spread the science, not the virus
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C O L L E G E O F P O P U L AT I O N H E A LT H
August 18, 2020 | 4:00-5:00 pm ET
Spread the Science, NOT the VirusClinical Lessons from the Northeast Surge
| THOMAS JEFFERSON UNIVERSITY | COLLEGE OF POPULATION HEALTH
Jefferson College of Population Health
| THOMAS JEFFERSON UNIVERSITY | COLLEGE OF POPULATION HEALTH
Well-being of the Healthcare Workforce
Presented by
Sharon C. Kiely, MD, MPM, FACP
Moderated by
| THOMAS JEFFERSON UNIVERSITY | COLLEGE OF POPULATION HEALTH
Today’s Panelists
Heather Farley, MD, MHCDS, FACEP
Chief Wellness Officer
ChristianaCare
Susan M. Parisi, MD, FACOG
Director of Wellbeing & Practicing Physician
Nuvance Health
Jonathan Ripp, MD, MPH
Professor of Medicine, Medicine Education and Geriatrics and Palliative Medicine
Senior Association Dean, Well-Being and Resilience and Chief Wellness Officer
Icahn School of Medicine, Mount Sinai
Physician Well-Being: What’s Changed and What’s
More Important than Ever in the
Wake of COVID-19
Jonathan Ripp, MD, MPH
Chief Wellness Officer, Mount Sinai Health System
Senior Associate Dean for Well-Being+Resilience,
Icahn School of Medicine at Mount Sinai
Co-Chair, Collaborative for Healing and
Renewal in Medicine (CHARM)
The Pandemic Curve and Associated Stressors
6
Greatest Stressors
Time
Number of
Cases
Fear
for B
asic N
eeds
Uncertainty
Processing Experiences
1) Fear for Basic Needs
• When/what will I eat?
• How will I be kept safe and keep others safe?
• Who will care for my children?
• How will I get to and from work?
2) Uncertainty
• How long will this workload continue?
• Will I be able to do the job if redeployed?
• Am I doing enough?
• Will I be supported by my employer?
• Will I be able to make the difficult decisions?
3) Processing Experiences
• Grief and loss
• PTSD or PT Growth
• Catching my breath and time to reflect and facing the impact of societal upheaval around racial injustice
Shanafelt et al. JAMA. 2020; Ripp et al. Academic Medicine. 2020
The Pandemic Curve and Associated Stressors
7
Strategies to Address
Time
Number of
Cases
Fear
for B
asic N
eeds
Uncertainty
Processing Experiences
Time
Number of
Cases
Provid
e Bas
ic D
aily
Resourc
es
Communications
Mental H
ealth and
Psychosocial Support
1) Provide Basic Daily Resources
• Food (free and subsidized)
• PPE Clarity
• Childcare resource
• Transportation and Parking
2) Communication
• Weekly wellness messages
• Town Halls
• Transparency
3) Psychosocial & Mental Health
• Support Groups
• Phone Lines
• Telepsychiatry
• Mental Health “PPE”
• Frontline Relief
Shanafelt et al. JAMA. 2020; Ripp et al. Academic Medicine. 2020
8
9
Making the Case for Well-Being – Pre-COVID
10
Making the Case for Well-Being – In the COVID-19 Era
11
How ready is your employer to “buy in”?
12
Lessons Learned
▶ The approach to clinician well-being almost certainly requires a pivot in light
of the pandemic
– Be aware that we’ve all just experienced (are experiencing) a communal trauma.
– Shifting Needs and Drivers of Well-Being may lead to shifting priorities and
consideration of Societal Factors
– But, pre-COVID models can still apply in many respects…
▶ Uncertainty is a huge source of anxiety and stress during a pandemic
▶ Regular, authentic, transparent and supportive communications can’t be
overemphasized
▶ Trauma and Moral Distress will likely lead to significant long-term
consequences
▶ Everyone needs support, some will need treatment
– There are lots of resources to help for support
13
COVID 19-
Caring for Our Caregivers
HEATHER FARLEY, MD, MHCDS
CHIEF WELLNESS OFFICER
Center for Worklife Wellbeing
WHO
HOW
WHAT
WorkLife
Center for
WorkLife
Wellbeing
Rounding
Peer Support
“The solidarity of a
group provides the
strongest
protection against
terror and despair,
and the strongest
antidote to
traumatic
experience.”
–Judith Herman, MD (1997)
Meaning-Making
Caregiver Relief Fund
“The solidarity of a
group provides the
strongest
protection against
terror and despair,
and the strongest
antidote to
traumatic
experience.”
