Healthcare provider experiences during COVID-19 redeployment

Schulz-Quach, Christian; Lyver, Brendan; Li, Madeline

doi:10.1097/spc.0000000000000609

Cited by 4 publications

(4 citation statements)

References 37 publications

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“…Step 3: Listen to Frontline Staff While it is always essential to ensure voices of frontline staff are heard, this becomes particularly crucial when addressing WPV in healthcare. WPV is a demoralizing issue contributing to undesirable patient outcomes, HCP burnout and high turnover rates, thus, making HCPs feel heard on this subject by their own organization can have a positive impact on staff engagement with the WPV QI process [31].…”

Section: Interpretation Systematic Framework To Address Wpv In Health...mentioning

confidence: 99%

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Schulz-Quach,

Lyver,

Reynolds

et al. 2024

Preprint

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Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.15 events per 1000 visits (p<.0001). In response, UHN initiated a comprehensive quality improvement (QI) project to address WPV. This study presents the project's design, implementation, results, and key takeaways, aiming to showcase effective and trauma-informed strategies for mitigating WPV in healthcare settings. Methods: Our multi-intervention QI initiative was guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework. We also leveraged the SEIPS 101 tools to aid in crafting each QI intervention. This approach amalgamated various methodologies to approach WPV, incorporating literature reviews, a modified Delphi method, qualitative interviews, surveys, quantitative data gathering and pragmatic interventions. Results: Our complex intervention contained a total of 12 subprojects. We reviewed existing literature (n=84) pertaining to WPV in healthcare. N = 229 quality indicators utilized to measure WPV in healthcare were extracted from the literature and underwent a Delphi process which yielded 17 quality indicators for a new organizational WPV dashboard. WPV theories were critically reviewed in the context of intervention development. Educational initiatives (n=2) were implemented including ad-hoc point of care training, as well as rollout of a comprehensive trauma-informed training program for WPV prevention, verbal de-escalation and management of escalated responsive behaviour. Further changes involved establishing a Code White Governance Committee, enhancing WPV reporting and addressing underreporting. Debriefing was structured into hot and cold debriefing models. Additionally, environmental indicators promoting mutual respect were introduced, alongside security enhancements including wearable video devices for all security guards and a 100% increase in ED security guards. Outreach initiatives were implemented including qualitative interviews with ED staff (n=75) and the development of a patient partner and community outreach group. Conclusions: WPV in healthcare is a complex phenomenon that urgently requires effective solutions. We developed a 13-step framework that offers guidance for healthcare institutions seeking to develop a systemic approach in addressing WPV tailored to their organization’s needs.

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Section: Interpretation Systematic Framework To Address Wpv In Health...mentioning

confidence: 99%

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Schulz-Quach,

Lyver,

Reynolds

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…The exception is the reported gain of new research skills during the pandemic. Indeed, other studies have suggested that the concept of "benefit-finding", a process mainly described in cancer patients by which an individual identifies positive growth experiences resulting from trauma, can be applied to the experience of COVID-19 [17]. Overall these results suggest that while individuals are able to draw on reserves of internal motivations, institutions should support this feeling by incentivizing desired behaviors, and helping guide employees towards an understanding of the new skills and capabilities that may have been gained through a difficult experience.…”

Section: Plos Onementioning

confidence: 99%

Experiences of oncology researchers in the Veterans Health Administration during the COVID-19 pandemic

Becker,

Csehak,

Barbaro

et al. 2024

PLoS ONE

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The Veterans Health Administration is chartered “to serve as the primary backup for any health care services needed…in the event of war or national emergency” according to a 1982 Congressional Act. This mission was invoked during the COVID-19 pandemic to divert clinical and research resources. We used an electronic mixed-methods questionnaire constructed using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation (COM-B) model for behavior change to study the effects of the pandemic on VHA researchers. The questionnaire was distributed electronically to 118 cancer researchers participating in national VHA collaborations. The questionnaire received 42 responses (36%). Only 36% did not feel that their research focus changed during the pandemic. Only 26% reported prior experience with infectious disease research, and 74% agreed that they gained new research skills. When asked to describe helpful support structures, 29% mentioned local supervisors, mentors, and research staff, 15% cited larger VHA organizations and 18% mentioned remote work. Lack of timely communication and remote work, particularly for individuals with caregiving responsibilities, were limiting factors. Fewer than half felt professionally rewarded for pursuing research related to COVID. This study demonstrated the tremendous effects of the COVID-19 pandemic on research activities of VHA investigators. We identified perceptions of insufficient recognition and lack of professional advancement related to pandemic-era research, yet most reported gaining new research skills. Individualizing the structure of remote work and ensuring clear and timely team communication represent high yield areas for improvement.

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“…As organizational change can induce uncertainty, anxiety and stress for staff leading to burnout [13] and as healthcare providers were already experiencing burnout before the pandemic [14,15], our goal was to minimize the stress created by implementing change. 1-2 different technologies were released every 4-6 weeks after smaller pilot testing with a smaller sample group [12].…”

Section: Planning and Implementing Digital Transitionmentioning

confidence: 99%

Quality Improvement Project to Transition Psychosocial Oncology Clinical Care to a Telehealth Workflow during the COVID-19 Pandemic: a Quasi-Experimental Study

Sethi,

Lyver,

Gorla

et al. 2023

Preprint

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Introduction. The COVID-19 pandemic created an urgent need for an innovative method of care delivery for psychosocial oncology. The psychosocial oncology services at the University Health Network in Toronto, Canada transitioned expeditiously to digital technologies that were readily available and accessible for patients and clinicians, facilitating care provision while reducing the transmission of COVID-19. This study aims to provide a validated framework for transitioning to digital delivery methods of care. Methods. A quality improvement team was established and tasked with successfully transitioning services from primarily in-person to digital delivery methods of care quickly and seamlessly. This included analyzing the psychosocial oncology workflow, planning and implementing a digital transition, and collecting data and feedback on the impact of this digital workflow through the use of surveys. Results. The average response rate of the surveys was 69.1%. Feedback and data collection demonstrated that more than 90% of psychosocial oncology processes were completed with digital tools following the transition with limited impact on clinical delivery. The clinicians reported feeling confident and satisfied providing care using digital workflow tools. Conclusion. The psychosocial oncology quality improvement team at the University Health Network provides a validated framework for transitioning to new methods of delivering care. As technology continues to develop, guidance on transitioning clinics and departments to new digital tools will be crucial for healthcare institutions. The framework provided in this study can be utilized to ensure the successful implementation of new technologies.

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Healthcare provider experiences during COVID-19 redeployment

Cited by 4 publications

References 37 publications

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Understanding, Measuring, and Ameliorating Workplace Violence in Healthcare: A Canadian Systematic Framework to Address a Global Healthcare Phenomenon

Experiences of oncology researchers in the Veterans Health Administration during the COVID-19 pandemic

Quality Improvement Project to Transition Psychosocial Oncology Clinical Care to a Telehealth Workflow during the COVID-19 Pandemic: a Quasi-Experimental Study

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