Listening and learning from the COVID-19 frontline in one US healthcare system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Denise M. Cumberland ◽  
Andrea D. Ellinger ◽  
Tyra G. Deckard
Keyword(s):  
Healthcare System ◽  
Healthcare Workers ◽  
Professional Lives ◽  
Frontline Employees ◽  
Healthcare Staff ◽  
Content Type ◽  
Healthcare Facilities ◽  
Frontline Workers ◽  
Administrative Functions ◽  
Frontline Healthcare Workers

PurposeThe on-going COVID-19 pandemic has drastically impacted healthcare systems worldwide. Understanding the perspectives and insights of frontline healthcare workers caring for and interacting with patients with COVID-19 represents a timely, topical, and important area of research. The purpose of this qualitative action research study was to assist one US healthcare system that has an expansive footprint with the implementation of a needs assessment among its frontline healthcare workers. The leadership within this healthcare system wanted to obtain a deeper understanding of how the COVID-19 pandemic was impacting the personal and professional lives of its workers. Further, the organisation wanted to solicit employees’ feedback about what they needed, understand the issues they were facing, and solicit their ideas to help the organisation know where to take action.Design/methodology/approachThis qualitative research employed 45 focus groups, referred to as virtual listening calls (LCs) in this organisation, which were held over a four-week period. A total of 241 nursing staff, representing healthcare facilities across the country, attended 26 of the LCs. A total of 19 LCs were held with 116 healthcare workers who are employed in other clinical roles (e.g. therapists) or administrative functions.FindingsExtending beyond the available research at the time, this study was initiated from within a US healthcare system and informed by the frontline healthcare employees who participated in the LCs, the findings of this study include the perspectives of both nursing and other healthcare workers, the latter of which have not received considerable attention. The findings underscore that the COVID-19 pandemic has wreaked havoc on the personal and professional lives of all of these healthcare workers and has exacted an emotional toll as noted in other studies. However, this study also highlights the importance of listening to employees’ concerns, but more importantly, their recommendations for improving their experiences. Notably, the organisation is in the midst of making changes to address these frontline workers’ needs.Originality/valueThe study, inclusive of nursing and other healthcare staff, demonstrates how an organisation can adapt to a crisis by listening and learning from its frontline employees.

scholarly journals COVID-19 Pandemic: An Inhibitor of Universal Health Coverage Programme: A ViewPoint

2021 ◽  
Vol 4 (5) ◽  
pp. 1-13
Author(s):  
Helen Idubamo Wankasi
Keyword(s):  
Universal Health Coverage ◽  
Healthcare Workers ◽  
Sustainable Development Goals ◽  
Health Coverage ◽  
The Sustainable Development ◽  
Healthcare Facilities ◽  
Effective Governance ◽  
Development Goals ◽  
Frontline Healthcare Workers ◽  
Universal Health

Ever since the re-emergence of Covid-19 as a pandemic, healthcare facilities (human and materials) have been overstressed, evidenced by the rate at which frontline healthcare workers fall sick and die in the course. In some healthcare institutions, the narrative has changed with regards to the number of days to access physicians for treatment, but selected and booked only on specific days and periods, except in extreme emergencies are able to access physicians un-booked. This is inconsistent with the intent of Universal Health Coverage and the Sustainable Development Goals. This paper, therefore, highlighted the objectives, covering a brief overview of COVID-19 and Universal Health Coverage; identified countries developed (Germany 1883) and emerging (South Africa/Nigeria) that have adopted Universal Health Coverage as well described how COVID-19 stands as an inhibitor to the achievement of Universal Health Coverage. At the tail end, recommendations are made on the way forward on the need for effective governance, manpower sourcing and general strengthening of the healthcare system.

The effects of relationship bonds on emotional exhaustion and turnover intentions in frontline employees

2014 ◽  
Vol 28 (4) ◽  
pp. 319-330 ◽  
Author(s):  
Edward Shih-Tse Wang
Keyword(s):  
Emotional Exhaustion ◽  
Emotional Labor ◽  
Turnover Intention ◽  
Affective Commitment ◽  
Turnover Intentions ◽  
Service Industry ◽  
Frontline Employees ◽  
Continuance Commitment ◽  
Content Type ◽  
Frontline Workers

Purpose – This paper aims to extend the relationship marketing concept to examine which relationship bonds (social, structural and financial bonds) have different effects on employee affective (want to stay), normative (ought to stay) and continuance commitment (have to stay). Preventing emotional exhaustion in frontline employees and helping them stay on the job is an important topic for emotional labor research. The research also investigates which types of commitment influence emotional exhaustion and turnover intentions significantly. Design/methodology/approach – Data were collected through a self-reported questionnaire administered to 401 restaurant service industry frontline workers. Findings – The findings support the hypothesis that whereas social and financial bonds influence affective commitment, structural and financial bonds influence continuance commitment. Furthermore, affective commitment is a crucial factor for preventing emotional exhaustion and turnover intentions, whereas continuance commitment positively affects emotional exhaustion. Originality/value – This research offers academic and managerial insights into the various types of relationship bonds and controls these bonds for facilitating employee organizational commitment, which consequently affects emotional exhaustion and turnover intention.

scholarly journals Battling the COVID-19 Pandemic: Is Bangladesh Prepared?