–Judith Herman, MD (1997)
Susan M. Parisi MD, FACOGDirector of WellbeingNuvance Learning Institute
Connecticut Statewide
Provider Wellness and
Resilience Collaborative
during COVID-19
August 18, 2020
23 Nuvance Health
Presentation Objective
Provide a statewide collaborative, replicable approach to developing a framework for Provider Wellness and Resilience during the COVID-19pandemic
– Connecticut Hospital Association (CHA) is an infrastructure that convenes member organizations for discrete purposes
– The CHA’s Safer Hospital Initiative recognized Worker Support as an important pillar
– CHA identified provider wellbeing as fundamental in addressing and supporting our caregivers during the COVID-19 pandemic
Background
The initial goal was expanded to include:
• Define guiding principles
• Develop a framework and toolkit for provider wellbeing
• Foster collegiality and sharing of wellness strategies across CT
• Recognize that all clinicians and staff members of the healthcare team would benefit from job-based approaches outlined for providers
• Ensure a thriving work force now and moving forward in CT
The Goal
Provide collective guidance based
on best practices and evidence for
how Connecticut hospitals were
responding to COVID-19 from a
Wellness standpoint
26 Nuvance Health
Nuvance Health27
Connecticut COVID-19 Statistics (May 6, 2020)
https://portal.ct.gov/-/media/Coronavirus/ctdphcovid19summary5152020.pdf
Nuvance Health28
Solving for “How to organize and discuss in a meaningful way”
Hospitals were at different stages of developing Wellness Programs pre COVID-
19 with different leadership structures and resources
Novice: traditional HR/EAP
Advanced: Chief Wellness Officer led Wellness Departments
How to create an accessible framework with common language to share with all
CHA members?
The Solution….
29 Nuvance Health
30 Nuvance Health
1. Hear me & Respond to me (Guiding Principles- multimodal,
bidirectional, timely and complete response)
2. Protect me (Guiding Principles- physical safety, psychological safety)
3. Prepare me (Guiding Principles-training, up to date & evidence-based
education, transparency)
4. Support me (Guiding Principles- holistic support of the individual in
the context of the community)
5. Care for me (Guiding principles- ensure basic needs are met
(Maslow’s hierarchy))
6. Honor me (Guiding principles- coordinated, inclusive, planned and
executed authentic appreciation and acknowledgement)
Connecticut Framework for Provider Wellness in COVID-19
31 Nuvance Health
Hear Me & Respond to Me(Guiding Principles- multimodal, bidirectional, timely and complete response)
Interventions to consider:
• Rounding: Walk rounds, GEMBA rounds
• Sharing stories: Schwartz Rounds, tell stories, Fifty Word Stories (JAMA),
• Communication: One Call support number, Intranet, dedicated Wellness
Intranet site, Daily communication; common messaging, Team huddles with
leadership, safe space, aligned with executive strategy and interests; 12
Leadership Traits re Wellness-(CITE); Virtual Town Hall, CEO Calls; identify both
low and high-level leaders to listen, GME newsletters, DIO forums
• Measurement: Pulse checks and other surveys: Maslach, Press Ganey, Internal
research, Mayo, mini Z, Stanford (PFI), AMA Survey specific to COVID.
• Equity: ensure safety to speak up across all levels including trainees
Challenges/ Barriers: mental, emotional and physical fatigue, exhaustion, extra
shifts and dealing with the long curve, trainees unique needs, cumulative impact on
healthcare workforce, attrition, unknown consequences of this pandemic, focus on
6-12 months and impacts on families and friends, isolation persists, disruption of
usual means of communication .
Takeaways1. Wellness of providers and staff was and continues to be a common and
prominent concern of CT hospitals during the COVID-19 pandemic
2. The COVID-19 pandemic presented an opportunity for CT hospitals to
collaborate on a developing situation impacting the healthcare workforce
3. Wellness is emerging as a critical skill set for healthcare systems and did not
need to be aligned with other initiatives for validation and importance
4. Wellness programming can be adapted based on this framework to the
individual hospitals’ needs
Next Steps in Connecticut- Present the Framework for Provider Wellness in COVID-19 to Safer
Hospital Initiative
- Continue provider wellness collaborative in CT moving forward
- Expand toolkit to include entire healthcare workforce wellness
| THOMAS JEFFERSON UNIVERSITY | COLLEGE OF POPULATION HEALTH
Questions?
| THOMAS JEFFERSON UNIVERSITY | COLLEGE OF POPULATION HEALTH
Spread the Science, NOT the VirusClinical Lessons from the Northeast Surge Series
Presented by the Healthcare Association of New York State
Featuring:
Noreen B. Brennan PhD, RN-BC, NEA-BC
Nicolette (Nikki) Fiore-Lopez, PhD, RN, CNEP
Courtney Vose, DNP, MBA, RN
Loretta Willis, RN
Weekly Webinar recordings can be found at Jefferson Digital Commons https://jdc.jefferson.edu/covid-19-ssnv
For more information or questions visit our website
or contact Mary.R.Cooper@Jefferson.edu.
Next Week:
Leading Patient Care during the COVID-19 Pandemic
August 25 at 4:00 pm ET | Register Here
| THOMAS JEFFERSON UNIVERSITY | COLLEGE OF POPULATION HEALTH
Thank You!
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