Experiences with Swing Bed Operation Changes in Critical Access Hospitals During COVID-19

Authors

DOI:

https://doi.org/10.14574/5ja35x67

Keywords:

Critical Access Hospital, swing bed, team approach, COVID-19 pandemic

Abstract

Purpose: Critical access hospitals (CAHs) play a crucial role in rural healthcare, especially during crises (e.g., the COVID-19 pandemic). This study addresses how changes in swing bed operations from spring to fall of 2020 influenced CAHs by focusing on their operations, staff experiences, and community engagement.

Sample: Fourteen staff from five CAHs in the US participated in this study.

Method: Descriptive, qualitative research design with semi-structured interviews.

Findings: During the first year of the COVID-19 pandemic, CAHs faced challenges in maintaining swing bed operations due to resource constraints and increased patient volumes, leading to changes in swing bed operation. The findings highlight four team approaches adopted by CAHs during the changes in swing bed operations: (1) implementing innovative patient care strategies, (2) providing support, (3) strengthening community bonds, and (4) empowering community education. Staff developed innovative patient care strategies (e.g., using baby monitors) due to insufficient standardized protocols, equipment, and in-house care for severe cases. Telehealth became a critical tool to maintain patient care amidst staff shortages and patient reluctance to visit clinical settings. Community support, including local residents and retired healthcare professionals, played a crucial role in meeting the demands. Upper management highlighted cross-training, financial incentives, and role adjustments to address staffing shortages and enhance team unity. CAHs actively engaged in community education and support through various platforms to provide information on COVID-19, testing, and vaccinations.

Conclusions: Collaboration among CAH staff and strong community support facilitated effective resource management and a return to pre-pandemic operational levels. This study underscores the importance of CAHs in rural healthcare during crises and highlights the need for continued support and investment in these essential healthcare providers to ensure they can sustain operations and effectively respond to future health emergencies.

DOI:  https://doi.org/10.14574/ojrnhc.v24i2.777  

Author Biographies

  • Nayeon Lee, MSN, RN, PhD Student, The University of North Carolina at Chapel Hill

    PhD candidate at the School of Nursing

  • Marianne Baernholdt, PhD, MPH, RN, FAAN, The University of Virginia

    Pew Charitable Trusts Dean and Professor 
    School of Nursing

  • Jennifer Leeman, DrPH, MPH, MDiv, The University of North Carolina at Chapel Hill

    Associate Professor
    School of Nursing

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Published

2024-12-10

Issue

Vol. 24 No. 2 (2024): Online Journal of Rural Nursing and Health Care, 24 (2)

Section

Articles

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