4
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Leadership through crisis: fighting the fatigue pandemic in healthcare during COVID-19

      , ,
      BMJ Leader
      BMJ

      Read this article at

      ScienceOpenPublisher
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          COVID-19 presents many challenges to healthcare systems internationally, none more so than the significant reporting among healthcare workers (HCWs) of occupational fatigue and burnout or Long COVID related symptoms. Consensus on the extent of HCW fatigue during the pandemic remains largely unknown, as levels of Long COVID related fatigue in HCWs appears to be on the rise. What is known is that, among current levels, impacts of fatigue on HCW well-being and performance is likely. Developing strategies to mitigate fatigue are the responsibilities of all healthcare system stakeholders. Leadership that goes beyond organisational efforts of mitigating fatigue through mandated working hour limits alone are needed. A process to facilitate identification, mitigation and prevention of fatigue is likely to be best suited in this regard. This might involve development of operational systems modelled off successful industries, such as aviation, for performance optimisation. These system-based designs provide the foundation for systematic yet innovative approaches to enable effective design of macro-level to micro-level interventions for fatigue mitigation. Shifts in organisational culture have occurred in healthcare since the onset of the pandemic, with increasing agility and embracing of innovation. Creating a culture whereby we recognise and support people in being malleable through a pandemic and beyond is at the level of leadership. Leveraging this cultural shift allows an opportunity for organisational change. One focus of such a leverage within systems could be the incorporation of the evidence-based practical recommendations informed by the authors of this paper.

          Related collections

          Most cited references10

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study

          Summary Background Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. Methods We did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509. Findings Among 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors. Interpretation In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed. Funding Zoe Global, Wellcome Trust, Engineering and Physical Sciences Research Council, National Institutes of Health Research, UK Research and Innovation, Alzheimer's Society, National Institutes of Health, National Institute for Occupational Safety and Health, and Massachusetts Consortium on Pathogen Readiness.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            A cross-national study of work engagement as a mediator between job resources and proactive behaviour

              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Symptoms in Health Care Workers during the COVID-19 Epidemic. A Cross-Sectional Survey

              In March–April 2020, the Corona Virus Disease 19 (COVID-19) pandemic suddenly hit Italian healthcare facilities and in some of them many staff members became infected. In this work 595 health care workers from a public company were tested for Severe acute respiratory syndrome coronavirus 2 (82 positive) and asked to complete a questionnaire on early COVID-19 symptoms. Respiratory symptoms were present in 56.1% of cases. Anosmia and dysgeusia in COVID-19 cases were found to have an odds ratio (OR) = 100.7 (95% Confidence Interval [CI] = 26.5–382.6) and an OR = 51.8 (95%CI 16.6–161.9), respectively. About one in three of the cases (29.3%) never manifested symptoms. Anxiety was reported by 16.6% of COVID-19 cases and depression by 20.3%, with a significant increase in the estimated risk (OR = 4.3; 95%CI = 2.4–7.4 for anxiety, OR = 3.5; 95%CI = 2.0–6.0 for depression). In cases, sleep was a significant moderating factor in the relationship between occupational stress, or organizational justice, and anxiety. The early diagnosis of COVID-19 in health care workers, must consider, in addition to respiratory disorders and fever, anosmia, dysgeusia, exhaustion, myalgias and enteric disorders. The frequency of anxiety and depression disorders in the population examined was not higher than that commonly recorded in the same company during periodic checks in the years preceding the epidemic. In COVID-19 cases there was a significant risk of anxiety, especially in those who had low sleep quality. Mental health support and improvement interventions must mainly concern workers with positive tests and should also tend to improve sleep quality.
                Bookmark

                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                BMJ Leader
                leader
                BMJ
                2398-631X
                February 22 2021
                : leader-2020-000419
                Article
                10.1136/leader-2020-000419
                9aec514b-af04-48e6-9d2d-2e31432fdc08
                © 2021

                Free to read

                https://bmj.com/coronavirus/usage

                History

                Comments

                Comment on this article