Example: stock market

Caring for health care workers during crisis: Creating a ...

2020 American Medical Association. All rights reserved. 1 Summary: Action steps taken by an organization before, during and after a crisis will reduce psychosocial trauma and increase the likelihood your workforce will cope or even thrive. How physicians and other health care workers are supported during a time of acute stress impacts how they cope and whether they recover from the crisis, or alternatively, whether they will adopt unhealthy coping mechanisms and show signs of stress injury ( , burnout, insomnia, dysphoria) or even worse, chronic stress illness ( , depression, anxiety, PTSD, substance abuse). Effectively Caring for the health care worker may decrease their risk of leaving practice or limiting their fulltime effort. Successful organizations will take a systems approach and focus on becoming a resilient organization prior to times of crises, rather than limiting their efforts to a focus on individual resilience or only attending to the well-being of health care workers after crises develop.

May 08, 2020 · A grief injury Due to the loss of people, things or parts of oneself A moral injury ... “Caring for Yourself & Others During the COVID-19 Pandemic: Managing Healthcare ... Loss of coping skills Exhaustion Insomnia Panic Crisis Guilt Coping and recovery No intervention.

Tags:

  During, Loss, Coping, Grief, Covid

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of Caring for health care workers during crisis: Creating a ...

1 2020 American Medical Association. All rights reserved. 1 Summary: Action steps taken by an organization before, during and after a crisis will reduce psychosocial trauma and increase the likelihood your workforce will cope or even thrive. How physicians and other health care workers are supported during a time of acute stress impacts how they cope and whether they recover from the crisis, or alternatively, whether they will adopt unhealthy coping mechanisms and show signs of stress injury ( , burnout, insomnia, dysphoria) or even worse, chronic stress illness ( , depression, anxiety, PTSD, substance abuse). Effectively Caring for the health care worker may decrease their risk of leaving practice or limiting their fulltime effort. Successful organizations will take a systems approach and focus on becoming a resilient organization prior to times of crises, rather than limiting their efforts to a focus on individual resilience or only attending to the well-being of health care workers after crises develop.

2 Furthermore, resilient organizations will need to rapidly reconfigure their well-being priorities to meet the biggest new drivers of stress in a crisis : Crises are inherently stressful and often involve uncertainty, unpredictability and increased work intensity. Such events also require flexibility, endurance, equanimity and professionalism from health care workers precisely when these attributes are most threatened. For health care professionals to successfully navigate these challenges and serve their patients and society during a public health emergency, they need organizational support. How well organizations plan for and support their workforce during a crisis will influence the organization s capacity for patient care, and the personal impact of the crisis on the health care stress has the potential to lead to long-term growth and thriving ( , post-traumatic stress growth ) or to long-term stress injury and illness depending on the infrastructure, culture and actions of an organization.

3 (Figure 1) Creating a plan to provide support for the workforce during and after a crisis will help maintain a healthy and sufficient workforce to meet societal needs over health care organizations have an emergency preparedness incident management system, such as a hospital incident command system (HICS), covering important topics, like planning, response and recovery capabilities for unplanned and planned events. It is critical such preparations include plans to support physical, emotional and psychosocial needs of the workforce. It is also critical for organizations to attend to the well-being of the health care workforce prior to an emergency so that the they do not enter times of crises with a team that is already exhausted, depleted and burned out. In most cases, the well-being infrastructure that is in place prior to a crisis can serve as the framework to apply new or modified support systems in the midst of an emergency.

4 This module provides a 17-step process for activities before, during and after a of steps for Caring for health care workers during a crisis1. Before: Creating a resilient organization1. Appoint a chief wellness officer (CWO) and establish a professional well-being Create a Caring for the health care workforce during crisis plan and coordinate with HICS Develop a plan to support workforce needs for professional competency during crisis Establish a plan to suspend or reduce non-essential Develop mechanisms to assess stress and needs within the during : Supporting physicians and other health care workers during a crisis6. Assess the current situation and evaluate the adaptability of the pre-existing plan to the current If necessary, develop new support and resources to meet needs specific to the a resilient organizationCaring for health care workers during crisisTait D.

