Overlake Medical Center and Clinics in Bellevue, Washington, saw its first Covid-19 positive patient on February 29, 2020. I recently spoke with Lisa Brock, Overlake's chief human resources officer and chief compliance officer, and Lisa Morten, Overlake's director of human resources, about their experience over the past five weeks keeping staff and frontline providers safe and informed as the number of Covid-19 patients climbed.

Starter list: How you can support frontline staff during the Covid-19 crisis

Overlake's experience offers five lessons for workforce leaders as they navigate Covid-19.

1. Invest now in employee health and accommodation processes.
   • Relatively small employee health functions may soon be front-and-center; consider proactively shifting resources so these departments can function well from the onset.
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   • CDC and state/county guidance on who should not interact with Covid-19 patients may apply to a large number of employees. Ensure accommodation processes are well-defined, accessible, and responsive. Given the frequency with which guidance is updated, be mindful of the need to consistently re-visit these accommodation processes.
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   • Be ready, from a compliance perspective, to track waivers that are granted, so that you are well-prepared to decide what waivers will remain or expire once more typical operating circumstances resume.
2. Be prepared to manage and support the workforce's emotional responses. Overlake's HR leaders spoke with great empathy about their workforce's state of being and "what it takes to get-up and come-in to work" several weeks into Covid-19. They stress that Covid-19 is "not your average crisis" and differs from other kinds of emergencies. As you prepare for emotional responses, Overlake’s leaders advise:

   • Expect sustained emotional responses. In a natural disaster, staff may experience heightened emotion in the opening hours that potentially distracts from their ability to function highly at work, such as not knowing if their children are safe. But with Covid-19, Overlake's leaders stress that triggers of heightened emotion do not necessarily subside after the initial shock. Staff may be at ongoing health risk, and concerned about their own well-being and that of their loved ones.

     The sheer length of the crisis—as well as lack of clarity about when it will subside—creates its own challenges: fatigue, emotional exhaustion, burnout. Expect some difficult conversations with employees who feel nervous about coming to work.

   • Recognize that changing guidelines also can re-trigger emotions. The chaotic nature of information does not subside after a few hours—or even a few days. Be prepared for constantly changing guidelines from public health and government authorities—and for potentially renewed anxieties and concerns with each policy shift. School closures—and inconsistent policies among local school districts—create an added layer of anxiety about parental obligations and child care. (Overlake, which owns a specialty school for behaviorally-challenged students, was able to quickly convert this facility into a child-care facility for its own employees.)
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   • Honor the imbalance and variation in staff experience. Staff are experiencing Covid-19 very differently: some staff (e.g., critical care) are overworked, while other staff may go weeks with low volumes. Some are taxed by the need to come to work; others (asked to work from home) may wish they could be on the frontlines. While all of these experiences are stressful—with the common theme of disrupted routines—"one size fits all" solutions quickly expire.
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   • While employee assistance program (EAP) resources are important, do not expect automatic uptake. To enable staff to benefit fully from EAP, HR leaders should set expectations with your EAP vendor, especially around if counselors will go directly to critical care units to be most accessible to employees. You should also work with line leaders to raise awareness about, increase accessibility to, and de-stigmatize EAP.
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   • Ensure leadership—not just staff—is tuned-in to the need for emotional support. Overlake has found a “buddy system” to be helpful—for instance, using a dyad partner to serve as a sounding board. You should also be proactively thinking about delegation: it’s unlikely and unhealthy, given the length of the crisis, for the top 1-2 HR leaders to be on-call 7 days a week. Consider now the HR business partners to whom you might delegate weekend call and deputize with operational decision-making. Doing so creates capacity to lead during the crisis and gives necessary space for emotional recovery.

     Given the imbalance and variation in staff experience mentioned above, underscore with departmental leaders that their own leadership matters tremendously. These line leaders cannot assume that organizational messages are enough—especially when it comes to expressing care and concern for associates’ well-being.

3. Exercise caution around initial commitments, first instincts, and assumptions. Given the length of Covid-19 and the potential impact on health system finances, Overlake's leaders urge caution around the (noble) commitments you might be tempted to make to the workforce. In particular:
   • Do not assume "more is helpful." There may be wide interest among non-critical care staff—and even community volunteers—to help taxed units. While such interest is noble, too many people and/or inadequately-trained people can quickly tax resources and distract decision-makers.
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   • Frame information carefully: "This is what we're doing for now" is a key phrase you can use, with clear updates provided as circumstances change.
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   • Assume struggling employees and managers will struggle. Overlake's HR leaders emphasized that while the vast majority of their team has risen to the occasion—often heroically—nothing about the Covid-19 situation itself has converted struggling and/or disengaged employees and leaders into successful and/or engaged ones. HR should assume those employees and managers will need added support.
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4. Double-down on communication. Overlake is proud of how it's been communicating with associates since the launch of its command center. Here's what's worked:
   • Extend or replace existing communication channels. For example, Overlake conducts a daily safety huddle with managers from across the enterprise—and have integrated forum time for managers to pose questions about Covid-19. The daily nature of this huddle allows leaders to quickly close-the-loop on answers to questions—and quickly get the message out across a broad swath of the enterprise.
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   • Commit to daily updates from a consistent voice. A daily message from Overlake's senior leadership has been very important. This has been supplemented by a Covid-specific landing page on the employee intranet, videos, etc.
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   • Engage the union. Overlake is unionized. Throughout the crisis, they have included union leadership on the same daily communications issued to employees.This has helped decrease the number of information requests they are fielding from the union.
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   • Get specific where necessary. While daily, organization-wide updates are essential, honor the imbalance and variation in how the workforce is experiencing this crisis with department-specific communications (in partnership with managers), particularly around sensitive issues like staffing.
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   • Incorporate Covid-19 into recognition vehicles—and include the community's gratitude. During the crisis, Overlake has launched "Overlake Heroes," an image-heavy all-staff e-mail newsletter. It includes several messages from the community: a note of support from a skilled nursing facility near the hospital, a Twitter shout-out from the city, and actions that local businesses and citizens have taken to support the hospital.
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   • Face-to-face (or its virtual substitute) matters—more than ever. As important as e-mails, videos, and intranet resources are, Overlake's face-to-face conversation mechanisms (e.g., CNO Michelle Curry rounding) have been critical, especially in navigating staff concerns and demonstrating emotional intelligence. “How are you?” is much more effectively asked in-person (or over video) than over e-mail.
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5. Give big decisions space. Overlake's command center runs with the pace that term implies. During the crisis, its senior executive team has increased their meeting frequency to three times a week (outside of the command center), realizing that certain decisions remain bigger than the crisis itself and thus require space for executive debate and dialogue.

Our gratitude goes to Overlake's HR leaders for taking the time to share these insights with us—and to their workforce, who is doing so much on behalf of the citizens of the Seattle area. We hope their experiences and lessons learned are helpful to you as you navigate this situation.