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Using the experiential learning method of Plan‐Do‐Study‐Act (PDSA), small tests of change became a part of daily work in COVID units (QSEN, 2020). Continuous flow of information on managing COVID patients and evolving workflows, as well as ongoing quality improvement, became imperative. At one hospital, the COVID step‐down care unit was eliminated so that COVID patients were in either intensive care (ICU) or an acute care unit. Constant data monitoring revealed that rapid responses within 48 hours for patients with COVID increased when patients transferred from the COVID ICU to acute care because of increasing oxygen care needs, necessitating transfer back to the COVID ICU due to oxygen requirements, and then returning to COVID acute care within 24 hours. To maximize bed utilization and staffing, leaders and staff from the two units collaborated to create guidelines for increased oxygen care on the acute care unit, an example of collaboration on care standards and clear expectations on how and when to escalate care. After implementation and several rounds of PDSA, the frequency of rapid responses and escalation in care from COVID acute care to COVID ICU decreased by more than 50%. This PDSA work and outcomes were a result of frequent communication and strong relationship management among front‐line staff and leaders.

Core competencies are easily ignored during moments with high stakes, frequent practice changes, and multiple decision points, but it is exactly during such moments where core competencies, as highlighted by QSEN (2020), are needed the most.

Sources: American Organization for Nursing Leadership, 2021, AONL Nurse Leader Competencies; Quality and Safety Education for Nurses 2020, QSEN Competencies.