5 Shanafelt, MD; Jonathan Ripp, MD; Marie Brown, MD; Christine A. Sinsky, MD Updated: 05/08/20 2020 American Medical Association. All rights reserved. 2 8. Emphasize and embody the importance of visible leadership. 9. Connect with other institutions, share and learn together. 10. Assess the needs and stress level within the workforce at regular intervals. 11. Adapt support plan to meet evolving After: Learning from a crisis to be an even more resilient and effective organization in the future12. Debrief unit by unit as well as by Catalogue what was learned and update the crisis plan for next Deploy an organization-wide approach for supporting the workforce after the crisis; identify new needs to facilitate recovery and Honor the dedication, commitment and sacrifice of health care Memorialize health care professionals that have been Resume efforts to attend to organizational and system factors that promote well-being and create a resilient model: Caring for health care workers during crisisWhen crisis occurs, there are inevitable stress reactions.

6 In an ideal state, workers feel well-trained, physically and mentally fit, motivated, calm, steady and in control prior to the crises. Then the unexpected happens: a pandemic occurs with a new pathogen for which there is no cure, a natural disaster strikes bringing in mass casualties, a nuclear reactor explodes and contaminates and sickens an entire region, or some other calamity not yet does the workforce respond to this crisis? Stress may come from one of four major sources: A threat to the worker s personal/family health and life A loss of colleagues or threat to professional mastery and identity An inner conflict between ones values and aspirations and what they are able to accomplish in their work Fatigue, simply feeling worn out by the relentless work and need, without time for rest and recovery (See Figure 1)Figure 1.

7 Four causes of stress injuryLife threatLossInner conflictWear and tearA traumatic injuryDue to the experience of or exposure to intense injury, horrific or gruesome experiences, or deathA grief injuryDue to the loss of people, things or parts of oneselfA moral injuryDue to behaviors or the witnessing of behaviors that violate moral valuesA fatigue injuryDue to the accumulation of stress from all sources over time without sufficient rest and recoveryHow one reacts to stress may vary, from a minor reaction ( , feeling irritable or down, experiencing muscle tension or minor difficulty sleeping), to a serious stress injury ( , not feeling like one s normal self, having excessive guilt, shame or blame, feeling out of control, experiencing dysthymia or panic), and if left untreated the acute stress reaction can evolve into a persistent social or occupational impairment ( , depression, anxiety, substance abuse, PTSD, suicidal ideation).

8 Fortunately, progression from a stress reaction to stress injury to a chronic stress illness is not inevitable. Proactive institutional supports initiated before a crisis, stress first aid delivered during the crisis and recovery aid provided after the crisis will each increase the odds that individuals will recover and thrive. (Figure 2) Caring for health care workers during crisis: Creating a resilient organization 2020 American Medical Association. All rights reserved. 3 Figure 2: Conceptual model: Stress first aid during and after crisis impacts outcomesAdapted from The Schwartz Center, Patricia Watson, PhD, Caring for Yourself & Others during the covid -19 Pandemic: Managing Healthcare workers Stress. Before: Creating a resilient organization1. Appoint a CWO and establish a professional well-being programWith a CWO and well-being program in place there is a unit which can rapidly shift the focus of their work to address the needs created by the crisis event.

9 [See AMA Steps Forward module on Creating the Organizational Foundation for Joy in Medicine] In crises with significant societal disruption and anticipated psychological stress, it will be necessary for the CWO to partner with behavioral health , communications and other support many organizations the CWO is appointed to lead the workforce support response in a crisis since the CWO will have built partnerships/relationships with all of these health care system units prior to the crisis. Depending on the nature of the crisis, the CWO may establish a task force structure to help coordinate across many areas ( , food, transportation, lodging, security, communications, behavioral health ).2. Create a Caring for the health care workforce during crisis plan Assemble a time-limited group, charged with identifying the needs of the workforce for the tangible physical, logistical and psychosocial support at work and at home during a crisis.

10 Ensure that the HICS plan includes these dimensions of basic logistical, communications, psychosocial and mental health support. In Creating a plan to support health care workers , be aware that the barriers to seeking and receiving help may be greater among those in the healing professions. The Stanford Medicine Hear me, Protect me, Prepare me, Support me, Care for me model8 is one framework. The Mt. Sinai model of a hierarchy of needs is another, available at Mt. Sinai s Well-Being Staff Resources during covid -19. See Table 1 for domains of needs and examples of programs to meet those needs. An organization that has cataloged existing resources, identified potential workforce needs and outlined a plan for how to address will be a step ahead when a crisis for health care workers during crisis: Creating a resilient organizationPre-existing institutional supports CWO Well-being program Pre-existing CCC plan Communication Recovery aid Rest Time away Counseling Reflection to find meaning in work during time of crisisStress first aid Basic needs: PPE, food, hydration, transportation, lodging, childcare, Administrative burden relief Psychosocial/MH support: Peer support, 24/7 mental health , Plan for dealing w/deaths of colleagues Communications.


Related search queries