2020 ◽  
Author(s):  
Hasinur Rahaman Khan ◽  
Tamanna Howlader ◽  
Md. Mazharul Islam
Keyword(s):  
At Risk ◽  
Spatial Distribution ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Polynomial Regression ◽  
Spatial Cluster ◽  
Short Term ◽  
Hospital Capacity ◽  
Order Polynomial ◽  
Frontline Healthcare Workers

Following detection of the first few COVID-19 cases in early March, Bangladesh has stepped up its efforts to strengthen capacity of the healthcare system to avert a crisis in the event of a surge in the number of cases. This paper sheds light on the preparedness of the healthcare system by examining the spatial distribution of isolation beds across districts and divisions, forecasting the number of ICU units that may be required in the short term and analyzing the availability of frontline healthcare workers to combat the pandemic. As of May 2, COVID-19 cases have been found in 61 of the 64 districts in Bangladesh with Dhaka District being the epicenter. Seventy-one percent of the cases have been identified in 6 neighboring districts, namely, Dhaka, Narayanganj, Gazipur, Narsingdi, Munsiganj and Kishoreganj, which appear to form a spatial cluster. However, if one takes into account the population at risk, the prevalence appears to be highest in Dhaka, followed by Narayanganj, Gazipur, Kishorganj, Narsingdi and Munshiganj. These regions may therefore be flagged as the COVID-19 hotspots in Bangladesh. Among the eight divisions, prevalence is highest in Dhaka Division followed by Mymensingh. The number of cases per million exceeds the number of available isolation beds per million in the major hotspots indicating that there is a risk of the healthcare system becoming overwhelmed should the number of cases rise. This is especially true for Dhaka Division, where the ratio of COVID-19 patients to doctors appears to be alarmingly high. Mymensingh Division also has a disproportionately small number of doctors relative to the number of COVID-19 patients. Using second order polynomial regression, the analysis predicts that even if all ICU beds are allocated to COVID-19 patients, Bangladesh may run out of ICU beds soon after May 15, 2020. We conclude that in spite of a significant increase in hospital capacity during 2005-15 and a 57 % rise in the number of doctors during the same period, the healthcare system in Bangladesh and Dhaka Division in particular, may not be fully prepared to handle the COVID-19 crisis. Thus, further steps need to be taken to flatten the curve and improve healthcare capacity.

scholarly journals Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jo Billings ◽  
Brian Chi Fung Ching ◽  
Vasiliki Gkofa ◽  
Talya Greene ◽  
Michael Bloomfield
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Psychosocial Support ◽  
Grey Literature ◽  
Opportunity To Learn ◽  
Health Impact ◽  
Frontline Workers ◽  
Health And Wellbeing ◽  
Frontline Healthcare Workers ◽  
The Impact

Abstract Background Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress. Conclusions The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

scholarly journals Documenting Response To COVID-Individual and Systems Successes and Challenges: A Longitudinal Qualitative Study

2021 ◽  
Author(s):  
Natasha Shaukat ◽  
Daniyal Mansoor Ali ◽  
Butool Hisam ◽  
Sheza Hassan ◽  
Rubina Barolia ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Mobile App ◽  
System Level ◽  
Individual Level ◽  
The Future ◽  
Frontline Healthcare Workers ◽  
Prospective Longitudinal

