1. Background

In April 2020, the Colorado Department of Public Health and Environment (CDPHE) along with the Colorado National Guard (CONG) started drive-through COVID testing sites as a response to the pandemic [3]. By June 2020, CDPHE was investigating alternative methods for testing throughout the state which included using contract staffing agencies. In July 2020, Insight Global (IG) began as a contracted vendor for COVID testing under the state’s Rapid Response Program.

The Rapid Response Testing (RRT) Program was responsible for all short-notice and high-risk testing through the CDPHE Lab. After vaccines were available, this team also assisted with data gathering and logistics for vaccination sites through CDPHE. From July 27, 2020 to August 18, 2021, the RRT contracted staff from Insight Global worked over 64,000 man-hours on 13,000 site assignments that resulted in over 100,000 tests administered and assisted with 20,000 clients getting vaccinated. Given the high tempo and multiple stakeholders of the program, it became evident on the need to communicate effectively between testing staff, CDPHE site leads, CDPHE program coordinators, CONG staff, other contractors, and leadership.

2. Actions, Results and Discussion

Prior to the start of the feedback system, IG had an attrition rate of nearly 40% within the first 6 weeks of the program. This resulted in additional costs to recruit, screen, and onboard new staff. Along with this, the program was not achieving the 95% benchmark attendance rate for staff and had multiple concerns raised up from CDPHE and CONG site leads about performance. Based on this, the contracted Operations Manager worked with CDPHE to conduct a site visit to a testing site to review protocols. The Operations Manager and IG leadership worked with CDPHE site leads on lessons learned from the first month of sites.

The result was a 3-pronged approach to feedback. First, IG developed a client-facing interface for roster management and feedback. This allowed site leads to provide real-time feedback for the team members that included positive and negative performance and attendance. Secondly, regularly scheduled meetings with program coordinators and available site leads were set up to review trends of behavior or interactions that would not warrant specific feedback for an individual staff member. Lastly, Staff members were also provided feedback mechanisms to submit for any site or protocol.

Over the next 2 months, attendance rose to an average of 98% per week, attrition dropped to 12%, and the amount of positive feedback from site leads grew almost 600%. At this time, additional revisions were made to the feedback systems to address elements that included updating rosters/site leads more effectively, integration of information provided by the state for staff on site details, and standardized language and protocols for newly experienced concerns such as inclement weather (i.e. heavy snowfall, ice).

It is vital to ensure that you utilize multiple methods when receiving feedback from stakeholders, especially with very diverse teams [4]. By relying on concepts like “gemba walks” from Lean and Agile feedback loops, this program was able to ensure that the needs of the larger Colorado population for COVID testing and vaccination were met. When programs have multiple stakeholders present, it is essential to gain perspectives from each stakeholder group and allowing for both real time and more deliberate, strategic feedback from all levels.

Competing Interests

The author declare that there is no competing interests regarding the publication of this article.