Exploring published literature of emerging practice as a response to challenges due to COVID-19
26 June 2020
The summaries below are of articles that might help thinking about what has been learned from the COVID-19 experience so far, along with suggestions on how this might be used to support improvement in future.
This week, featured articles include those regarding:
Summaries
Health and care staff wellbeing
A Tool to Promote Psychological Safety During and After COVID-19
An article arguing that in supporting emotional wellbeing of staff, new QI initiatives need to explicitly consider the psychological impact for staff implementing them. In the context of a workforce recovering from burnout and the experiences of the COVID-19 pandemic, it is important that QI methodologies are sympathetic to their emotional fatigue.
The article introduces the idea of 'psychological safety' as the "belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes." Across a range of professions, what links high-performing teams is the presence of this crucial belief. This is linked with notions of empathy, whereby as QI methodologies are used to look at how the system can respond better to future surges in demand, these methodologies and resulting changes need to show empathy for the workforce.
The article suggests a three step approach to explicitly link psychological safety and empathy to QI initiatives during and after the COVID-19 pandemic:
- Actively seek feedback on what went well and what to change for the future from staff in all areas and at all levels via electronic and paper surveys.
- Share identified feedback themes widely and seek out further details and clarifications as needed.
- Prioritize projects using the below matrix to ensure that resources are spent working on activities that promote psychological safety and empathy along with clinical and operational impact.
Learning from staff experiences of COVID-19: let the light come streaming in
A blog from The King's Fund discussing the importance of control, belonging and being trusted in supporting staff wellbeing in times of high stress.
"The past few months have taught us that staff must have autonomy and control, feel a greater sense of belonging and be supported in order to have a sense of competence, rather than simply being overwhelmed by excessive workload."
Staff have been given greater autonomy and control in a way that has enabled a positive attitude and allowed for rapid responses to a changing situation, and decisions are being made by the people closest to the person being cared for. Virtual clinics and consultations have been developed at a local, hospital or ward level in ways that has involved and respected all staff involved.
Teams have become more stable and tight-knit through the pandemic. Multi-disciplinary teams have had a clear and common sense of purpose, which has built cohesion and a sense of team compassion and support. This 'blurring of hierarchical and professional boundaries' has helped teams feel more cohesive and collaborative.
The stripping out of unnecessary red tape and hierarchical decision-making has freed up time for staff to focus on doing the right thing. Some of this has been aided by the shift in the constraining power of national bodies. Care Quality Commission inspections have stopped except in the most challenged settings. Several themes have emerged: the national bodies have provided some breathing space from control, inspection and their routine demand on the system. As we start planning for recovery, this provides an opportunity to establish new mutually supportive and adult relationships with national partners and avoid stifling control.
Built-in Resilience: Community Landowners’ Responses to the Covid19 Crisis
A report from Community Land Scotland and the Community Woodlands Association that explores the role of community land ownership in the community resilience that has been demonstrated during the COVID-19 pandemic.
The report provides examples of work done by community trusts across Scotland:
- Carloway Estate Trust (Urras Oighreachd Chàrlabhaigh)
- Galson Estate Trust (Urras Oighreachd Ghabhsainn)
- Govanhill Baths Development Trust
- Kinning Park Complex
- Kyle and Lochalsh Community Trust
- Mull and Iona
- Pollokshields Trust
Throughout these examples there is discussion on how the presence of these trusts, with their deep connections in the community has supported a rapid response to COVID-19.
The trusts have an understanding of the people in the community that is based on interpersonal relationships, there is a better awareness of where people are vulnerable and in what way – 'Small communities know where the fragile and break points are, they know how to garner support and put things in place for those in immediate or potential need'.
On practical issues, Community Trusts offer an infrastructure around which new initiatives, pieces of work and services can build. They have offered physical spaces for food to be collected and prepared, they have offered back office functions for coordinating phone calls and they are a draw for volunteers looking to help.
"It highlights the deep connections into communities that democratic community ownership demands. Having the organisational infrastructure and resources already in place, meant that community landowners were able to respond quickly, effectively and, most importantly, appropriately to what their individual communities needed. These organisations have confidence in their own ability to deliver, as well as their communities having confidence in them that they will act."
Dancing in the Streets: An Asset-Based Community Development informed local authority response to COVID-19
A blog outlining how Leeds City Council engaged with the third sector and developed a new approach to volunteering to support community responses to COVID-19.
Recognising that volunteers would play a significant part supporting communities through the pandemic, and the huge number of people wanting to volunteer, Leeds City Council built their volunteer strategy around three 'tiers' of volunteers.
The first two tiers were within the existing frame of volunteering – tier one being those currently volunteering, with DBS checks, who could provide more complex services including picking up methodone prescriptions; tier two was those new to volunteering, wanting to help out during the crisis. However, the Council were concerned that "we don’t want Jane at number 24 registering to volunteer to then go through a process to then be matched to help out Mary at number 32." Therefore, the third tier of volunteering was the informal networks of individuals helping out their immediate community through social check ins, WhatsApp groups etc.
This framework allowed the Council to understand the relationships between volunteers, the Third Sector and statutory services. They were led by asset based approaches that acknowledges that the starting point should be in what a community can do for itself.
Learning and Insight about COVID-19 / Coronavirus
The National Lottery Community Fund has been working to support community groups responding to emerging needs resulting from COVID-19 and related containment policies. They have produced summaries of the types of groups and activities they are funding across a range of different areas:
- Bereavement and end of life
- Black, Asian and ethnic minority communities
- Money and finances
- Loneliness
- Supporting young people
- Food
- Community infrastructure
- Networks and peer support
Digital access for people experiencing homelessness during and beyond COVID-19
A report on a pilot by the Simon Community and Get Connected Scotland that supported people experiencing homelessness to get online.
The pilot gave out 36 mobile devices with unlimited data, calls and texts. They supplemented this with personalised support through a Digital Champion training programme that centred on communicating digitally, accessing reliable information, managing money and leisure and entertainment.
Reflections from participants show significant benefits stemming from the pilot, such as:
- Increased confidence and self-belief
- Ability to connect better with friends and family
- Feeling more autonomous and independent
- Access to videos and games increased wellbeing
Some challenges faced were:
- A steep learning curve
- A lack of confidence
Reflections from staff show benefits beyond just getting people connected:
- Involvement in the pilot has highlighted to people how important connectivity is
- Shifted perceptions around digital from 'nice to have' to 'essential'
- Staff feeling more engaged in the support they are providing
There are a number of case studies within the report highlighting the positive impact of the pilot on outcomes for people including people being able to reconnect with their families, start/continue studying and getting involved in volunteering.
The Simon Community are exploring ways to expand this work.
Curate and Connect: Social Isolation
IRISS have started a new project that brings together special collections of their resources based on topics at the forefront of the COVID-19 crisis. Each collection includes insights from a member of the social services workforce about the impact of COVID-19 and why this is an important topic right now. We also offer ways we can help you use the resources in practice.
The first collection contains resources on social isolation. Social isolation has become a key challenge in the COVID-19 pandemic as measures taken to tackle the virus have resulted in people being socially isolated for long periods of time. The collection includes podcasts discussing different aspects of social isolation, articles on how technology can support people who are socially isolated and resources for starting conversations about isolation.