One year later — the invaluable lessons of SARS

How employees at Toronto's Sunnybrook and Women's College Health Sciences Centre battled SARS
By David Brown
|Canadian HR Reporter|Last Updated: 03/09/2004


or five long Gruelling months last spring and summer, the 8,500 employees of Toronto’s Sunnybrook and Women’s College Health Sciences Centre were consumed by SARS.

It dominated everything they did, every minute of the day. It reached into their homes and on some days seemed ready to overwhelm them.

But it didn’t.

The hospital was the main patient-care centre for the first outbreak of SARS. It wasn’t easy, but the leadership team created order from the chaos that hit Toronto when the previously unknown disease was first recognized as a full-blown crisis late last March, says Marilyn Reddick, director of HR.

“We learned a whole lot about crisis management,” she says, reflecting on some of the lessons learned last spring and summer. Crisis planning has since become an ongoing activity in the organization — as it should be in every organization, she adds.

In the next five years there are going to be a lot of people talking about pandemics, she predicts. Already this year, the world has watched with uneasy expectation as several countries in Southeast Asia struggled to contain the avian flu. If there is a pandemic, it will make SARS look like a minor setback, she says. HR departments need to be talking about and planning for how they will respond.

The situation was most frantic in the early days of SARS, as the health-care sector struggled to find its feet and put in place a plan to fight the outbreak. Most days brought a new mini-crisis that required strong leadership, she says.

On a Friday at noon, they were told that by Monday morning they would need a process to screen all 10,000 people who enter the building each day. Hundreds of staff had to be redeployed and a process mapped out. On occasion, rumours would spring up and spread like wildfire. Procedures for gowns and masks were constantly under review. And eventually the organization had to deal with staff exposure to the deadly virus.

In a crisis, leaders have to be willing to act quickly and decisively whenever a new challenge pops up, Reddick says. Most of the leadership team were okay with that, but in a few cases some of the leaders did struggle. “They were unable to make decisions on the spot,” she says.

They just weren’t able to cope with the high pressure and pace; they were accustomed to making decisions only after a lot of thought and research. Because that simply wasn’t an option, colleagues and co-workers would simply make decisions around them, she says. If there was a problem because of a delay, “You just had to pick up the pieces and move on,” she says.

But the need for strong leadership should not be mistaken for micro-management either, she says. Managers and leaders need to be empowered to make their own decisions. The most quiet person in every meeting of the hospital’s decision-making group of 32 senior staff — dubbed the SARS control committee — was Leo Steven, the hospital’s president and CEO. The discussion was left to the experts in each area, she says. The only time Steven would weigh in would be to ask if they wanted him to call the Ministry of Health. Otherwise, he left it all up to his team.

On just the second day of the crisis, the HR team was faced with one such major dilemma.

Many employees at the hospital were part-time or casual workers and therefore had no sick-time entitlements. Some hospitals involved in the SARS crisis had already said staff wouldn’t be given sick time, but Reddick decided that was not the way to go. Anyone who had to miss work would still be paid.

It was clear they were in the middle of something very big and very bad. For the hospital to deal with the crisis, staff needed to be focused and completely committed to their jobs.

It cost the hospital a lot of money, but the decision was hers to make alone and she has no doubt it was the right decision. “When staff are stressed, I don’t want them to worry about their pay,” she says.

In the beginning, there was a lot of uncertainty and confusion about the disease because symptoms so closely resembled those for the flu. So in part, it just made sense that anyone who had any symptoms not come into work. But just as important was the impact on employee relations.

“You can’t nickel and dime (employees) because they will never forgive you and never forget,” she says.

“Employees knew from day one we were looking after their best interest. We weren’t thinking about money; we were thinking about their health and safety.” It is difficult to overstate the beneficial effect that had on employee relations, she says.

Another important lesson, already well-known but re-learned in a vivid fashion, was the importance of communication. While most HR professionals may know the old adage about there being no such thing as too much communication in a crisis, the response to SARS produced some variations on that theme.

All written communication was given a different look and feel created especially for the crisis. Daily updates and bulletins summarized whatever news had emerged, a useful channel for putting to rest any rumours that may have been circulating. HR created its own special crisis communication format.

But written communication had to be supplemented with face-to-face and verbal communication. When staff get very tired and stressed, they don’t process information as well as they would in a normal situation, she says. Employees would receive bulletins and memos about new procedures but, whenever possible, someone would talk with them about it or demonstrate exactly what was meant.

“We had to verbally talk to them as well as show them the new masks. In a time of crisis the show-and-tell and demonstration of how to do things is absolutely key.”

Very quickly communications with employees developed a consistent and constant rhythm that was comforting to employees, she says.

Every morning the SARS control committee would meet from 8 a.m. until noon. Everyone from that meeting would go directly to meet with their managers and relay what new action, if any, was required that day.

It was important for leaders to go directly to managers so that the messages and directives coming out of the SARS control committee meeting would be unchanged. If people are given time to talk or think about it, they may end up changing things, Reddick says.

Not surprisingly, morale became a real concern as the crisis wore on.

At first everyone got by on adrenaline, and in a setting where employees were used to dealing with death day in and day out, many of the staff were uniquely able to cope, she says. But after a while, people grew tired and discouraged. Managers had to be on the lookout for staff who reached the end of their ropes and had to be sent home for some time off.

Anything that would boost spirits was encouraged, and even in the darkest days, humour always helped, she says. One doctor posted a top 10 list of good things about SARS and staff added their own wry comments. One married employee observed that a benefit of SARS was that she got the bed to herself.

The Easter long weekend was particularly tough for the hospital after two accidental exposures to SARS patients in quick succession led to 11 staff being diagnosed with the disease.

So when Reddick showed up for the first SARS committee meeting after the weekend, she was stunned to find everyone around the meeting table giddy with laughter. The CEO was making the whole team tinfoil hats to protect staff from the aliens that must surely be responsible for their bad luck.

The hats got sillier and sillier and everyone laughed for a while and then got back down to work, she says. “I don’t know how we would have coped if someone hadn’t thought of bringing in the tinfoil,” she says.

Still, when a second SARS outbreak was identified in June, just as it looked like the crisis was winding down, the weight became too much to bear for some.

“There were people who just sat and cried,” she says.

Wisely, new SARS patients were sent to other hospitals, but it was important to realize that employee resolve was running down. In the first case, not knowing what they were dealing with was actually useful because if at day one people knew this was going to last for months, personal lives would disappear and friends and co-workers would get gravely ill, it would have been tougher for them to go on.

“We had to remind them how good they had done and how many lives they had saved,” she says.

Eventually the all clear was given in August and a celebratory picnic was held in early October, where a “Sunnybrook Idol” contest was held, with the judges from the Canadian Idol television show judging the singing talents of Sunnybrook staff.

A recognition program was created and special rewards were given to staff who actually went into the rooms to treat SARS patients. The unions filed some grievances about the awards, but Reddick suspects those will be dropped.

Counsellors from employee assistance plan provider Warren Shepell, who were on site throughout the crisis, also conducted debriefing sessions. It just gave everyone a chance to relax and talk about how trying it was and how they were affected, Reddick says.

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