A Review into the Acute Emergency Response of Operational Partnerships During the Rohingya Refugee Crisis in Cox’s Bazar

Background: The unprecedented influx of Rohingya refugees into Cox’s Bazar, Bangladesh, in 2017 led to a humanitarian emergency requiring large numbers of humanitarian workers to be deployed to the region. The World Health Organization (WHO) contributed to this effort through several well-established deployment mechanisms: the Global Outbreak Alert and Response Network (GOARN) and the Standby Partnerships (SBP). The aim of the study was to capture the views and experiences of those humanitarian workers deployed by WHO through operational partnerships between December 2017 and February 2019.Methods: A mixed methods design was used. A desktop review was conducted to describe the demographics of the humanitarian workers deployed to Cox’s Bazar and the work that was undertaken. Interviews were conducted with a subset of the respondents to elicit their views relating to their roles and contributions to the humanitarian response, challenges during their deployment and how the process could be improved. Thematic analysis was used to identify key themes.Results: We identified sixty-five deployments during the study period. Respondents’ previous experience ranged between 3 and 28 years (mean 9.7 years). The duration of deployment ranged from 8 to 278 days (mean 67 days) and there was a higher representation of workers from Western Pacific and European regions. Forty-one interviews were conducted with people who experienced all aspects of the deployment process. Key themes elicited from interviews related to staffing, the deployment process, the office environment and capacity building. Various issues raised have since been addressed, including the establishment of a sub-office structure, introduction of online training prior to deployment, and a staff wellbeing committee. Conclusions: This study identified successes and areas for improvement for deployments during emergencies. The themes and subthemes elicited can be used to inform policy and practice changes, as well as the development of performance indicators. Common findings between this study and previous literature indicate the pivotal role of staff deployments through partnership agreements during health emergency response operations and a need for continuous improvements of processes to ensure maximum effectiveness.

The importance of self-compassion for health visitors' wellbeing

This article presents an extended literature review, undertaken to understand the significance of self-compassion for health professionals' wellbeing and its relevance for the health visiting workforce. The review showed that self-compassion reduces compassion fatigue, burnout, anxiety, stress and depression. Further, self-compassionate employees are more compassionate towards colleagues and patients, and compassionate practice enhances staff wellbeing. Organisational support for wellbeing increases staff members' sense of worth, resulting in improved ownership of their own wellbeing, and group interventions in particular foster self-compassionate work cultures. The review concludes that self-compassion enhances staff wellbeing and recommends that all NHS staff should be provided with the tools to prevent compassion fatigue and burnout.

“Time is of the essence”: relationship between hospital staff perceptions of time, safety attitudes and staff wellbeing

Background Hospitals are perceived as fast-paced and complex environments in which a missed or incorrect diagnosis or misread chart has the potential to lead to patient harm. However, to date, limited attention has been paid to studying how hospital sociotemporal norms may be associated with staff wellbeing or patient safety. The aim of this study was to use novel network analysis, in conjunction with well-established statistical methods, to investigate and untangle the complex interplay of relationships between hospital staff perceived sociotemporal structures, staff safety attitudes and work-related well-being. Method Cross-sectional survey data of hospital staff (n = 314) was collected from four major hospitals in Australia. The survey included subscales from the Organizational Temporality Scale (OTS), two previously established scales of safety attitudes (teamwork climate and safety climate) and measures of staff-related wellbeing (job satisfaction, emotional exhaustion, depersonalisation). Results Using confirmatory factor analysis, we first tested a 19-item version of the OTS for use in future studies of hospital temporality (the OTS-H). Novel psychological network analysis techniques were then employed, which identified that “pace” (the tempo or rate of hospital activity) occupies the central position in understanding the complex relationship between temporality, safety attitudes and staff wellbeing. Using a path analysis approach, serial mediation further identified that pace has an indirect relationship with safety attitudes through wellbeing factors, that is, pace impacts on staff wellbeing, which in turn affects hospital safety attitudes. Conclusions The findings of this study are important in revealing that staff wellbeing and safety attitudes can be significantly improved by placing more focus on temporal norms, and in particular hospital pace. There are implications for increasing levels of trust and providing staff with opportunities to exercise greater levels of control over their work.

Protocol for a Pilot Study of Schwartz Rounds in an Australian Setting: A Team and System Level Wellness Intervention (Preprint)

