Hiring and Managing Staff | Rapid hiring via external contracting organizations H + H as a hospital system had more capacity to set up and actually operationalize a new function. That was by fact of 1) Just their expertise, 2) The funding vehicles that could come. You know on an operation standpoint when you're kind of standing up the tracers, you gotta hire a lot of people. The HR department of the many hospitals of H + H or even central H + H are more adept at bringing on a bunch of nurses and doctors and MAs and NPs. And also, then equipping them with the necessary tools to do all the contact tracing. They had more real estate, more offices. (City Hall Leadership) Concerted efforts to hire diverse workforce of NYC residents facilitated engagement with cases and contacts I think what the message was, and my understanding was that the teams really, to me, always were to comprise of persons that lived in the zip code or neighboring communities. And they were reflective for the most part of the demographics in those communities. So, whether it be language or ethnicity, that basically if someone is ringing your doorbell or speaking to you on the phone, they can feel like there is some connection. (Community Engagement Specialist Supervisor) CES were employed to reach hard-to-reach people If they [case investigators (CIs)] were not successful, could not reach somebody due to missingness of data, wrong number, that would go to the IGs, information gatherers, also working remotely. And they [information gatherers] would hunt that down and either send it back to the CIs, the call center, or send it over to my team, who would then go and knock on the door. Or the case investigators would send it directly to my team if there was simply no phone number or the contact intake was incomplete. You caught somebody, and they were like, “I’m at work.” They answer five questions, “All right, it’s taking too long. I gotta go,” right? And they would hang up. Or soft refuse, and then it would come to my team. So, we [community engagement team] got the hardest to reach, the unable to reach, and the unwilling to cooperate, and we had to warm them up and get them to cooperate. (H + H Leadership) | Lack of quality control for new hires; brief and superficial hiring process; job descriptions were unclear But it seems like when I got a lot of my [case] investigators, the ones under me, they were told that they can work whenever they wanted to. It was this ultra-flexible thing. They thought they didn’t have to work weekends and holidays. The thing was, I guess, depending on who interviewed you – because it wasn’t one person – they were told whatever they felt to get the person to be on board, almost. (Case Investigation Supervisor) Some CES were resistant to traveling outside of their communities They needed people, again, that mirrored New York City. The problem that it created, however, is that people walked away – my team – with the mindset that they’re working in their community solely. And the dragon that is COVID-19 doesn’t respect a map. We could not have a hyperlocal staff for a citywide problem, because if I have Hebrew speakers, Yiddish speakers in Brooklyn, but I’ve got a pocket of a community in Queens, then you’re going there, and that is that campaign and organizer lens. You go where we need you, and know that your community is wherever the members of your community are. (H + H Leadership) Management did not preemptively staff up for surges So, we had some of these spikes and valleys when it comes to the pandemic, where certain times of the year, it would shoot up. And then certain times of year, like the summer, it would go down. And it’s predictable. After the first year, you can predict it almost by days, how they were going up, how are they going down. But they would wait until it was at a peak to be like, ‘Oh, my God, we cannot handle this. Let’s either hire someone or try something new,’ not preparing ahead of time, and that would produce a lot of headaches and also a lot of anxiety for the workers, and it would stress them out. (Case Investigation Supervisor) Undesirable working conditions (e.g., rigid work schedules, inadequate break times) You will literally just be making calls back-to-back-to-back. And I think at one point, they were saying you could only take 30 seconds between each call. And you would be on the queue from 10:00 [a.m.] to 7:00 p.m. It just became unbearable at a certain time. (Case Investigator) Frontline staff often had multiple supervisors and job satisfaction varied between supervisors …I had many supervisors. I think I had maybe four or five… [T]he first supervisor left in October of 2020. And then, the second supervisor came in, in October 2020. I had her for most of my time with Test & Trace. She was lovely. She helped me a lot. She was very patient. And the third supervisor, we didn’t get along, and she made the job very – I don’t know how to put this. She made the job very difficult and unenjoyable. And then, the last supervisor, we really didn’t have any communication. It was just strictly for monitoring us. We didn’t talk at all. (Cross-Trained Monitor) Job performance evaluation metrics were deemed unfair and emphasized quantity of calls over quality interactions with cases/contacts It did change the focus from really trying to provide people with quality care, and to really care about the people that you're contacting when you're worried about metrics, and you're worried about someone reaching out to you and telling you, ‘You didn't spend enough time on this call. You missed this word.’ I think it took a little bit away from the actual work. (Case Investigator) |
