Case study of The Beryl Institute focused on Temos program "COVID-19 Safe"
Thank you to The Beryl Institute for publishing this June 2021 case study for its members. It focuses on the journey taken by Temos International Healthcare Accreditation to create, design, implement, and launch its “Certificate of Compliance: COVID-19 Safe” program to reduce the risk of transmission while making the program’s standards free to healthcare providers anywhere in the world.
The Challenge
The COVID-19 pandemic put pressure on healthcare systems worldwide, creating an environment of uncertainty for patients, staff, and visitors. It changed the delivery of healthcare services overnight. Many hospitals and clinics closed fully or partially. Those providers that continued to offer services were challenged by additional infection prevention measures, shortage of staff and personal protective equipment (PPE), uncertainty and fear, new or changing regulations, and more. Providers and patients asked for guidance and answers where there were no answers yet. Even well-established services and patient experience programs went into a tailspin.
Early in 2020, our Temos accredited partners contacted us and requested guidance to develop new systems and processes necessitated by COVID-19. A few requests quickly snowballed into more requests that grew in urgency. The severity of the COVID-19 situation quickly became apparent to the Temos team. Our clients, colleagues, and contacts were asking us to use our expertise in infection control & prevention, risk management, patient safety, patient experience, and more to create solutions and guidance for them. They turned to Temos for guidelines to assure patients and staff that the risk of transmission was being reduced and that patient experience was not being compromised.
The Solution
In response to the urgent requests for guidance and assistance, Temos’ CEO and Founder, Dr. Claudia Mika, convened an urgent virtual regional office meeting. She explained to the team that our clients and colleagues were asking for our help. Clearly our team has the expertise, established systems and processes, skills, and knowledge to offer something of value to our clients as well as healthcare providers and governments around the world.
The idea was formulated to pull together a small team who would volunteer their services to conduct research upon which to build a set of COVID-19 standards for hospitals and clinics that focused on reducing the risk of transmission while managing a new patient and staff experience.
This new COVID-19 program would follow the traditional business model of offering a certificate program for which clients would pay for access to the standards as well as Temos’ online tools that support self-assessment, offer resources, and access to the company’s team of experts. Given the harsh financial situation many providers were facing as well as the extreme urgency of the pandemic, we realized that many hospitals & clinics would not be able to afford even the modest price for the certificate program.
The regional office representatives discussed the idea of offering the “standards only” for free for hospitals and clinics to download on demand. The risk of competitors downloading the standards and creating their own programs was acknowledged. Despite this business risk, the Temos regional offices voted unanimously to create a “free option”, making the standards available to anyone who wanted them. Our corporate principles were more important than making money.
In March 2020, the small team of subject matter experts was created along with marketing support to create the program. The research was conducted, source materials identified, standards drafted, online tools for self-assessment developed, website and marketing content written, and press release prepared. By May 2020, within two short months, the “COVID-19 Safe: Certificate of Compliance” program to reduce the risk of transmission was launched.
The certificate program was and still is offered as either a paid program or the “standards only” free option.
The Goals
Our team set four goals for the COVID-19 program.
First, by offering the set of standards free of charge, we wanted to contribute in a positive way – as an international accreditation body and as part of our corporate social responsibility - to offer a solution relevant to minimizing the challenges of these difficult times. The program is a tangible expression of our appreciation for the incredible sacrifices made by healthcare professionals around the world.
Second, we wanted to assure that all hospitals and clinics worldwide have access to our world-class standards based on best international clinical practices, scientific studies and guidelines published by WHO, CDC, ISQua and other reputable sources, as well as the vast experience of our team of experts.
Third, the decision was made from the outset to continuously update the standards for free as more is learned about this disease. The decision represents the commitment to our clients, our assessors, our regional offices, and the individuals who downloaded the standards for free. Version 3.0 was recently released as informed by the latest research and developments as the disease continues to evolve.
And fourth, we wanted to reduce the risk of transmission for patients, staff, and visitors as much as possible for as many providers as possible.
The Actions
A small but experienced team of experts started by conducting comprehensive research in March 2020. Reputable sources like WHO, CDC, ECDC, and ISQua were contacted, available sources gathered, reviewed, and synthesized, and experts contacted. A first draft of the new set of standards was prepared. Feedback from Temos accredited partners, white papers, e.g., regarding the use of telemedicine and teleconsultation services, case studies as well as statements from scientific organizations (e.g., European Society of Human Reproduction and Embryology - ESHRE, American Society for Reproductive Medicine – ASRM) were also considered and included. All sources and references were added to the standards document with their weblinks to enable readers to go into more details where wished.
The following chapters were defined:
1. Standard Infection Prevention Measures during COVID-19 Outbreak: Standard Precautions and Transmission-based Precautions
2. Management of Human Resources and Provision of a Safe Workplace Environment
3. Patient-centered Care during COVID-19 Outbreak – Screening and Clinical Management
4. Facility, Environmental and Technical Resources’ Management
5. Teleconsultation and Telemedicine Services
6. International Patient Management and COVID-19
7. Crisis Communication
In addition, three annexes provide further guidance for dental settings, reproductive care centers and by a list of references and sources.
