Session: Staff resilience during extended downtime

Editor's Note

The story of how the perioperative team at Ann & Robert H. Lurie Children's Hospital responded to a recent cyber event revealed insights about resilience, communication, team-building, and preparedness in one of the concluding sessions of this week’s OR Manager Conference in Las Vegas.

The session was presented by Zeh Wellington, DNP, RN, NE-BC, director of procedural care at the Chicago hospital, which lost access to medical records, scheduling, communication, and other electronic systems for 7 weeks after systems failed on February 1. “There was no way to chart, no badges, no phones,” Dr Wellington recalled.

With a volume of 80-100 daily procedures across multiple ORs, the nursing staff rallied, converting electronic records to 100% paper tracking. Dr Wellington emphasized the importance of “team tenacity, persistence, and determination,” offering a motivational metaphor: “Be like the bison—run towards the storm.”

Among other recommendations, Dr Wellington offered various actionable insights for leaders who might find themselves in the grip of a similar crisis. Examples include:

• Create a comprehensive downtime protocol. Having only minimal hard copies and outdated forms left the perioperative team unprepared for extended paper-based operations. Dr Wellington recommended ensuring adequate stock of needed supplies, including patient forms, writing tools, and reliable emergency contacts.
• Teach and train on paper charting. Many younger nurses lacked paper-charting skills. “We weren’t teaching paper charting. Nurses need to know how to use it,” Dr Wellington stressed. Today, paper-charting practice is integrated into academic and staff training.
• Develop drills and role-based protocols. Routine drills for staff, specifically simulating full digital downtimes, are now a standard at the hospital. This includes practicing manual specimen labeling, batch processing, and even the simple task of recording expiration dates manually, which became crucial without electronic support.
• Establish physical communication resources. During the attack, even cell reception was limited, forcing staff to physically move between floors. Stocking basic office supplies and establishing dedicated, low-tech lines of communication goes a long way, Dr Wellington said.
• Let people step up. Some of the youngest, most inexperienced team members also happened to be the most familiar with IT fundamentals, Dr Wellington said. "Our young nurses stood up and knew what to do,” he recalled. The lesson is that effective crisis management requires both strategic foresight and the courage to empower frontline workers.

Taken together, such insights demonstrate the value of open communication and strategic foresight in managing any crisis. “Listen to your nurses, listen to your patients, listen to your families, and listen to your gut," Dr Wellington concluded.