Outbreak learning 2nd May 2021

It’s been a couple of weeks like no other for the IPC Team.

We have been working with teams across the Trust to start bringing together outbreak reports so that we can share the learning across the Trust, we’ve been flat out. So its been a full on fortnight spent deep diving into into excel spreadsheets, ward handover sheets, bed state data and many, many outbreak meeting minutes.

This is of course our bread and butter work. Carrying out a root cause analysis and asking all the questions to get to possible sources of infections and gaps in practice or policy that allowed them to happen is our super power. Time to demonstrate the COVID-19 was not going to be our kryptonite.

Ask a team to do something though and I know my team will excel.

I have had the privilege of chairing the meetings to help guide staff through the information and emotion that going back to this time held. From the outset it was clear these were going to be hard to review. I felt good, felt strong and happy. Felt that what I had been through was truly behind me but opening records and listening to the stories the staff told of shifts with no end, unending challenges trying to do the right thing in the mistral of chaos this pandemic has brought was tough. Like stepping back into a memory or a dream where you know the end is coming but can’t do anything to change the outcome.

Sitting in the office with the busyness of the day around me listening via video calls to staff pour their emotions onto paper describing the impact of staff illness, of seeing colleagues admitted, of seeing and hearing about people who now cannot return to work because of the trauma they had been through. The impact upon staff and their fear as they watched wards around them change from green, admission wards without covid-19 to becoming the dedicated area to provide cohorted care for confirmed cases. The inevitability they then felt as with more cases identified and more staff became unwell they were going to be next.

Then as their outbreaks started how they desperately tried to manage wards with increasing numbers of cases, patients already unwell with other conditions and needing high levels of medical input to keep them safe whom were now even harder to look after. The Trust nearing breaking point as less and less staff were available to support wards trying to deliver essential care. Acuity rising, staff staying longer and doing more bank shifts, patient requiring hour by hour input who were just not unwell enough for critical care or not suitable for admission as they would not survive the treatment. Staff exhausted, unable to recoup with no where free from the impact of this with 24 hours news, TV specials and billboards reminding us of the rules.

No escape.

I wrote this in May. I hope that it served as a cathartic process for those that were able to join and talk. I am sure we will revisit these and bring more staff together to share their thoughts…

Now its June and with case numbers low in hospital but increasing in the community I fear for what may come next. So its our job to use this learning. To inform us for this pandemic and to help learn how to avoid repeating the impact of this one.