Changes in Operations Due to the New Coronavirus Disaster Outspoken Opinions from Six Comedical Professions
The global epidemic of novel coronavirus infection has brought unprecedented changes to various sectors of society. Medical institutions are at the forefront of these changes, and in order to find out how this crisis has affected the work of healthcare professionals, Nikkei Research conducted a survey of 1,147 comedicals on their attitudes toward changes in their work due to the outbreak of new coronavirus infection. The results are presented in this column.
About 80% of the respondents felt that their work had changed
According to the survey, about 80% of the comedicals responded that their work has changed more or less (sum of “changed a lot,” “changed,” and “changed a little”). Nurses and physical therapists, in particular, were more likely than other professions to feel that their work had changed significantly, at 18.0% and 16.3%, respectively. This may be because the work of these two professions involves particularly close contact with patients.
On the other hand, less than 10% of the radiologists and dietitians responded “significant change,” probably because their work allows them to maintain a relatively high distance from patients, and the percentage of those who responded “significant change” was low.
Thus, it can be seen that the impact on comedicals was not uniform, and that there were differences in the impact of the new coronavirus disaster depending on the type of work.
Those who answered that there was a change were asked to describe the specific type of change, which could be classified into two categories: changes common to all job categories and changes applicable to specific comedicals.
Strengthening of infection control measures
One change common to all comedicals is the “strengthening of infection control measures.
The changes resulting from this impact can be divided into four major categories.
- Thorough enforcement of new infection prevention rules, such as the wearing of personal protective equipment and cleaning and disinfection procedures.
- Measures during examination and care, such as group patient care, restricted visits, and limited flow lines
- Elimination of offline and improvement of work efficiency through promotion of DX, represented by an increase in remote meetings
- Changes in the way people work
Some specific descriptions include:
- Increased awareness of disinfection, temperature checks, wearing masks and vaccinations, etc. (Nurse)
- Change to online interviews, etc. No more on-site workplace patrols (Nurse)
- Staggered work hours, where the assigned work hours are staggered by one hour before and after, were initiated (Nurse)
- Cleaning methods were clarified (Clinical technologist)
- Business reform has progressed, including the introduction of IT and telework (Clinical technologist)
- Increased testing for coronavirus. Need to ensure social distance for patients. Stricter physical condition management and leave policies for medical staff always wearing masks, etc. (Clinical technologist)
- Infection control measures became stricter. Workplace gatherings, such as year-end and New Year's parties, are no longer held. No more planned events such as study meetings with patients, dinners, bus trips, etc. (Clinical engineering technician)
- No more unnecessary meetings, and if there are any, they are now web-based and more efficient (Clinical Engineering Technician)
- Some floors have been restricted. Fewer conferences. Fewer opportunities to interact with patients' families (Physical therapist)
- Stricter infection control measures during work hours. More generous with staff sick leave and time off for illness (Physical therapist)
- Opportunities for multiple patients to eat at the same table have been eliminated, and patients are now only allowed to eat at their bedside individually (Dietitian)
- The degree of infection control measures, thorough implementation of temperature checks, etc., and the wearing of masks, aprons, and gloves became mandatory. The route for patients with fever was separated from the usual route. Chairs in the waiting area are now facing in one direction. Even after the easing of the admission restrictions, the complete appointment system is still in place. Visits to hospitalized patients were prohibited during the coronavirus disaster, but certain restrictions remain in place after the relaxation (Radiology technician)
The strengthening of infection control measures has both advantages and disadvantages, as noted in the description. The advantages are increased awareness of infection control measures and improved operational efficiency.
On the other hand, the disadvantage is the weakening of communication among hospital staff and patients/families. In a more serious case, the following comment was made
- I retired from a nursing college. Although human interaction is important in nursing education, it was difficult to provide basic education in a situation where opportunities for human interaction were greatly restricted, such as coordinating online classes and practical training. The burden on faculty was doubled in terms of classes and exercises (Nurse).
- Due to Corona, there were changes in working styles and a clear weakening of workplace relationships, and the number of people with mental health problems increased. There was more pressure to deal with them (Nurse).
- Young people are not receiving rigorous training at Corona, and it is difficult to develop human resources. The number of young people who work with enthusiasm has decreased (Physical therapist).
DX and other business efficiency improvements are expected to be promoted more and more in the future. On the other hand, how to maintain relationships with people will be re-examined now that the corona has settled down.
Changes in specific comedical
The following are two changes that were frequently described by specific comedicals. Please note that these are only opinions that emerged from the survey, and it is possible that there were similar or other characteristic changes in other comedicals not mentioned here.
The first is clinical technologists. Many of them mentioned that tests such as specimen collection and PCR had been added due to the coronavirus disaster. Specifically, they are as follows:
- The number of test items related to infection, such as PCR tests, has increased significantly. In addition, specimen collection has become more directly related to patients.
- Before the Corona disaster, influenza kit tests were performed in the specimen testing laboratory, but since a safety cabinet was purchased for the Corona disaster, influenza kits are now performed in the safety cabinet as well as the Corona tests. The laboratory where the safety cabinet is installed is a little far from the specimen testing room, so although it is safe, it has become a little cumbersome.
- Before the corona, specimens were collected by nurses, but after the corona, specimens, including those for influenza, are now collected by clinical technologists. The number of tests has been decreasing, but recently it is on the increase again.
The second is physical therapists. There were many descriptions of changes in zoning, such as floor restrictions:
- The division between outpatient and inpatient rehabilitation is now strictly enforced. Infection control measures are now more strictly enforced than before, and they are more conscious of the condition of their patients.
- Infection control measures such as wearing goggles. Ward system in charge
- Dispersion of provision system. From a large rehab room to multiple smaller delivery sites. Provision outside of the rehab room.
Other issues raised by the nurses, physical therapists, and dietitians included the dilution of relationships with patients and their families due to online access and restrictions on use, as mentioned above.
As mentioned in the common characteristics at the beginning of this report, these three occupations have more opportunities to interact with patients, and many of them described a decline in their interactions with patients and their families more often than they described a decline in their interactions with hospital staff.
Conclusion
Although the responses we have discussed here represent only a small portion of those who cooperated in the survey, we did find a few positive comments about how the promotion of DX has made their work more efficient.
However, the overwhelming majority of the respondents said that even today, the number of patients has not returned to the pre-Corona level, and that there is a shortage of manpower and a decrease in contact with patients. Some also said that the system that changed in Corona is still in place today. Furthermore, in April 2024, overtime regulations for physicians began. This regulation naturally affects not only physicians but also comedicals.
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