Whether it is a worldwide pandemic, a natural disaster, a nuclear reactor explosion or some other tragedy not yet imagined, unexpected crises happen. But what makes a difference is the actions taken by health systems and organizations before, during and after a crisis. Those actions will increase the likelihood that physicians and other health professionals can cope or even thrive in the face of a crisis such as the COVID-19 pandemic.
Proactive institutional supports that are initiated before a crisis, “stress first aid” delivered during, and “recovery aid” provided after the crisis can increase the odds that individuals will recover and thrive moving forward, according to the AMA STEPS Forward™ module, “Caring for the Health Care Workforce During Crisis.” This free online module provides a list of key steps to complete before, during and after a crisis.
Before a crisis, health systems should complete five steps.
- Appoint a chief wellness officer (CWO) to help establish a well-being program.
- Create a plan in coordination with incident command.
- Support needs during reassignments.
- Identify nonessential tasks that can be cut or eliminated.
- Develop ways to assess stress and needs.
During a crisis such as a pandemic, the AMA module outlines the following steps.
Even with the most well-intended, meticulous playbook, organizations will need to reassess with the current crisis. The CWO and wellness leadership team, as well as psychiatry and behavioral health leads, should assess the situation, evaluate the adequacy of the plan, and consider the need to evolve it before deployment.
It is vital that leaders at all levels of an organization are visible to the health professionals they lead. These leaders must also be adept at receiving and responding to the needs and concerns of their teams. Unmet needs can create increased anxiety and stress. While leaders may not always have the answers, they should strive to be transparent about what is known, what they can do and what they are trying to do.
Health care organizations can—and should—learn from each other instead of building programs from scratch. Existing networks of CWOs or other hospital leaders, professional associations and social networking sites can each serve as a rapid way to disseminate shared learnings.
Assess the adequacy of support resources and the need for new ones. Accurate assessment can help identify who needs a break, the need for more person-power to bring more team members in, and areas where support is lacking. Listening sessions, leadership walk-rounds, and pulse stress surveys can help track stress levels during and after a crisis.
The AMA is offering two free surveys to help health care organizations monitor the impact COVID-19 has on their workforce during this pandemic. The surveys can be used to track trends in stress levels, identify specific drivers of stress, and develop supportive infrastructures based on these drivers. Organizations that use the surveys will receive free-of-charge support from the AMA in launching the surveys and access to data through an easy-to-use reporting dashboard.
Depending on the duration of the crisis, sources of concern and needs may need to evolve as time goes on. These sources might include the need for new information or support. Leaders must continually develop plans to address new and emerging needs of health professionals.
The STEPS Forward module also covers steps that should be taken after the crisis has passed, such as debriefing, lessons learned, and restoring normal operations.
The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.