Abstract Background This feasibility study aimed to assess the use of WhatsApp for qualitative data collection to document the evolution of perceptions of frontline healthcare workers (FHCW) regarding their wellbeing and the quality of health systems' response to the COVID-19 pandemic over four months. Methods This was a prospective longitudinal qualitative study conducted during the four months coinciding with the peak and trough of the first wave of the COVID-19 pandemic (June-September 2020). We approached frontline healthcare workers (physicians and nurses working in emergency departments) in two hospitals using the WhatsApp group of the Pakistan Society of Emergency Physicians (PSEM). We introduced the study and obtained consent using a google consent form. Each participant was asked to self-record their perception of their personal wellness and their level of satisfaction with the quality of their hospitals' response to the pandemic. Each participant sent their voice notes/audio-recording to a central WhatsApp number. We transcribed and analysed the recordings and identified themes and sub-themes, and the changes to these themes over six months. Results We invited approximately 200 FHCWs associated with PSEM to participate in the study. Of the 61 who agreed to participate, 27 completed the study. A total of 149 audio recordings were received and transcribed. Three themes and eight sub-themes have emerged from the data. The themes were individual-level challenges, health system-level challenges, and hope for the future. Sub-themes for individual-level challenges were: fear of getting or transmitting infection, financial stressors, stress due to turning away those patients who need care, anxiety due to the general public's lack of compliance with preventive measures, physical exhaustion, and fatigue. For the healthcare system, sub-themes were: issues with logistics and management of the hospital/healthcare system and lack of focus on providing air conditioning to address heat due to PPEs and sub-themes under hope for the future were the improved disease knowledge and vaccine development. Conclusion Despite a lower level of completion, our study identified possible use of a ubiquitously available mobile app to collect longitudinal real-time data from FHCWs during the initial period of the pandemic. The overall perceptions and experiences of FHCWs evolved from negative to positive as the curve of COVID-19 went down.

scholarly journals Perceptions of mHealth applications and features to support psychosocial wellbeing among frontline healthcare workers involved in the COVID-19 pandemic response (Preprint)

2020 ◽  
Author(s):  
Sungwon Yoon ◽  
Hendra Goh ◽  
Gayathri Devi Nadarajan ◽  
Sharon Sung ◽  
Irene Teo ◽  
...  
Keyword(s):  
Peer Support ◽  
Healthcare Workers ◽  
Peer Interactions ◽  
Structured Interviews ◽  
Frontline Workers ◽  
Psychosocial Wellbeing ◽  
Tangible Rewards ◽  
Visual Materials ◽  
Frontline Healthcare Workers ◽  
Future Work

BACKGROUND Frontline healthcare workers are experiencing a myriad of physical and psychosocial challenges amid the COVID-19 pandemic. There is growing recognition that digital technologies have the potential for improving wellbeing of frontline workers. However, there is limited development of wellness interventions using mHealth technology. More importantly, little research has been conducted on how frontline workers perceive mHealth-based support to promote their wellbeing. OBJECTIVE This study aimed to explore frontline workers’ experience of conventional psychological wellness programs and their perceptions of the usefulness of mHealth apps and features for promoting wellbeing. It also sought to identify factors that influence uptake and retention of a mHealth-based wellness program. METHODS We conducted semi-structured interviews using purposive sampling with frontline workers involved in the COVID-19 response. Various visual materials, collated from existing mHealth app features, were presented to facilitate discussion. Interviews were audio-recorded and transcribed verbatim. Thematic analysis based on grounded theory was undertaken. Themes were subsequently mapped to key nudge strategies, commonly used for mHealth development, to assess participants’ preferences for particular features and their reasoning. RESULTS A total of 42 frontline workers participated in twelve one-to-one interviews or focus group discussions. Frontline workers generally had limited mental health literacy to identify their own psychological problems and liked the reminders functionality to track their mood over time. A personalised goal-setting feature (tailoring) and in-app resources were generally valued while frequent coaching and messages (framing) were seen as a distraction. The majority desired a built-in chat with a counsellor (guidance) for reasons of accessibility and protection of privacy. Very few participants appreciated a gamification function. Frontline workers commonly reported the need for ongoing social support and desired access to in-app peer support community (social influence). There were concerns regarding potential risks from virtual peer interactions. Intrinsic motivational factors, mHealth app technicality and tangible rewards were identified as critical for uptake and retention. CONCLUSIONS Our study highlights the potential of mHealth with relevant features to safeguard the wellbeing of frontline workers. Future work should focus on developing a non-intrusive and personalised mHealth app with in-app counselling, peer support to improve wellbeing, and tangible and extrinsic rewards to foster continued use.

scholarly journals Challenges Faced by Healthcare Professionals during the COVID-19 Pandemic: A Review

2021 ◽  
pp. 89-92
Author(s):  
Pratibha Wankhede ◽  
Mayur Wanjari ◽  
Sampada Late ◽  
Hina Rodge
Keyword(s):  
Healthcare System ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Developing Nations ◽  
Healthcare Facilities ◽  
Societal Issues ◽  
Private Healthcare ◽  
Ventilatory Assistance ◽  
The World ◽  
Pandemic Response

