Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study

Sonis, Jeffrey; Pathman, Donald E.; Read, Susan; Canter, Courtney; Curran, Patrick J.; Jones, Cheryl B.; Miller, Thomas

doi:10.1097/jhm-d-21-00208

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…The healthcare team experienced signi cant stress and uncertainty, referred to as working in a pressure cooker, due to the COVID-19 pandemic. This is consistent with previous research that has shown that the unprecedented nature of the pandemic led to challenging working conditions, limited resources, lack of information, and concerns about infecting loved ones (32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). The collective global impact of COVID-19 on healthcare systems is likely a contributing factor to these stressors (45)(46)(47)(48).…”

Section: Altruistic Behaviorssupporting

confidence: 88%

Healthcare Team Resilience During COVID-19: A Qualitative Study

Ambrose

Catchpole

Evans

et al. 2023

Preprint

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BACKGROUND Resilience has been identified as the ability to maintain the safety and the performance of healthcare systems and is aligned with the principles of anticipation, monitoring, adaptation, and learning. In early 2020, the COVID-19 pandemic challenged the resilience of US healthcare systems due to the lack of equipment, supply interruptions, and a shortage of personnel. The purpose of this qualitative research was to describe resilience in the healthcare team during the COVID-19 pandemic with the healthcare team situated as a singular cognizant entity defined by its collective identity, purpose, competence, and actions. METHODS We developed a descriptive model which considered the healthcare team as a unified cognizant entity. This model combined elements from the Patient Systems Engineering Initiative for Patient Safety (SEIPS) and the Advanced Team Decision Making (ADTM) models. Using a qualitative descriptive design and guided by our adapted model, we conducted individual interviews with healthcare team members across the United States. Data were analyzed using thematic analysis and extracted codes were organized within the adapted model framework. To ensure the rigor of our study, we utilized the input of an expert in qualitative researcher and maintained an audit trail throughout the analysis process. Additionally, we explored factors participants’ described that may have either hindered or enhanced the resilience potentials within the healthcare team. RESULTS Five themes were identified from the interviews with acute care professionals across the US (N = 22): working in a pressure cooker, consistent with working in a high stress environment; healthcare team cohesion, applying past lessons to present challenges, congruent with transferring past skills to current situations; knowledge gaps, and altruistic behaviors, aligned with sense of duty and personal responsibility to the team. Participants’ described how their ability to adapt to their environment was negatively impacted by uncertainty, inconsistent communication of information, and emotions of anxiety, fear, frustration, and stress. Cohesion with co-workers, transferability of skills, and altruistic behavior enhanced healthcare team performance. CONCLUSION Working within the extreme unprecedented circumstances of COVID-19 affected the ability of the healthcare team to anticipate and adapt to the rapidly changing environment. Both team cohesion and altruistic behavior promoted resilience. The adapted model was useful to describe the healthcare team as a singular cognizant entity. Our research contributes to a growing understanding of the importance of resilience in healthcare and provides a bridge between individual and organizational resilience.

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Section: Altruistic Behaviorssupporting

confidence: 88%

Healthcare Team Resilience During COVID-19: A Qualitative Study

Ambrose

Catchpole

Evans

et al. 2023

Preprint

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“…1,2 In September 2021, 76% of US healthcare workers reported burnout, compared with 54% in 2019. 3 Drivers of increased stress and burnout among physicians during the pandemic include individual-level factors like fear of exposure and transmission 4,5 and social isolation, 5,6 and organizational factors like inadequate personal protective equipment 7,8 and poor leadership. 7,9 Health inequities are an additional yet underrecognized source of physicians' occupational stress.…”

Section: Introductionmentioning

confidence: 99%

“…3 Drivers of increased stress and burnout among physicians during the pandemic include individual-level factors like fear of exposure and transmission 4,5 and social isolation, 5,6 and organizational factors like inadequate personal protective equipment 7,8 and poor leadership. 7,9 Health inequities are an additional yet underrecognized source of physicians' occupational stress. Wide-ranging racial-ethnic and socioeconomic health disparities prior to the onset of the COVID-19 pandemic are well established in the United States.…”