In parallel, Temos IT started with the needed work on the database, the online system and website registration programming to assure that downloading was available as soon as the standards had been defined and approved.
Marketing and promotional plans were set in place to create website content, brochures, social media posts, articles, blogs, and press releases were prepared.
On May 06th, 2020, the version 1.0 of the “COVID-19 Safe: minimizing the risk of transmission” program was published as the first “open-source guidance” for hospitals and clinics worldwide.
The Resources
Our volunteer team of experts was the major resource used to create this program. Human Resources were invested to do the research, define the standards and to do the transfer to the database. In addition, time had to be spent on the programming and to make the standards accessible as a download. Due to data confidentiality requirements (European GDPR), respective data security protocols were added for the registration.
Finally, resources were engaged for communication via personal emails, social media, press releases, newsletter, and more to invite hospital, clinics, and all interested parties to make use of the standards. Each regional office was asked to contribute time and energy to promote the program especially the “standards only” free option.
The Measures
Our main objective was to support healthcare organizations worldwide in their efforts to cope with the pandemic. Accordingly, the main measured variable is the number of downloads of the standards. Since the publication of version 1.0 in May 2020 to version 3.0 in October 2020, more than 200 organizations from six continents have availed themselves of the “standards only” free option.
As a second parameter, we measure the number of organizations that have implemented the standards and requested formal certification from Temos. The current number is 14.
As a third parameter, we evaluate the feedback from organizations that have been using the standards. Besides the much-appreciated feedback on how to further improve the set of standards, we received very positive feedback regarding the usability and understandability of the standards how we supported the work of healthcare organizations worldwide by an effective and useful tool.
The Feedback
Hospitals and clinics from around the world sent messages of thanks to Temos for the guidance made available to them. Here is one representative example:
"As the COVID-19 pandemic emerges, all the healthcare providers worldwide were struggling to find the best practice to respond to this pandemic, including our hospital. We searched many sources to find the needed information to guide us to maximize the safety for our patients, and our staff safety which we always appreciate, became our first priority during COVID-19 pandemic.
One very informative and useful source is TEMOS standards for "Certificate of Compliance: Covid-19 Safe “Minimizing the Risk of Covid-19 Transmission in Healthcare Organizations, which greatly helped us finding clear and up-to-date standards with helpful remarks, plus the continuous support from the TEMOS team through and after the certification journey.
Now TEMOS standards are part of our daily practice in GNP hospital, our patients can feel safer, and our staff can feel that they did a great achievement even through the stressful time of COVID-19 pandemic as the first TEMOS certified COVID-19 safe hospital worldwide.
Thank you TEMOS team, and we are looking forward for more cooperation between TEMOS and GNP Hospitals in the near future."
Dr. Faisal Al Battah, CEO GNP Hospital Group Saudi Arabia
The Outcomes
Our COVID-19 program continues and will continue until providers no longer need it. The program has run from May 2020 to the present so we will continue to review the outcome of our efforts.
From May 2020 to May 2021, more than 200 hospitals & clinics as well as government representatives around the world have downloaded the standards and used them to improve their management of the disease. While it is impossible for us to measure how our decision to offer free standards has impacted those providers who are not our “clients”, we are confident that we have helped to reduce the risk of transmission, leading to fewer deaths, fewer cases of COVID-19, protected staff, and helped those providers to improve the quality of their services overall.
Feedback from our certified partners has been positive. Some providers used the standards to build their systems and protocols from the ground up. Other providers used the standards as a way to organize their COVID-19 responses so that there is increased efficiency, costs savings, and a better patient experience. Some providers used our standards to fill the gaps in their programs as well as to expand their services into telehealth & telemedicine. Our clients report that they feel better prepared to respond to the next wave or the next crisis.
In addition to the COVID specific topics, new standards - teleconsultation & telemedicine services as well as crisis communication standards - were included in the COVID-19 Safe program. These new standards have been added to all of our other accreditation programs. It is clear that these changes due to COVID will continue to be part of the healthcare landscape.
The Lessons
The pandemic is far from over and nobody knows what challenges we will face in the future. Responsiveness to clients, flexibility, innovation, and risk taking in business are needed. As a team, we developed a much-needed solution on very short notice.
The Temos team benefitted from our response. Our team was tested, and we rose to the occasion. There is a sense of pride and accomplishment in contributing something of value to fight the pandemic. During the summer of 2020, we watched as the number of downloads grew, bolstering our morale and giving us confidence that we had made the right decision. These intangible benefits helped make our team even stronger.
Communication with healthcare organizations and “stakeholders” is crucial. Our clients turned to us for help during this extraordinary time. We found solutions to their problems.
Being in business involves taking risks. Our risk – offering the standards for free – did result in lost business opportunities including competitors and governments using the standards to create their own programs. Others benefitted financially from our work. It was a calculated risk based on identified and accepted consequences. Our team is happy and proud that we chose to do what we did.
Temos continues to face these challenges, focuses on its clients and the patients they serve. And as more is learned, new challenges occur and as the science evolves, Temos will continue to gather, distill, and distribute these insights with innovation, focus, and confidence.
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