Applying a Continuous Improvement Model to Stay Current with COVID-19 Protocols
Today (May 28, 2021), the CDC issued new COVID-19 guidance for summer camps, which reflects ongoing changes to which outdoor programs will need to adapt. We believe these sands will almost certainly continue to shift as we keep learning about COVID-19, and as more treatments and vaccines continue to proliferate, and so offer the following concepts to help outdoor programs stay in step with this dynamic and fluid environment. Abrupt changes to guidance, while ultimately helpful, can create challenges as camps and outdoor programs scramble to adapt.
As CDC, FDA, State, and Local guidance and regulations will continue to adapt and shift, outdoor programs may find themselves in a perpetual process of adapting and trying to react. Having a clear model to follow helps organizations with common language, strategy, and ability to integrate new material into existing plans. One such model, presented below, is the Risk Management Continuous Improvement model, adapted from an original concept by recreation law attorney Charles “Reb” Gregg (adapted in 2021 with input and permission by Gregg). We are grateful to Reb for his original concepts and willingness to allow us to revisit them here.
Five Steps for Continuous Risk Management Improvement:
1. Analyze what you are doing, and its conformity to your mission. Know the risks of what you are doing, inherent and otherwise, and do not expose your participants to risks you cannot reasonably manage. 2. Manage those risks you choose to confront, anticipate what can go wrong, decide what to do when they do go wrong (for bad things happen to even the best programs), and reduce the chances of their happening again. 3. Inform your participants and their families about your program goals and activities and about the risks and shared responsibilities for managing those risks. 4. Report Incidents and Near-Misses to accurately capture any unplanned or unusual events, and to recognize any unwanted trends. Management should positively reinforce the reporting of incidents and near-misses. 5. Learn from both successes and from failures, and use that learning to improve the quality of the programs. There is a responsibility to act upon the incidents and near-misses that are reported.
Applying the Continuous Improvement Model to COVID-19:
The circular nature of the model is helpful in dealing with ongoing and ever-adapting guidance from the CDC. Generally speaking, the trend seems to be moving from more restrictive guidelines from the past, to a less restrictive approach as vaccination rates continue to increase across the United States.
Federal, State, and Local regulations and advisories pertaining to COVID-19;
Local case numbers, including variants;
Impact of COVID-19 cases on local community and resources such as healthcare, search-and-rescue, etc.
Assess the role of vaccination status on your staff and participants, while following applicable privacy and employment laws;
Anticipate expected (and perhaps some unlikely but impactful) challenges and rehearse your organizational response to these using scenarios in advance;
Discuss how your program will respond to a COVID exposure (or outbreak)?
Follow CDC guidelines, along with local regulations;
Consider proven strategies such as masks, distancing, use of cohorts, handwashing, testing;
Set expectations around pre-program behavior and on-program behavior to minimize transmission;
Remember that COVID-19 is not the only risk you're managing, and that we can create new risks as a result of our management of COVID-19 risks;
Emotional safety and mental health may be equally as significant as medical / physical safety;
Stay focused on your mission and educational outcomes, and adapt your programs accordingly;
Create an expectation of flexibility and adaptation in advance;
Be sure to inform parents and participants about your approach to COVID protocols, so there are no surprises;
Be sure that staff understand your policies and procedures;
Inform staff about sick leave and other relevant policies so no one is incentivized to come to work if possibly sick;
Educate staff and participants about vaccination;
Integrate COVID-19 language into your liability waiver, participant agreements, employee contracts / handbook, etc.
As CDC guidance forces changes to your policies and practices, be sure to adjust your language on your website, participant agreements, staff handbook, etc.
Encourage the reporting of incidents and near-misses, with a focus on looking forward to prevent (not looking backwards to blame);
Use reported incidents and near-misses to identify trends and make adjustments to policies, culture, and training;
Be transparent with staff how their incident and near-miss reports positively contribute to quality programs and continuous improvement;
Report known cases of COVID-19 exposure (or close contacts) to state and local health authorities, and to your program staff and participants, according to your written protocols;
Identify trends in reported incidents and near-misses;
Debrief frequently, focusing not just on what went wrong but also on what worked well;
Identify the positive capacities that help your programs succeed;
Ask your staff and participants for feedback on their physical and emotional safety (and inclusion);
Feed this learning back into the Analyze phase as the Continuous Improvement Model cycle starts over again.