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Quarterly: Spring 2020 - Kymber Waltmunson

Are you ready for a pandemic? An audit and how to telework

By Kymber Waltmunson

Unless you have been living in a cave, you are aware of the coronavirus disease 2019 (COVID-19) outbreak. We are writing from the first county in the U.S. where the virus has taken hold, King County, Washington. COVID-19 has been in the news for a while, but it had felt an arm’s-length away until this week. On March 2, guidance from county leadership was mostly about taking precautions and washing hands. By March 4, direction shifted to being told that unless we were in a critical role we should work from home and take “social distancing” measures.

It has been an eventful week, and we have learned a great deal and would love to share our insight with you. There are two places we would like to take this story:

Part 1: Auditing Public Health Response to Outbreaks Such as COVID-19

Why audit public health entities? What could be the scope?

According to the National Association of County and City Health Officials, communicable disease control is one of the highest-priority services for local public health agencies, because no other actor in the community provides disease response and surveillance across all residents. Our performance audit evaluated how the Prevention Division Communicable Disease and Epidemiology (Epidemiology) program managed limited staff capacity during serious disease responses. We looked at why, and how often, the demands of disease responses exceeded staff capacity, and how the program handled this. We also looked for opportunities to improve the efficiency of disease response.

What did we find?

We found that there were a number of management practices (or lack thereof) that kept Epidemiology from being as efficient and effective as possible during a disease surge. Our analysis showed that Epidemiology staff was overwhelmed and triaged high-priority tasks without clear guidance from leadership. In addition, the program lacked the data needed to inform its disease response strategy, overtime may have been underused and unreported in the midst of outbreaks, and processes to get temporary staff were inefficient.

We saw a huge leap in need for public health services during the period we reviewed, which made it even more important to ensure that Epidemiology was working efficiently.

Source: Auditor’s Office analysis of information provided by King County Public Health’s Prevention Division.

What criteria did we use?

Here is a partial list of our resources for local government public health entities:

  • Surge Capacity: A Proposed Conceptual Framework, The American Journal of Emergency Medicine
  • Training for and Maintaining Public Health Surge Capacity: A Program for Disease Outbreak Investigation by
  • Student Volunteers, Association of Schools of Public Health
  • Public Health Workforce Surge Guidelines, New South Wales Ministry of Health Guidelines (Australia)

What did we recommend?

We made 13 recommendations in our 2017 audit and Public Health implemented 11 at our first follow up evaluation a year ago. Some of the key recommendations we made to Epidemiology to support it in building an effective emergency response framework included:

  • conduct a workload priorities review
  • assess resource distribution to ensure that communicable disease control funding reflects strategic priorities
  • collect and analyze data about how staff members use their work hours, and use the results to inform staffing decisions
  • analyze staff capacity throughout the program, and develop and document a plan to efficiently use existing staff and temporary administrative staffing options to manage periods of high workload
  • establish a specialized disease response group with a more efficient way to request volunteers
  • implement a process for expediting technology setup and network access for temporary employees and volunteers.

Is now the right time to audit your own public health entity?

Probably not. As auditors, we know it is important that our evaluations do not interrupt critical work. If your public health entities are not already doing some of these things it may be too late to do this planning and strategy work and would likely only slow down their COVID-19 response. It is an excellent time, however, to identify how you will begin this audit work when surge response slows. Engaging with an auditee just as they are coming off of a crisis is an excellent time to drive change so that the next time these issues arise they are better prepared. When coming off of a major disease response, program staff will also have a better idea of what does and does not work. We are happy to share more detail about our methodology, criteria, and experience with the topic, if you need it.

Part 2: Lessons Learned When Moving Teams to 100% Telework

Guidance to apply social distancing (things like limiting large groups of people coming together, closing buildings, and canceling events) is in place in many parts of the country. There is some likelihood that audit shops—among all kinds of public entities—will need to find ways to keep getting work done without employees coming into a central office. The King County Auditor’s Office has only been at 100% telework for a few days, and the learning curve was steep. We would like to share some of that curve with you, so you have time to prepare in case similar practices are needed in your jurisdiction.

There are some key principles that will make whole-team telework more effective:

  1. Having the right technology
  2. Planning ahead
  3. Keeping the communication going

Aside for managers

Managing people in an all-telework environment is going to take some new skills and frameworks. To prepare for this, I’ve spent the last several days reviewing information on the web and consulting with friends who manage distributed teams in the tech industry. Here are some high-level tips I gathered, that aren’t repeated below:

  • Increase your 1:1 check-ins—monitor project work and employee mental health.
  • Require video for some online meetings to keep people connected as a team.
  • Find ways to get connected to what each person’s new life looks like—e.g., yesterday, I met several people’s cats and for others, their kids popped into the video frame to say hello.
  • Cultivate your culture of accountability but remain flexible to the real-life situations your employees are experiencing.
  • If you have not tried Agile/Scrum project management, now might be the time.
  • Rethink dress codes for home and, if using video, provide clarity to employees whether there are meetings for which they would still be expected to dress more formally.
  • Give staff flexibility to innovate and to share ideas with the rest of the team—e.g., using new apps or technologies, different ways of sharing information, etc.

