The Healthcare Workers During the Covid 19 Pandemic

Implementation of a New Health Initiative

Title

Implementation of Initiatives Designed to Enhance the Well-Being and Health of the Healthcare Workers During the Covid-19 Pandemic.

Abstract

There is a need for a detailed approach to address several elements of well-being and health to protect healthcare workers. This study unpacks the barriers and facilitators to the enaction of solutions to enhance the well-being and health of healthcare workers through the Covid-19 pandemic. This study adopted a collective case study approach because it allows multi-faceted, in-depth explorations of complex challenges in real-life settings. Participants in the study included representatives of 13 healthcare provider institutions. The study received multiple responses from the 13 organizations, outlining various initiatives within their facility. Multi-level preparedness and coordination are essential to ensure that initiatives for well-being and health can be enacted within a conducive space.

Introduction

Since Covid-19 was identified in Wuhan, China, in 2019, it has continued to threaten lives across the globe, particularly the healthcare workers who are at the frontline. Hence at disproportionate risk of severe psychological and physical outcomes (O’Brien et al. 2022). According to Amnesty International, at least 17000 healthcare workers across the globe died during the first year of the Covid-19 pandemic. This finding was substantiated by other research studies worldwide that also established that healthcare workers were concerned about their safety and transmitting the virus to their loved ones.

Subsequently, there is a need for a detailed approach to address several elements of well-being and health to protect healthcare workers. Healthcare facilities must establish infection prevention and control to protect their well-being and physical health. This would protect healthcare workers from infections (McCauley & Hayes, 2020). Approaches that support healthcare workers’ physical health and well-being must be guarded by strong leadership and proper staff psychological support.

In most instances, the contribution of healthcare workers to a well-functioning health system is usually not acknowledged with proper response from leaders. Establishing and implementing solutions designed to address and minimize well-being and health challenges under financial, human resource, and time pressure is a serious challenge for several institutions and health systems worldwide (O’Brien et al., 2022). This study unpacks the barriers and facilitators to the enaction of solutions to enhance the well-being and health of healthcare workers through the Covid-19 pandemic. Moreover, even though various approaches have been put in place globally, the well-being and health of healthcare workers remain a huge concern for healthcare institutions globally. Thus, the need for better mechanisms how to support them.

Methodology

Design and Theoretical Approach

This study adopted a collective case study approach because it allows multi-faceted, in-depth explorations of complex challenges in real-life settings. This approach is different from the experimental design, where researchers attempt to control and manipulate the variables of interest. This design involved studying several cases simultaneously to produce a broader appreciation of a specific challenge. Moreover, according to Gilson et al. (2011), in studies with several issues, deliberate and systemic cross-case comparison endorses analytic generalization, other than making conclusions that can be generalized statistically to a broader study population. This research was also grounded in implementation research.

Subsequently, the following questions were asked.

· Whether and how initiatives can bring a difference to patients and healthcare workers.

· Letting new knowledge into one setting with effort or automatically allowing its applicability in another.

Finally, this study also conducted a thorough literature review before conducting the research. The literature review established existing research gaps, including barriers and facilitators to implementing initiatives to enhance the healthcare workers’ well-being and health (O’Brien et al., 2022). A phenomenon that this study addressed, hence, bridging the gap.

Methods

Data collection and participant selection

Participants in the study included representatives of 13 healthcare provider institutions. Recruitment and identification of the participants were initiated through the networks of the research team, the NIHR Imperial Patient Safety Translational Research Centre, and the Imperial College London Leading Health Systems Network. This research used a survey developed in Qualtrics to select case studies, while the research team developed and tested the questions. Those questions centered on initiatives and facilitators that were recently implemented, including challenges to their implementation, allowing participants to provide a free-text response. Follow-up questions were made through email to a particular individual participant (O’Brien et al. 2022). Imperial College Research Ethics Committee provided ethical approval.

Data analysis

To systematically analyze and code data, more so in cataloging codes to connect and establish broader themes, the study used the NVivo 1.0 qualitative data analysis computer software package. Also, the ground-up approach was adopted by the research team to develop codes that were obtained from primary data to link the codes and concepts to particular themes (O’Brien et al., 2022). Lastly, the study also undertook word frequency queries on NVivo to detect frequently repeated words in the dataset and their absolute and relative frequency to establish the aspect of the research topic that is mentioned most.

Results

The study received multiple responses from the 13 organizations, outlining various initiatives within their facility.

Facilitators to implementation

Respondents described multiple facilitators of implementation. The main facilitators were feedback, engagement, staff input (N=7), and leadership commitment (N=6). Others included standard communication across the institutions (N=5), government involvement with the organization (N=4), and enough financial resources (N=3) (O’Brien et al. 2022). Within the facility were institutional readiness (N=2), teamwork (N=2), proper infection control and prevention (N=1), and the establishment of protocols and guidelines (N=1).

Barriers to implementation

Respondents described multiple barriers to implementation. Healthcare workers’ fear of contracting and passing Covid-19 to loved ones was the most noted barrier (N=5). Challenges in engaging staff to take up initiatives were also commonly noted. These were a result of burnout and exhaustion (N=4), challenges of PPE (N=4), and inadequate human resources (N=3) (O’Brien et al. 2022). Within the facilities, lack of proper staff training and education (N=1), exhaustion (N=1), and failure by organizations and teams to concentrate on initiatives (N=1) were as well considered hindrances to enacting initiatives to enhance the well-being and health of healthcare workers within pandemic context.

Conclusions and Recommendations

Healthcare workers are at high risk of severe psychological and physical effects since they are at the frontline of the Covid-19 pandemic. Multi-level preparedness and coordination are essential points to begin from to make sure that initiatives for well-being and health can be enacted within a conducive space. However, misinformation and fear amongst the healthcare workers must also be managed in the process (O’Brien et al., 2022). Finally, various stakeholders also have to appreciate that the healthcare workers’ well-being and health will continue post-pandemic due to the prolonged impact of their experiences.

Discussion

Multi-Level Coordination: The Role of Leadership and Effective Engagement

From the study findings, the role of leadership, teamwork across the institutions, and establishment of protocols and guidelines, it is vivid that multi-level coordination can also be a facilitator of initiatives. Multi-level preparedness and coordination are necessary to prepare an organization in the event of a pandemic and facilitate healthcare workers managing, developing, and rolling out initiatives to enhance the well-being and health of the staff (O’Brien et al. 2022). Effective coordination with regional and national governments, external partners, as well as within organizations, and per the World Health Organization guidance, is an essential component of managing healthcare providers’ well-being and health in a pandemic situation.

Another element of the multi-level coordination issue identified through the lens of PPE during the pandemic is a proper translation of evidence and challenges embedded with rapidly changing regional, national, and organizational guidelines. During the study, many respondents recorded confusion about the correct PPE equipment for other staff and hospital locations (O’Brien et al., 2022). On the other hand, effective staff collaboration can help translate knowledge and build trust between staff and organization, improving initiatives to enhance healthcare workers’ well-being and health.