Introduction: On March 11, 2020, the WHO formally declared the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks a pandemic by publishing public health guidelines to guide pandemic response. Serious illnesses may necessitate hospitalization and ventilatory assistance. The pandemic of coronavirus disease 2019 (COVID-19) has posed new concerns for healthcare workers around the world. However, in many developing nations, including India, information is scarce concerning these issues. Healthcare facilities are one-of-a-kind and difficult to understand. The Indian healthcare system consists of both governmental and private healthcare facilities. Healthcare practitioners face a variety of obstacles daily. The unexpected appearance of COVID-19 created a new threat to an already overburdened healthcare system. The pandemic altered the healthcare dilemma by introducing new employment and societal obstacles to healthcare workers. The goal of this review research is to uncover the causes of the workplace and societal issues that healthcare workers encounter.

scholarly journals Sociodemographic risk factors for COVID-19 infection among Massachusetts healthcare workers: a retrospective cohort study

2021 ◽  
pp. 1-23
Author(s):  
Fan-Yun Lan ◽  
Robert Filler ◽  
Soni Mathew ◽  
Jane Buley ◽  
Eirini Iliaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Healthcare System ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healthcare Workers ◽  
Occupational Risk Factors ◽  
Frontline Workers ◽  
Factors Associated ◽  
Occupational Risks

Abstract Objective: To better understand COVID-19 transmission among healthcare workers (HCW), we investigated occupational and non-occupational risk factors associated with cumulative COVID-19 incidence among a Massachusetts HCW cohort. Design, setting, and participants: The retrospective cohort study included adult HCWs in a single healthcare system from March 9 to June 3, 2020. Methods: Participants’ SARS-CoV-2 nasopharyngeal RT-PCR results and demographics were de-identified and extracted from an established occupational health, COVID-19 database at the healthcare system. HCWs from each particular job grouping had been categorized into frontline/non-frontline workers. Incidence rate ratio (IRR) and odds ratio were used to compare subgroups after excluding HCWs involved in early infection clusters before universal masking. A sensitivity analysis was performed comparing jobs with the greatest potential occupational risks with others. Results: 152 out of 5177 (2.94%) HCWs were diagnosed with COVID-19. Affected HCWs resided in areas with higher community attack rates (median: 1755.2 vs. 1412.4 cases per 100,000, P<0.001)(multivariate-adjusted IRR: 1.89, 95%CI: 1.03–3.44 comparing 5th to 1st quintile of community rates). After multivariate adjustment, African Americans and Hispanics had higher incidence than non-Hispanic white HCWs (IRR: 2.78, 95%CI: 1.78–4.33; and IRR: 2.41, 95%CI: 1.42–4.07, respectively). After adjusting for race and residential rates, frontline HCWs had a higher IRR (1.73, 95%CI: 1.16–2.54) compared to non-frontline HCWs overall, but not within specific job categories, nor when comparing the highest risk jobs to others. Conclusions: After universal masking was instituted, the strongest risk factors associated with HCWs’ COVID-19 infection were residential community infection rate and race.

scholarly journals Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Ramandeep Kaur ◽  
Tyler T. Weiss ◽  
Andrew Perez ◽  
James B. Fink ◽  
Rongchang Chen ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Nosocomial Transmission ◽  
Extensive Literature ◽  
Medical Procedures ◽  
Respiratory Illnesses ◽  
Frontline Workers ◽  
The Usa ◽  
Extensive Literature Search ◽  
Frontline Healthcare Workers

Abstract Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.

scholarly journals The Silent Pandemic: The Psychological Burden on Frontline Healthcare Workers during COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Luise J. Froessl ◽  
Yazan Abdeen
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Healthcare Workers ◽  
Psychological Impact ◽  
High Stress ◽  
Psychological Burden ◽  
Additional Risk ◽  
Frontline Workers ◽  
Preventative Measures ◽  
Frontline Healthcare Workers

This narrative review explores the full scope of harmful psychological effects of the COVID-19 (Coronavirus Disease of 2019) pandemic on FLHCWs (Frontline healthcare workers). Additionally, we highlight the risk factors for worse outcomes. A literature review identified 24 relevant papers included in this synthesis. The majority of studies reported a high number of mental health conditions in HCWs (Healthcare workers) overall. Working in the frontline setting was repeatedly identified as an independent risk factor for poorer mental health. Additional risk factors, such as gender, occupational pressure, and low level of support from hospital administration, family, and the community, were also commonly identified. In the past, defined interventions have been shown to mitigate the psychological impact of high-stress situations on frontline workers. This review is aimed at identifying individuals at higher risk to help effectively target preventative measures in future stress situations in our healthcare system.

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