A Guide to Overcoming the Pandemic

The secret to beating COVID-19 may have less to do with PPE and testing, and more to do with processes, design and mission.

By Donna Moore

In late January, the first case of novel coronavirus was confirmed in the U.S. Previously unheard of, COVID-19 dominated nightly newscasts. By February, seniors were dying in nursing homes. This coronavirus was seemingly more contagious than anything seniors housing operators had ever faced. We regularly control infections and wear personal protective equipment (PPE). 

COVID-19 was different

Immediately, my senior leaders at Park Springs in Stone Mountain, Georgia — a 61-acre life plan campus including 500 members in independent living, short-term rehabilitation, assisted living, memory care and skilled nursing care — began a dialogue. 

What if COVID-19 came here? Are we equipped to handle it? 

Conventional steps were not enough. Dialogue became planning sessions, which led to one radical strategy: to keep COVID-19 out we would lock ourselves in, slam the door shut and ride out the storm. Literally. We decided a lock in limiting human traffic into Park Springs was the best way to protect our members and staff.

We asked for volunteers, and instantly 60 employees committed to remain on campus without leaving, including nurses, certified nursing assistants, food and beverage services, environmental services, plant operations and administration. 

We moved in over the course of three days, beginning March 30. In independent living, employees were assigned guest suites, fully furnished models and vacant homes. In our skilled nursing and memory care households, many employees shared rooms, alternating day and night shifts. Others slept on air mattresses in offices, common rooms or tents. 

Originally planned for two weeks, our staff sheltered-in-place 24/7 with our members for 75 days.

What did we learn during those 75 days? The secret to beating COVID-19 in senior centers might have less to do with PPE and testing, and more to do with processes, design and mission.

Lead and learn from the ground floor

Executives often know their business from data, anecdotal stories, complaints and the profit-and-loss statement. During our lock-in, our leadership team learned about operations and processes from the ground floor where work happens. 

We cooked and delivered meals, cleaned members’ homes and found creative ways to offer services, including wine tastings via Zoom meetings and live concerts and fitness classes via our community TV channel. In the process, we learned to provide services more efficiently and effectively.

Our food and beverage director was shoulder to shoulder with his cooks daily. He learned more about food usage, waste, preparation, food packaging and home delivery than he could from spreadsheets and food cost per resident day. Our director of human resources spent two days a week in our laundry department identifying process improvement opportunities. I vacuumed, did laundry, delivered and fed meals, cleaned and spent quality time with our members. I learned how our business really operates. 

Being on the ground floor enabled us to see our processes in action and prepare for the long term. We have since implemented 12-hour shifts to reduce employee traffic, adopted a disinfecting system used by the National Guard, and more effectively implemented infection control, visitation restrictions, portable handwashing stations and testing.

Household model promotes care and control

At Park Springs, we practice the household model of relationship-based care in our assisted living, memory care and skilled nursing households. We emphasize caring for the whole person, not just clinical care. Our household design includes 18 private bedroom suites, a kitchen and dining room run by a personal chef or homemaker, living room, den and outdoor courtyard.

Our households become family. Nursing assistants focus on engagement rather than tasks, creating important interactions that improve member wellbeing. 

Being member-led, there is a structure to the day, but strict schedules are not adhered to. Members choose when to eat or do activities such as watching movies, putting together puzzles, playing games, going to art class or taking a nap — just as they would at home with their families. 

Because we took preemptive measures to isolate our community and even created separation between areas of our campus, we were able to continue care within each of the households as we had before the pandemic. In skilled nursing, assisted living and memory care, we were able to hug our members because, just as with a primary family, we only interacted within our households.

The household model plays a role in infection control as well as quality of life. Our household design creates smaller cohorts of members and staff in a home environment rather than larger groups in congregate living.

Staff consistently work with the same members and co-workers by household. With the household design, food service and staffing were already independent from other households, making it possible to completely separate rehab with a plastic zipper wall. Consequently, the design intended to promote relationships also promotes infection control. 

Mission is the best motivator

We consistently discuss our mission with our employees. Our focus throughout this period was never solely on keeping our members from contracting coronavirus, but rather to ensure they were maintaining the best quality of life possible. 

Social distancing does not mean social isolation, so we implemented programs to provide services while taking necessary precautions. Park Springs staff responded to members’ well-being, monitored nutritional health, created engaging activities and offered interactive programming. 

Commitment to our mission was consistently demonstrated by employees who worked 12- to 16-hour days, seven days a week. While tired, they were energized by each other and by the positive affirmation they received daily from our members, who were immensely grateful for the sacrifice and dedication of our team. 

Our staff also knew, without a doubt, that the top of the organization supported them in making choices to live our mission by loving and serving our members.

At the end of 75 days, we were successful in keeping our 500 members safe with zero cases of COVID-19 in assisted living, memory care and long-term care. All the while, we barely touched our PPE or required campus-wide testing. 

Our employees’ commitment to the mission, our use of household models and learning our operations from the ground floor allowed us to provide care throughout the initial stages of this pandemic.

What we learned during our 75 days of lock-in bought us time to develop a sustainable strategy to carry us through the long term. We gained a better understanding of both COVID-19 and our processes to enable us to enter our next phase. We have won the battle and are better prepared for the war. We will continue to learn and improve every day.

Donna Moore serves as the chief operating officer for Atlanta-based Isakson Living and has accountability for operations at Park Springs in Stone Mountain, Georgia, and Peachtree Hills Place in the Buckhead neighborhood of Atlanta.

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