This too shall pass! PALTC is united

March 30, 2020

When a crisis hits, besides shedding light on the system gaps, it also highlights the strengths of a community. The stresses of the novel coronavirus pandemic (COVID-19) have clearly highlighted the many positive attributes of the post-acute and long-term care (PALTC) community. As the president of AMDA, The Society of Post-Acute and Long-Term Care Medicine, I have been in awe watching several heroic stories emerge in this fight of our lifetime.

In the twilight of 2019, China announced its first COVID-19 outbreak. In a few weeks, it evolved from just an interesting story to a humanity-threatening concern for researchers, clinicians and politicians across the globe. As of now, the outbreak has reached pandemic status, prompting governments to enact emergencies and community shutdowns across the world.

No community has been impacted by COVID-19-related concerns in the US more than the PALTC setting. As an environment of care for the frailest of the frail, and with less than ideal financial support, staffing demands and inconsistent medical models, if this sector fails to receive the necessary attention and support it requires, PALTC may face dire consequences.

Over the last couple of weeks, I have observed teams in PALTC exhibit speed, resolve and agility as they initiate CMS and CDC guidelines to implement sweeping changes. This crucial reorganization in operations has occurred in admissions, staff and patient screening, use of personal protective equipment (PPE), communication flow, daily assessments, vendor partnerships, visitor policies and much more. Getting this accomplished within a couple of weeks has been an amazing feat well worth acknowledging (please access COVID-19 related resources at https://paltc.org/COVID-19).

Frontline staff accolades

My first acknowledgement and commendation is reserved for the frontline staff, including the certified aides and licensed practical and registered nurses. Like always, these staff members continue to perform around the clock, demonstrating a true commitment to their residents and families. With these residents, restricted from in- person visits with families and friends, these dedicated teams have worked tirelessly to keep residents engaged and connected with the outside world, while meeting their physical, clinical, and psychosocial needs.

Frontline advanced practitioners (PAs/NPs) and physicians, without regard to their own well-being, have also kept up with the rising wave of COVID-19 illnesses, on top of the usual chronic care needs among their residents and patients. Many practitioners and physicians are under quarantine due to exposure to the virus, but continue to engage with their teams through telecommunications and telehealth systems, even with this payment system in flux.

I am also hearing stories of partnerships between facility leaders including infection preventionists (IPs), administrators, directors of nursing and medical directors, setting new protocols, creating new tools and innovating to overcome resource shortfalls. A new library of incredible implementation tools and strategies is being created and the exceptional stories of innovation will be critical for years to come as they move the field of infection control forward beyond the pandemic.

None of this early success against the pandemic would be possible without the active collaboration among the corporate leaders of many small, medium and large skilled and senior living organizations. Executives, and chief medical and chief nursing officers, have quickly taken advantage of the power of web connectivity and social media to display the power of “co-opetition.” As a result, best practices have been shared and disseminated, producing swift action across the industry. The evidence of this historic collaboration is now documented forever on the pages of LinkedIn, Facebook and Twitter.

Professional organizations deserve praise