Coping with COVID-2019: Developing a Rapid-cycle Frontline Quality-improvement Process to Support Employee Well-being and Drive Institutional Responsiveness in a Tertiary Care Faith-based Hospital in Rural Kenya

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  • 1 AIC Kijabe Hospital, Kijabe, Kenya;
  • 2 Africa Consortium for Quality Improvement Research in Frontline Healthcare (ACQUIRE), Kijabe, Kenya

The coronavirus disease 2019 (COVID-19) pandemic has demanded rapid institutional responses to meet the needs of patients and employees in the face of a serious new disease. To support the well-being of frontline staff, a series of debriefing sessions was used to drive a rapid-cycle quality-improvement process. The goals were to confidentially determine personal coping strategies used by staff, provide an opportunity for staff cross-learning, identify what staff needed most, and provide a real-time feedback loop for decision-makers to create rapid changes to support staff safety and coping. Data were collected via sticky notes on flip charts to protect confidentiality. Management reviewed the data daily. Institutional responses to problems identified during debrief sessions were tracked, visualized, addressed, and shared with staff. More than 10% of staff participated over a 2-week period. Feedback influenced institutional decisions to improve staff schedules, transportation, and COVID-19 training.

Author Notes

Address correspondence to Mary B. Adam, AIC Kijabe Hospital, PO Box 20, Kijabe, Kenya 00200. E-mail:

Authors’ addresses: Mary B. Adam, Naomi Wambui Makobu, Wilson Karuri Kamiru, Simon Mbugua, and Faith Mailu, AIC Kijabe Hospital, Kijabe, Kenya, E-mails:,,,, and