Building Trust

Building a culture of trust among staff in long-term care facilities can assist in increasing vaccination rates.

Having a trusting relationship between leadership and facility staff is foundational for successful vaccine efforts.

Some ways chain leaders can build trust include:

  • Make themselves available to answer staff questions about vaccine hesitancy

  • Be a visible presence at vaccine-related events such as clinics or Town Halls to hear concerns and answer questions

  • Demonstrate their own confidence in the safety and effectiveness of vaccines

Additional Resources


Four-lesson virtual program full of tools and resources to help leaders build trust with staff View Here

TED Talk

Foundation for the AHCA course on building trust View Here

AMDA – The Society for Post-Acute and Long-Term Care Medicine

Provides practical suggestions and key takeaways from AMDA’s Healing Together webinar on improving trust. View Here

Role of the Medical Director

The Medical Director’s role and responsibility is to be a leader in the prevention and treatment of COVID-19 in the PALTC facilities they serve, and to oversee the development of effective and practical policies toward that end. As medical directors work to standardize the prevention and treatment of COVID-19 across PALTC settings, the Society recommends the following steps/strategies:

  1. COVID-19 Vaccination

Medical director should support policy for timely vaccination against respiratory illnesses including COVID and influenza vaccines.

This could include:

  • Coordination and consultation between providers and pharmacists in caring for and immunizing/treating patients

  • Including vaccination consents in admission documents

  • Empowering key facility staff through vaccine education thus enabling them to effectively counsel residents, family members

  • Ensuring adequate supplies of vaccines and frequency of clinics in collaboration with consultant pharmacists

  • Ensuring staff education through events like town halls/in-services/educational materials in collaboration with nursing and facility leadership

  • Encouraging open communication of concerns about the vaccine and creating a safe and supportive environment to build trust

  • Ensuring that the assigned infection preventionist/consultant pharmacist is tracking the vaccination of the residents and staff and appropriately documenting in the NHSN and other state vaccine databases

  • Including the vaccination rates in the QAPI/antibiotic stewardship data

  • Promoting coadministration of influenza and COVID vaccine to mitigate risk of preventable respiratory illnesses

  1. COVID-19 Prevention


  • Review facility policy and procedure

  • Review facility education regarding donning and doffing PPE

  • Review fit testing for N95 (initial, annual and PRN fit testing)

Infection control precautions

  • Review policy and procedure for infection control

  • Review signage for quarantine and isolation

  • Review PPE storage and discard

  • Review hand sanitizing and washing access and standards

  • Review environmental measures such as ensuring proper ventilation, closing doors, cleaning/sanitizing equipment and frequently touched surfaces, dedicated equipment in isolation and quarantine rooms, handling and washing of laundry and eating utensils

  1. COVID-19 Control
  • Testing protocol (for staff, consultants and visitors, and residents)

  • Testing standing orders

  • Review cohorting, quarantine, and isolation procedures