Section: Introductionmentioning

confidence: 99%

The impact of health inequities on physicians' occupational well‐being during COVID‐19: A qualitative analysis from four US cities

Browne

Jenkins

Berlinger

et al. 2023

Journal of Hospital Medicine

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Objective The aim of this study is to describe frontline physicians' perceptions of the impact of racial–ethnic and socioeconomic disparities in COVID‐19 infection and mortality on their occupational well‐being. Methods One hundred and forty‐five qualitative, semistructured interviews were conducted between February 2021 and June 2022 with hospital medicine, emergency medicine, pulmonary/critical care, and palliative care physicians caring for hospitalized COVID‐19 patients in four US cities. Results Physicians reported encountering COVID‐related health disparities and inequities at the societal, organizational, and individual levels. Encountering these inequities, in turn, contributed to stress among frontline physicians, whose concerns revealed how structural conditions both shaped COVID disparities and constrained their ability to protect populations at risk from poor outcomes. Physicians reported feeling complicit in the perpetuation of inequities or helpless to mitigate observed inequities and experienced feelings of grief, guilt, moral distress, and burnout. Conclusions Health inequities are an under‐acknowledged source of physicians' occupational stress that requires solutions beyond the clinical context.

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“…25,26 The pandemic also accelerated mounting awareness of the role of organizational factors in shaping clinicians' work-related well-being. [27][28][29][30][31][32][33][34] Perspectives from occupational health and safety sciences have been instrumental to expanding the individualistic lens on clinician burnout and drawing attention to the work environment as a determinant of health and safety outcomes for the healthcare workforce. 1 Adverse work environments have been linked to poor mental health outcomes, 35 as has poor work-related social support.…”

Section: Introductionmentioning

confidence: 99%

Multidimensional stressors and protective factors shaping physicians' work environments and work‐related well‐being in two large US cities during COVID‐19

Buchbinder,

Jenkins,

Staley

et al. 2023

American J Industrial Med

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IntroductionClinician burnout and poor work‐related well‐being reached a critical inflection point during the COVID‐19 pandemic. This article applies a novel conceptual model informed by the Total Worker Health® approach to identify and describe multilevel stressors and protective factors that affected frontline physicians' work environments and work‐related well‐being.MethodsWe conducted a qualitative study of hospital‐based physicians from multiple hospital types in Los Angeles and Miami who cared for COVID‐19 patients. Semistructured interviews lasting 60–90 min were conducted over Zoom. Interview transcripts were thematically coded using Dedoose qualitative software.ResultsThe final sample of 66 physicians worked in 20 hospitals. Stressors in the social, political, and economic environment included dealing with the politicization of COVID‐19, including vaccine hesitancy; state and federal governmental COVID‐19 policies and messaging; and shifting CDC guidance. Employment and labor pattern stressors included the national nursing shortage, different policies for paid time off, furloughs, reduced pay, and layoffs. Organizational‐level stressors included institutional policies, staffing constraints and high patient volume (i.e., increased number of cases and longer lengths of stay), and perceived poor leadership. At the individual worker level, stressors included concerns about viral transmission to family, strained personal relationships, and work‐life fit, particularly for those with young children. Respondents identified promising protective factors at multiple levels, including responsive state leadership, job security, concrete opportunities to provide input into institutional policy, strong leadership and communication, and feeling cared for by one's institution.ConclusionFindings support a multi‐level strategy that acknowledges internal organizational and external factors shaping clinicians' work‐related well‐being, consistent with the Total Worker Health® approach.

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Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study

Cited by 4 publications

References 30 publications

Healthcare Team Resilience During COVID-19: A Qualitative Study

Healthcare Team Resilience During COVID-19: A Qualitative Study

The impact of health inequities on physicians' occupational well‐being during COVID‐19: A qualitative analysis from four US cities

Multidimensional stressors and protective factors shaping physicians' work environments and work‐related well‐being in two large US cities during COVID‐19

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