The Rapid Implementation of a Psychological Support Model for Frontline Healthcare Workers During the COVID-19 Pandemic: A Case Study and Process Evaluation

Abstract

The COVID-19 pandemic highlighted the need for psychological support initiatives directed toward frontline healthcare workers, which can be rapidly and sustainably implemented during an infectious disease outbreak. The current case study presents a comprehensive model of psychological support that was implemented at an intensive care unit (ICU) during the first wave of the COVID-19 pandemic. The psychological support model aimed at promoting a resilient stress reaction among frontline staff by protecting physical, social, and psychological resources. The initiatives, targeting different groups of workers, included education and training, peer support, psychologist-supervised and unsupervised group sessions, on-boarding for transferred staff, manager support, and individual sessions for workers experiencing strong stress reactions. The results of the process evaluation of this rapid implementation suggest that peer support initiatives as well as daily group sessions were the most appreciated forms of psychological support. Psychologists involved in organizing and providing the support highlighted several aspects of a successful implementation of the support model: offering support during work hours (preferably after shift), positive attitude of line managers that framed support initiatives as a team effort, and involvement of experienced psychologists able to quickly adjust the content of the support according to the current needs. The study also identified two main problems of the current implementation: the lack of efficient planning due to the use of volunteer work and the need for more structural resources on the organizational level to ensure long-term sustainability of the support model and its implementation among all groups of healthcare staff. The current case study highlights the importance of establishing permanent structural resources and routines for psychological support integrated in clinical practice by healthcare organizations to improve both rapid and sustainable response to future crises.

Symptoms of Anxiety, Depression, and Post-Traumatic Stress Disorder in Health Care Personnel in Norwegian ICUs during the First Wave of the COVID-19 Pandemic, a Prospective, Observational Cross-Sectional Study

“…This controversy was unexpected but may have to do with the personal characteristics and preferences of those who choose to become leaders. However, caring for psychosocial well-being in pandemic situations is recommended for both the hospital clinical staff, the general population, and the leaders to prevent distress over time [ 18 , 29 ].…”

“…At the same time in Norway, 65% of HCPs experienced feeling lonely [ 25 ]. In a Swedish hospital, they rapidly implemented a comprehensive psychological support model for ICU frontline workers and support for managers, during the first wave of COVID-19 [ 29 ]. Peer support initiatives, as well as daily group sessions during work hours, were the foremost preferred psychological support for HCPs reported in the process evaluation of the model [ 29 ].…”

“…In a Swedish hospital, they rapidly implemented a comprehensive psychological support model for ICU frontline workers and support for managers, during the first wave of COVID-19 [ 29 ]. Peer support initiatives, as well as daily group sessions during work hours, were the foremost preferred psychological support for HCPs reported in the process evaluation of the model [ 29 ]. In a US nationwide study, critical care nurses (n = 285) reported inadequate leadership support as an important stress factor [ 30 ].…”

The Effect of COVID-19 Endemicity on the Mental Health of Health Workers

“…Additionally, attitudes toward patient safety have also deteriorated, with a significantly lower PAR for the total score (16.9% vs 25.9% in 2020). This is despite increased awareness and the institution of several protective policies 3 , 49 , 50 , 51 , 52 , 53 over the last 2 years.…”

Ethical Lessons from an Intensivist’s Perspective

“…Lack of effective treatments, difficulties communicating with patients and their relatives, the need to make rapid, complex ethical decisions regarding which patients to admit or when to withhold or withdraw treatment, responsibility for new, non-ICU-trained members of the team transferred from other units, and fears about catching the virus and passing it on to their own family members, all added to the psychological burden on ICU teams with high rates of insomnia, depression, anxiety, post-traumatic stress disorder, and burnout [ 38 , 39 , 40 , 41 , 42 , 43 ]. Various strategies have been proposed to try and limit some of the psychological impact, including adequate training and senior support for new or re-allocated staff, availability of clinical psychologists for individual assessments and consultation, and regular team debriefing and support sessions [ 44 , 45 ]. Psychological support should be offered openly, with a low threshold for intervention, and be easily accessible.…”