Having the right technology

We write this as technology users, not experts, so pardon any imprecise language. We have a fairly liberal telework policy in my office, but I admit that I really prefer to be in the same room with people. We have been pleased with the use of video meetings during this period of social distancing. I can see people’s faces and our conversations have been lively and productive.

  • IT support – It has been incredibly helpful to have people to call who can help with our technology needs. If you do not already have tech support relationships, we recommend making some friends over there pretty soon.
  • Laptops – All staff work from county-issued laptops that are equipped with video and audio capability, both in the office and at home. This has made telework much easier than if we did not have them. In the days leading up to the telework directive, everyone took home their laptops and power cords at the end of each day just in case they were told to work at home the next day.
  • Remote file access – It is critical to have access to email and electronic files to be able to maintain productivity. Combine this with good IT support and laptops and you have the basics.
  • Skype – If Skype for Business is part of your work suite, then it is a great tool to use. We added Skype links to each meeting, so all we had to do when a meeting started was to click on the Skype link and each participant could join by voice, video, or both. We also initiate video or voice calls with one another for check ins or Scrum stand ups, for example. Another tool is sharing your computer screen during a meeting in order to look at a file or follow an agenda with others. We haven’t tested for our full staff yet, but the interwebs say that you can have up to 10 people on video together. Seeing each other is welcome when working all alone and it reduces the tendency to interrupt one other, which can happen during group voice calls.
  • Text – Set up a text group with all staff member’s cell phone numbers. Staff typically see texts before opening work email, so this will allow you to communicate with everyone quickly. Be mindful of your agency’s public records guidance when communicating via text message, however.
  • Zoom – This is a free video conferencing service – there are several. We do not need it because Skype works well for us, but it is what many local teachers are being set up to use in the case of long-term school closures. I have used it several times with vendors or for personal appointments and it was easy and effective. I am sure that the paid version has more bells and whistles.

Planning ahead

  • Big picture – Will this impact audits and their timeframes? We met and determined which auditees would be likely to be impacted and how that might change our audit timelines and scopes. We slowed some projects down, re-scoped others, and identified new projects we could start early that are not contingent on auditee-held data. It is also a good time for staff to catch up on CPE using online training options or to focus on other projects that may have been on the back burner.
  • 2-3 week timeframe – You’ll need to take a 2-3 week look at your calendar. What milestones should you plan for? Have you added Skype meetings to the calendar? Have you touched base with audit interviewees to make plans for video interviews or phone calls? Have you canceled or rearranged meeting formats to try to get everything lined up? Do you have legislative meetings? What is happening with those and how will it impact your work?
  • Current day – Who will initiate video meetings? Which meetings are phone in and which require video? What documents will you need to have open to share with your team when sharing your screen? Have you tested the technology you plan to use for your meetings? Do all attendees know how they will participate? There may be some extra fumbling at the beginning of meetings to make sure that the audio and video are working correctly and as people get comfortable with the technology.
  • General – Make a plan for how teams will show each other what needs to be done, which tasks they plan to do, sharing team progress with tasks, and how work will be reviewed. Everyone will want to get paid correctly, so plan how staff prepares documents related to taking leave or documenting hours worked.

Keeping the communication going

There are transactional things that will need to have systems created for them, such as a method for communicating who is working each day and when so that there is accountability. If you are in an office with a “drop by” culture you may need to find ways to keep those casual conversations going. For example, we use text, IM, periodic calls, and team meetings to have discussions. I have been making regular contacts with each staff person to see how they are doing, what they are working on, and if they have any great tips for the rest of the team.

Finally, don’t forget this in your efforts to keep work moving: being socially isolated is HARD! I love seeing people every day, hearing about their weekends, getting social input, and getting outside for fresh air. Without that I get a little lonely and stir crazy. My cat is not a great conversationalist. Make sure to check in with each other on a personal level however you can. Spend a few minutes talking about personal things and not work. Go for walks and get out into the world (six feet away from other people, of course) several times a day. Hang in there, everyone, and for Pete’s sake, wash your hands!!

About the Author

Kymber Waltmunson is the King County auditor in Seattle and former Snohomish County auditor. She is a certified internal auditor and certified government audit professional with a master’s of public administration and a master’s in clinical psychology.