may be able to offer additional support. Now is the time to be vocal in pressing for increased resources to meet the needs of people who keep agencies running smoothly.

With more employees working remotely, many staff members who are not directly involved in immediate COVID-19 response activities will need ongoing assistance to adapt to remote work. Help operational staff develop guides to ensure day-to-day functions can move forward when complications arise. These resources may include job aids for troubleshooting connectivity problems as well as instructions for accessing e-mail, timesheets, and other necessary files. In addition, frontline staff should know whom to contact with specific questions about operational issues to cut down on redundancies.

Remember the Bigger Picture

Agency leaders must consider how their organizations can continue to support the health and well-being of the most vulnerable communities. Health inequities ran deep long before the COVID-19 pandemic, and we cannot lose sight of those most affected by the crisis.

While there is an understandable focus on frontline activities directly related to the COVID-19 response, including testing and contact tracing, functions across the wide spectrum of public health deserve attention as well. Community health workers are still on the streets helping people experiencing homelessness find alternative housing. Outreach workers in recovery support still need to connect people to syringe service programs, treatment, and counseling. It is the responsibility of agency leadership to take various functions of public health into account and be accessible to all employees.

Devote time to listen to employees involved in capacities beyond preparedness and response. What are they experiencing? How might the agency shift personnel to reach vulnerable populations? How can even limited resources be allocated so that employees in all roles can best serve their communities? Agency leaders need to be accessible to staff to hear feedback from the ground and find creative solutions to the challenges occurring across programs.

Maintaining workflow in the midst of a pandemic is no easy task, even for public health professionals who are adept at planning for and managing crises. There is little that we can control right now, but we can help staff sustain the activities that comprise a thriving, multifaceted public health agency. Take care of yourself and your team.

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