Data and Technology | Obtained emergency authorization for interagency data sharing So, I explained it to her [Chief Privacy Officer], and she drafted this data sharing MOU, which hopefully somebody sent you, which was the mechanism by which DOHMH could share the Maven data with us, and that we could then they could delegate their regulatory responsibility for contact tracing. Because that’s really their legal responsibility, and it’s not really ours, and so we needed something that made us their agent for this purpose. (H + H Leadership) | Extra step of transferring testing data from state and local health departments to T2 Because data gets reported to the health department and not Health and Hospitals, we had to set up a feed where in at two o'clock every day the data was cut and sent to Salesforce, so I think that came after say two o'clock it wasn't always to two o’clock but mid-afternoon it wouldn't make it to Salesforce until the following day to be uploaded the following night and so you're already building in potentially a delay in contact tracing is fairly important. (DOHMH Leadership) Difficult to make modifications to system I think a lot of our issues with Salesforce arose out of not having clear communication with or decision-making authority when it came to making programmatic changes and a lot of that lived with the DoITT which you know you typically don't have the IT team, making the programmatic decisions and that happened a lot. (DOHMH Leadership) Challenging to analyze data on the back end of Salesforce And there were just so many problems. I don’t know if it was a problem of Salesforce itself or the way [H + H] worked on it and the requirements not being stringent enough or whatever. But there’s so many issues related to, like, they couldn’t deduplicate people well. (DOHMH Leadership) |
Quality of Interactions with the Public | Shortening of call scripts in response to Omicron wave At one point during the last big surge, they shortened the script because we couldn’t afford to spend 25 minutes and up on a single case. So, they shortened the script and made it about 5–10 minutes. So, that was key. And that should have been done from the beginning to be honest with you because a lot of the questions were redundant. And that’s not coming from me, that’s coming from the actual cases. They themselves would say, ‘You already asked me that question.’ (Community Engagement Specialist) CBOs provided the “COVID contact line” and increased community awareness of contact tracing A lot of the community members would call us because we have a 24-hour hotline. They will call us and ask, “What is this [contact tracing] about?” They don’t even speak the language. They don’t even speak English. So, just understanding – It wasn’t even like, they didn’t even know how to assess the situation. It was more like; they were reacting to what this is about. They were so worried. They’re immigrants, also. They felt like, are they going after me, especially the undocumented ones. (CBO Leadership) | Not easy for cases/contacts to refuse participation in the program Technically, unless I heard the person say, it was a specific sentence that they had to say, something about ‘Do not call me anymore.’ I don’t remember the exact verbiage, but unless they told me that, I could not mark them as ‘refused.’ So, technically, I should’ve thrown them back in the queue, but I would mark them as ‘refused’, yeah. (Case Investigator) Telephonic translation service was time consuming That adds up, I spend four hours on calls sometimes with people. And that’s not including translator calls where one person could take 2–3 hours, because you’re not just translating what they’re saying, the translator [is] translating what you’re saying and the conversation back and forth. And most of the time they didn’t translate it correctly, so you’d have to repeat yourself. And the person on the other end didn’t understand it correctly, so you’d have to repeat it. (Case Investigator and Monitor) Did not have mechanism to directly transfer Spanish-speaking cases/contacts to the Spanish queue Especially because we had Spanish-speaking representatives, but I would still get countless Spanish calls. And they’d ask me to speak to somebody in Spanish, but I’d still have to do it myself knowing that there’s somebody else who could have done it. And that’s not fair, I understand that there’s different languages, like Urdu, I doubt we’re going to have Urdu translators or different dialects. But for the main languages, there should be at least a few representatives to talk with them. We should be able to transfer them into that queue and just say, “They’ll call you back whenever they’re available.” It’s going to save a lot of time, but they didn’t allow us to do that. (Case Investigator and Monitor) |