BACKGROUND Schwartz Rounds are a unique, organisation-wide interdisciplinary intervention aimed at enhancing staff wellbeing, compassionate care, teamwork, and organisational culture in healthcare settings. They provide a safe space wherein both clinical and non-clinical health staff can connect and share their experiences about the social and emotional aspects of health care. OBJECTIVE Although Schwartz Rounds have been assessed and widely implemented in the United States and United Kingdom, they are yet to be formally evaluated Australian healthcare settings. The purpose of this study is to evaluate the feasibility and impact of Schwartz Rounds on staff wellbeing, compassionate care and organisational culture, in a tertiary metropolitan hospital in Brisbane, Australia. METHODS This mixed methods repeated measures pilot study will recruit 24 participants in two groups from two departments, the Intensive Care Unit (ICU) and the gastroenterology department. Participants from each group will take part in three unit-based Schwartz Rounds. Primary outcomes will include the study and intervention feasibility measures while secondary outcomes will include Maslach Burnout inventory, the Schwartz Centre Compassionate Care Scale, and Culture of Care Barometer. Primary and secondary outcomes will be collected at baseline, post-round, and three-month follow-up. Two focus-groups will be held approximately two months after completion of the Schwartz Rounds. Descriptive statistics, t-tests, chi-square tests, and analysis of variance (ANOVA) will be used to compare quantitative data across time points and groups. Qualitative data from focus groups and free-text survey questions will be analysed using an inductive thematic analysis approach. RESULTS The study was approved by the Mater Hospital Human Research Ethics Committee (reference number: HREC/MML/71868) and recruitment commenced in July 2021; study completion is anticipated by May 2022. CONCLUSIONS The study will contribute to the assessment of feasibility and preliminary efficacy of the Schwartz Rounds in a tertiary Australian hospital, during the COVID-19 pandemic. CLINICALTRIAL Australian New Zealand Clinical Trials Registry Id is ACTRN12621001473853.

Emergency futures: An ethnographic design exploration of a public health crisis

<p>Overcrowding in emergency departments is becoming a public health crisis in Aotearoa New Zealand. As demand for acute care continues to rise, and hospitals are running over capacity, emergency department patients requiring admission to hospital wards have nowhere to go. Healthcare workers are being forced to use unsafe interim solutions like corridor stays. Despite numerous attempts at intervention, the situation is not improving, posing serious risks to patient safety and staff wellbeing. This research explores, first, what we can learn from the voices of frontline healthcare workers when trying to understand the problem of emergency department overcrowding and, second, how design might enable us to imagine possible futures for emergency care as a way to reflect on the values and assumptions underpinning the current system. Through in-depth interviews and onsite observations, I discovered that the key challenges staff face relate back to the relationship with patients, staff, and the organisation. Moral distress, victimisation and scepticism towards change were the key themes constructed across these different levels. My research suggests that speculative design can offer a fresh approach for the healthcare sector to ask questions and open up space for thinking about how things could be radically different, as well as building new connections between the disciplines of healthcare and design.</p>

Emergency futures: An ethnographic design exploration of a public health crisis

<p>Overcrowding in emergency departments is becoming a public health crisis in Aotearoa New Zealand. As demand for acute care continues to rise, and hospitals are running over capacity, emergency department patients requiring admission to hospital wards have nowhere to go. Healthcare workers are being forced to use unsafe interim solutions like corridor stays. Despite numerous attempts at intervention, the situation is not improving, posing serious risks to patient safety and staff wellbeing. This research explores, first, what we can learn from the voices of frontline healthcare workers when trying to understand the problem of emergency department overcrowding and, second, how design might enable us to imagine possible futures for emergency care as a way to reflect on the values and assumptions underpinning the current system. Through in-depth interviews and onsite observations, I discovered that the key challenges staff face relate back to the relationship with patients, staff, and the organisation. Moral distress, victimisation and scepticism towards change were the key themes constructed across these different levels. My research suggests that speculative design can offer a fresh approach for the healthcare sector to ask questions and open up space for thinking about how things could be radically different, as well as building new connections between the disciplines of healthcare and design.</p>

‘Fix the issues at the coalface and mental wellbeing will be improved’: a framework analysis of frontline NHS staff experiences and use of health and wellbeing resources in a Scottish health board area during the COVID-19 pandemic

Background Frontline healthcare staff working in pandemics have been reported to experience mental health issues during the early and post-peak stages. To alleviate these problems, healthcare organisations have been providing support for their staff, including organisational, cognitive behavioural and physical and mental relaxation interventions. This paper reports the findings of a study commissioned by a Scottish NHS health board area during the initial outbreak of COVID-19. The study aimed to understand the experience of NHS staff relating to the provision of wellbeing interventions between March and August 2020. Methods Data were gathered from free-text comments of eight surveys completed by a wide range of staff across sites within one NHS health board in Scotland. We conducted a framework analysis of the data. Results Our findings show that despite the provision of relaxational and cognitive behavioural interventions to support staff wellbeing during the early months of the COVID-19 pandemic, there were barriers to access, including heavy workload, understaffing, inconvenient locations and the stigma of being judged. Organisational factors were the most frequently reported support need amongst frontline staff across sites. Conclusions While relaxational and cognitive behavioural interventions were well received by staff, barriers to accessing them still existed. Staff support in the context of organisational factors, such as engagement with managers was deemed as the most important for staff wellbeing. Managers play a key role in everyday organisational processes and therefore are in the right position to meet increasing frontline staff demands due to the pandemic and removing barriers to accessing wellbeing support. Healthcare managers should be aware of organisational factors that might increase job demands and protect organisational resources that can promote wellbeing for frontline staff.