On March 10, 2020, MD Anderson leadership informed Volunteer Services and Merchandising that due to the COVID-19 pandemic, volunteers and staff would be sent home until it was safe to return to campus. It was estimated the closure would last two weeks, but leadership soon realized that due to the pandemic's severity, the department would be closed indefinitely. This case study reviews how MD Anderson's Volunteer Services and Merchandising team handled the COVID-19 pandemic and how the lessons learned can help manage future emergencies.

In 2022, the Joint Commission released revisions to their standards for Emergency Management recognizing that COVID-19 found many organizations inadequately prepared to respond (Joint Commission, 2021; Deloitte & Joint Commission, 2020) These new standards emphasize emergency policies and procedures; communication and coordination of response activities; and education and training for dealing with disasters (Joint Commission, 2022). While this case study paper addresses how MD Anderson managed volunteers during their pandemic, these best practices will assist any organization with meeting the updated Joint Commission standards.

• Communication: How could the department ensure that volunteers felt they were still connected to MD Anderson's Volunteer Services and Merchandising during the pandemic?
• Information: How could the department keep volunteers updated on MD Anderson's response to the COVID-19 pandemic?
• Compliance: How would the department track vaccination compliance with the current volunteer population?
• Return: How would the department structure the safe return of volunteers and track vaccine compliance?

The resulting solutions to these challenges provided a template for how MD Anderson can handle volunteers in future emergency situations.

Communication

• Communicated weekly emails via VSys One Letter Manager
• Held volunteer virtual Town Halls to share news and updates about how the COVID-19 will affect volunteering and possible next steps
• Invited volunteers to share and post what activities they were doing during the pandemic via the Volunteer Services Facebook page
• Informed volunteers that they can still make a difference in our patients lives by safely donating blood at donation centers
• Encouraged volunteers to send words of hope to cancer survivors to our department email which would then be turned into a video and shared with all cancer survivors, caregivers, and family members via our social media outlets
• Surveyed volunteers on their interest in returning

Information

• Shared the MD Anderson COVID-19 resource page to provide fact-based information to volunteers
• Provided a calendar of virtual events and classes volunteers can attend that teach them how to better support our cancer patients
• Created art classes that volunteers can attend virtually
• Encouraged volunteers to sign up for MD Anderson newsletters
• Communicated the process for volunteers to receive COVID-19 vaccines at MD Anderson with a clear definition of "fully vaccinated":
  • The administration of a single-dose vaccine (such as the Janssen (Johnson & Johnson) COVID-19 Vaccine), or the administration of all required doses of a multi-dose vaccine (such as the Pfizer-BioNTech COVID-19 Vaccine (interchangeable with the licensed Comirnaty Vaccine) or the Moderna COVID-19 Vaccine)

Compliance

• Ensured volunteers vaccination status met CMS (Centers for Medicare and Medicaid Services) and NHSN (National Healthcare Safety Network) standards
• Created certifications in VSys One to track volunteers COVID-19 vaccine compliance per the above definition
• Used VSys One Intellilists to filter volunteer vaccine compliance
• Created vaccine compliance reports for CMS and HNSN

Return

• Created an onboarding process for returning volunteers that included:
  • Proof of complete COVID-19 vaccination
  • Two shots of an approved vaccine (Moderna or Pfizer) or one shot of Janssen)
  • Required a photo of COVID-19 vaccine card
  • Current flu shot record
  • Required new volunteer photo for volunteer badge
  • Used Notification and Subscription tool in VSys One to automate steps
    • Send automated "Next step" letters to volunteers
    • Send updates to staff when onboarding requirements are met
  • Informed volunteers that a phased return schedule would be implemented: small groups of volunteers at first then more as CMS and HNSN allowed
  • Moved ongoing training and interviews to Zoom with plans to use the VSys Online Training Module in the future

Timeline of events

• March 13,2020: Informed volunteers that the department would be closed due to the pandemic
• April 4, 2020: Weekly email communication begins
• August 9, 2021: Virtual Volunteer Town Hall
• October 21, 2021: Informed volunteers of the onboarding process and steps
• February 10, 2022: COVID-19 documentation deadline
• February 22, 2022: Reorientation begins
• March 14, 2022: Phase I and II volunteers must complete all onboarding requirements
• March 21, 2022: First volunteers return to campus

COVID-19 forced a reimagining of our volunteering practices, emphasizing flexibility and creative solutions to continue making a positive impact on our patient, family, and caregiver population. While the pandemic did not fundamentally change the concept of volunteering, it drastically altered the ability to engage in volunteering activities. Notably MD Anderson found that application and volunteer numbers decreased, however their volunteer population remains committed.

While COVID only represents only one type of emergency, this response and reimagining of practices provides a template for other emergency preparedness responses. The Joint Commission recognizes the importance of volunteers and recommends that Volunteer Managers be included in Emergency Management planning as the role of volunteers is often expanded during emergencies (Campbell, 2024). While volunteers initially may be asked to stay at home during an emergency, their assistance may be required as was evidenced during the pandemic when volunteers with certain credentials were called in to assist at vaccination clinics.

Emergency Management plans should also consider cyberattacks and other types of emergencies beyond pandemics. The Joint Commission (2023) found that cyberattacks and other information breaches are among the most common types of emergencies seen in healthcare and that these are increasing year over year. The average time for an organization to recover from a cyberattack or data breach is 18 days and volunteers are often called in to assist with tasks previously done by computer systems such as badging (checking in staff) or communicating between departments such as running scripts to pharmacy (Campbell, 2024). This further emphasizes the need to include volunteer leaders in disaster recovery planning of all types. Additionally Volunteer Departments should have their own disaster recovery plan that includes documented policies and procedures, communication and coordination of response activities, education and training as per the Joint Commission Standards for emergency management.

Campbell, Robert (2024). "Joint Commission Regulatory Readiness", Society of Healthcare Volunteer Leaders (SHVL), Nashville TN, March 21 2024.

Joint Commission (2021). R3 Report: Requirement, Rationale, Reference. https://www.jointcommission.org/-/media/tjc/documents/standards/r3-reports/final-r3-report-emergency-management.pdf

Joint Commission (2023, August 15). Sentinel Event Alert: Preserving Patient Safety after a cyberattack. https://www.jointcommission.org/-/media/tjc/newsletters/sea-67-cybersecurity-7-26-23-final.pdf

Deloitte & Joint Commission (2020) COVID-19 Lessons Learned: A Resource for Recovery. September 18, 2020, https://www.jcrinc.com/what-we-offer/covid-19-lessons-learned-a-resource-for-recovery/