Managing the Unforeseen Through Agility and Adaptability: How a Credentialing Organization Achieved Business Continuity During a Global Pandemic

Friday, May 14, 2021

Understanding what your organization does and does not do well is vital in developing a long-term, sustainable business strategy and crisis management plan. While events like the current pandemic can transcend any amount of preparation, organizations with an understanding of their strengths and vulnerabilities, accompanied by a precisely honed sense of purpose will find the necessary resources to guide decisive action on how to survive and even thrive.

The pandemic may have thrown the organization off its routine, but the Pediatric Nursing Certification Board (PNCB) team had the tenacity, skills and knowledge to swiftly assess the situation, manage the impact, anticipate its own needs and that of stakeholders and set a decisive path forward. PNCB focused on its strengths: teamwork, communication and outstanding support to nurses. The priorities were clear: retain PNCB employees, keep certificants and volunteers safe and maintain the operation of essential business functions.

Ensuring Staff Safety and Wellbeing

In a desperate race to slow the spread of the coronavirus, states issued stay-at-home orders between March and April 2020. It became clear that PNCB would experience declines in candidate application submissions ― all leading to a revenue shortfall for the fiscal year and an interruption of work responsibilities. Beginning in April, PNCB implemented a short-term furlough for roughly 50% of our 16-member staff, shifting core tasks to remaining members of the team. Those furloughed maintained 100% of their benefits including health insurance.

There was enough cross-training at PNCB that the organization did not grind to a halt. Staff were aptly prepared for the task of stepping into other roles. Ultimately, having this type of flexibility is at the foundation of a truly agile work environment, allowing an organization to adapt to changes and still deliver on its mission. Although the process takes time to develop and implement, cross-training and leveraging staff knowledge across the organization can provide numerous benefits including the creation of stronger teams.

While the demand for workplace flexibility has been building for decades, at PNCB remote work was limited to senior staff. For certification organizations, remote work may pose challenges, particularly as it pertains to exam security and results import protocols. The pandemic serves as a cautionary tale of the need for organizations to adapt to the demands of a changing workforce. Ready or not, the coronavirus forced PNCB to quickly ramp up remote work plans to include all employees. PNCB’s remote work policy was updated to broaden work-at-home options and a pilot for an organization-wide program was launched. Staff were provided with secured laptops, virtual private network (VPN) service and softphones (software that utilizes the internet via a computer or smartphone to support business phone lines, call center integration and team collaboration tools).

Supporting the Needs of Pediatric Nurses

Critically important was ensuring that nursing professionals maintained their certification and the ability to care for their pediatric patients. To this end, in the early days of the outbreak, PNCB prioritized closing out the annual recertification process and processing new applications and exam test scores. Several temporary measures were also put in place to ensure nursing professionals maintained their certification. Examples of all types of measures include:

Process or Program Area	Pre-Pandemic	Pandemic Temporary Measure
PNP Exam Eligibility Requirements	For PNCB’s two pediatric nurse practitioner (PNP) exams, eligibility criteria require completion of a set number of clinical practice hours defined by national standards and individual PNP graduate program requirements.	As the pandemic unfolded, PNP students struggled to gain access to hospitals, private practices and preceptors, which limited their ability to complete these hours. When PNP programs temporarily amended their clinical hours requirements, PNCB did likewise while continuing to uphold national clinical hour requirements.
Testing Window Extensions	Requests for extending the testing window are initiated by individual candidates for a fee.	To make allowances for personal conflicts and safety related concerns, exam testing windows were extended without a fee, giving candidates additional time to prepare. Windows were extended in bulk for the candidates’ convenience and to reduce the one-off workload on staff.
Practice Tests	Discounts for these products have traditionally been limited to time-limited opportunities linked to conferences.	To encourage candidates to continue exam preparations, PNCB discounted all practice tests for an extended period.
Reinstatement of Lapsed Certification	The lapse of a certification can result in a nursing professional losing the eligibility to practice. Reinstatement is a fee-based time-limited opportunity.	As part of its relief efforts, PNCB provided those with a lapsed certification additional time to recertify without incurring additional fees.
Survey of Candidate Testing Experience	Historically only the test center vendor has conducted these surveys.	Test centers began to reopen in mid-2020. In June, PNCB launched its Candidate Experience Survey to gain insight into the experiences of candidates taking in-person examinations. Concerns had been expressed by exam candidates about the safety measures in place to mitigate the risk of spreading the virus. Collecting the data helped PNCB to inform the decisions of future exam candidates on testing preferences. It also provided the testing services provider with valuable data that could be utilized to ensure test center operations protected test takers.
Recertification Audit	Recertification audit historically has taken place in spring immediately after the renewal window closes.	In 2020, PNCB deferred the auditing of recertification applications until the summer.
Continuing Education (CE)	PNCB has long offered a CE product line that includes both fee-based and free modules.	A record number of nursing professionals lost their jobs as health care systems halted elective surgeries and routine procedures. Layoffs impacted access to CE needed for recertification. To prevent 2021 recertification fallout, PNCB heightened promotion of free CE that certificants could utilize to maintain their professional development goals.
Remote Testing	Prior to the pandemic, PNCB had not explored a live remote proctor option.	In response to test center closures and safety concerns, PNCB began to explore live remote testing options as an alternative method for candidates to take certification exams.

Maintaining Engagement and Collaboration Among Volunteers

Volunteers are the lifeblood in any organization and at PNCB they were instrumental in the organization’s recovery. Normally, PNCB hosts about eight to 10 face-to-face meetings a year where volunteers work together on CE modules, item writing, surveys and other task groups. Beginning March 2020, all meetings were held virtually. PNCB altered meeting agendas to accommodate time zones, compressed the workload and organized tasks to include independent activities. Despite their own work and personal challenges, volunteer committee members persevered in their tasks and maintained a strong sense of duty to support nurses who care for children.

Lessons Learned to Inform the Future

When I reflect on the many changes brought about by the pandemic, three big takeaways continue come to mind ― and influence our daily interaction as a team here at PNCB:

Lead Confidently: Do not be afraid to reset goals and reinvent the future of credentialing. Inspire your organization with a clear vision of the future and empower your teams to realize that vision. Drive innovation and growth in exam development activities and how certificant knowledge is validated. In 2020, we learned that rapid change and adaptivity under extraordinary circumstances is possible and needs to become the norm for the future. Credentialing organizations will need to embrace emerging and disruptive trends to effectively meet the changing personal and professional priorities of our candidates and certificants. There is no going back.
Invest in Technology: Enhancing PNCB’s IT capabilities was one of the most important investments made to support remote communication, collaboration and productivity. After reflecting on how much the lives and routines of staff have changed over the course of a year, it didn’t make sense to think that staff could return to work the same way they left. Some have children attending virtual classes; others are tending to elderly parents or relatives who need extra care. And, safety is an ongoing concern. The proposal to reduce our office space and adopt a hybrid workplace was presented to our board and the decision was highly welcomed by staff. Today, each department works in the office on an alternating two-day schedule. This plan reduces staff traffic by 50% and still provides time for enhanced team collaboration.
Build an Adaptable Culture: Organizational agility and adaptivity is essential when facing a major, disruptive change. The pandemic rattled long-standing business practices and forced us to embrace agile methodologies. We learned to rapidly implement alternative strategies at a moment’s notice. As we catch our collective breaths, now is the time to reflect on your experience in 2020. Use the lessons learned to redesign your revenue and operating models to succeed in the emerging new business reality. Commit to your mission, welcome ― and cultivate ― agile practices and build organizational resilience as you best serve your stakeholders no matter what lies ahead.