By Rachel L. Pratt, RHIA, CDIP, CCS
Many coding teams in healthcare facilities work remotely—and have done so for many years. The coding department at University of Utah Health has 24 inpatient coding professionals; half live locally in the Salt Lake City area and the other half are spread across the United States.
When COVID-19 came to the United States, the coders were already working from home and practicing social and physical distancing for the most part. When the directive came to begin working from home for the entire health information management (HIM) department, the coders had little to adjust to, physically. They had already been working from home for the majority of their time with the organization. Mentally and emotionally, however, there was a lot that they had to adjust to—and not just for work.
When working from home, the team has found that the best way to “stay sane” and to stay in touch is by being able to get together with friends or family outside of work and home. When the shelter-in-place orders were given, it effectively put a stop to those activities. The loss of that outlet caused many to become short tempered, antsy, anxious, and depressed. Coders normally able to separate work life from personal life were no longer able to as well as before. Their work lives started to bleed into their personal lives and their personal lives start to bleed into their work lives.
The Pandemic Brings Added Stress to Daily Life
A big thing to keep in mind right now is that there a several added stressors to daily life, all added on top of working employees’ normal fulltime jobs—jobs which may also be shifting in focus or demanding more energy than usual. Small things that would normally be taken for granted, things like being able to get takeout if there’s no time to cook dinner or even just go for a walk in your neighborhood, have become stressful activities that require planning and extra energy—if they’re still feasible at all.
Employees may also be taking on extra responsibilities for family or friends who are at higher risk during the pandemic, helping make sure they’re able to get things like groceries and important medications while minimizing exposure to others.
With the shelter-in-place directives now in effect, many coders have had to adjust to children being home from school all day, every day. And it wasn’t just the average summer break—virtual or distance learning was still expected to continue at home because the school year wasn’t over. Furthermore, children were not able to visit with friends, go over to another home for a few hours, or go to day care. The added responsibilities of child supervision and tutoring on top of full-time jobs added everyday stress for many coders—keeping an eye on their young children, making sure that they are able to work on devices that promote remote learning, playing referee to keep any fights that break out under control. It might be hard to explain to younger children why they can’t get together with friends and family right now. Transitioning to summer, children will not have the built-in schedule of schoolwork either. The coder gets no breaks from the kids, and the kids get no breaks from their parents.
The mental and emotional stress now put on coders while working remotely can understandably lead to shorter tempers as they navigate the added worry and fear while also dealing with feelings of isolation. The frustration of being locked up at home, unable to go anywhere, unable to get a break from their significant others and children, may now come out in their day-to-day jobs.
As the pandemic continues, there is also additional stress and fear for coders worrying about their jobs and livelihoods. There are millions of people who have lost their jobs or been laid off due to lack of work because of the restrictions in place. Hospitals are not exempt from this circumstance as many are facing reduced income as elective procedures are cancelled, and coders are worrying if they will have enough work or will be laid off.
These are just a few examples of the added stress coders—as many others cross the country and world—are facing as the pandemic unfolds.
Navigating Pandemic Stress
Through the course of this pandemic, University of Utah Health has been very intentional about checking on the well-being of its employees—not only physically, but mentally and emotionally.
One of the ways the organization has tried to keep in touch with employees and help alleviate some of the pandemic-related stressors is regular one-on-one touch-base meetings with each other, checking on their mental and emotional health. Staff ask themselves question such as: Are you meeting your basic needs? Are you taking breaks? Are you able to recognize the good that is happening? Do you know that it is okay to ask for help?
Daily huddles with the coding, clinical documentation integrity, and audit and education leadership also take place. Staff make an effort to validate each other’s emotions when expressed. Crisis can bring out the best and the worst in people.
It has also been helpful to re-emphasize the resources at the coders’ disposal, such as the Employee Assistance Program, the Resiliency Center, and other COVID-19 support resources. Making sure that staff can recognize concerning symptoms such as anger, poor self-care, and emotional outbursts that may indicate someone needs help is an important step to take during this time of heightened stress and anxiety.
Transparent communication regarding jobs and benefits and encouraging employees to join the twice-weekly employee forums and the daily health information employee forums to gather information have also been key.
Emphasizing compassion and grace and encouraging team building is imperative right now.
One of the ways the coding staff at University of Utah Health have kept in touch has been through a Yammer social site, sometimes called the “Facebook of the working world.” It is a closed page that only the specified organization and department can access.
Other little things can make a difference, like calling someone instead of writing an instant message or email in order to discuss a question or issue. Hearing another person’s voice boosts morale, and the discussion may be more fruitful. It is also suggested to turn on the video conferencing function during meetings. Some have found that seeing one another’s face during meetings can help to boost staff members’ mood. And sometimes having more frequent meetings can make it feel like the staff are not alone and are more connected.
You Are Not Alone
Everyone is dealing with this pandemic, and everyone is dealing with the impact of this virus. It is affecting everyone, from the smallest child to the oldest person. There has been a lot of talk about people who are moving to remote working and the struggle that they are having with it. And while it might be easy to overlook those who have had to make adjustments that already telecommuted fulltime, they may be struggling as well Just as our coding team has experienced, mental and emotional upheaval has impacted us all. Coders and health information professionals need to know that they are not alone during this time and need to know that they are essential workers, too.
University of Utah Health Resiliency Center. “COVID-19 Well-being Resources.” March 2020, https://pulse.utah.edu/site/resiliency/Pages/COVID.aspx.
Rachel L. Pratt (Rachel.Pratt@hsc.utah.edu) is inpatient coding supervisor at University of Utah Health.