How to Build Resilient Health Care Teams

How to Build Resilient Health Care Teams

Heather L Rusch, PhD

Heather L Rusch, PhD, is a Clinical Investigator at the National Institutes of Health and recipient of the 2020 Alies Muskin Career Development Leadership Award. Her research is mainly focused on developing innovative diagnostics and therapeutics for the treatment of trauma-related disorders, including PTSD. She investigates a range of psychological, neural, and molecular markers to better understand the factors that may increase human resilience in the face of traumatic stress. Dr Rusch’s research serves diverse trauma-exposed populations of civilians, military service members, medical students and residents, and healthcare professionals, including frontline healthcare workers that care for patients with COVID-19. Her work has been featured in the American Association for the Advancement of Science (AAAS), Anxiety and Depression Association of America (ADAA), JAMA, New York Academy of Sciences, MedScape, Mindful Magazine, New York Magazine, Psychology Today, and other media outlets. Dr Rusch is passionate about discovering evidenced-based interventions that foster human resilience, as well as expanding access to quality care through health science policy and implementation science.

Amanda Jiang

Amanda Jiang Headshot

Amanda Jiang is a Clinical Research Coordinator in the Youth Depression and Suicide Prevention Program at the University of Michigan. Amanda completed her A.A. at Wilbur Wright College and her B.A. at Smith College, where she majored in psychology with a specialization in eating disorders. Afterwards, she joined the National Institutes of Health as a UGSP Postbaccalaureate Research Fellow. There, she co-led studies examining the efficacy of mindfulness meditation and cognitive-behavioral interventions in populations with posttraumatic stress disorder and insomnia. Amanda is currently coordinating an NIH-funded study that investigates the feasibility of a just-in-time adaptive intervention for youth with suicidal thoughts and behaviors. In her present and future research, Amanda aims to develop accessible and personalized interventions to enhance wellbeing and quality of life among trauma-exposed populations.

How to Build Resilient Health Care Teams

Share
No
How to Build Resilient Health Care Teams

The current pandemic has unleashed unique stressors on our health care community. While many medical and mental health care workers have responded with resilience, our health care workforce is not immune to the trauma and suffering they face. Between May and October 2020, the American Medical Association conducted a national survey (Coping with COVID-19 for Caregivers) of 20,947 health care professionals from 42 organizations across the United States.1 The survey found that 38% of respondents reported high levels of anxiety or depression, and nearly 50% reported at least one symptom of burnout, like emotional exhaustion. Some health care workers are also grappling with moral injury - feelings of guilt, shame, or anger that result from engaging in health care decisions that transgress their deeply held commitment to uphold the standards of medicine. 

For the past 1.5 years, health care workers have been risking their lives without a full appreciation of their sacrifices. Many have suffered financial setbacks as well, including salary cuts and furloughs. Furthermore, violence against Asians, systemic racism, and childcare challenges for women in medicine have placed additional stress on these minoritized groups. When stress is extreme or enduring it can lead to devastating outcomes, not only for the health care workforce but also for patient safety. Health care leadership has the opportunity and moral imperative to ensure that the pandemic serves as a galvanizing moment - one that helps us learn and improve. Herein we offer six actions that leadership can implement to promote resilient health care teams and cultural change. 

Communicate empathetically. While timely and accurate communication is critical, empathetic communication fosters trust and improves performance. Some leaders are naturally more empathetic than others, but with training this skill can be developed and enhanced. Communicating empathetically means being present and showing your team that their feelings and needs are a priority to you. Establish formalized listening sessions or brief check-ins. Solicit genuine feedback, share stories of success, offer praise, gratitude, hope, and a path forward.

Determine sources of distress. Most health care workers do not experience significant occupational distress due to their extensive training. However, there may be times when they are faced with incredibly stressful decisions, such as allocating scarce resources or triaging care based on the probability of patient survival. Determine what policies and procedures work or not given the circumstances. Communicate organizational values and standards clearly. In collaboration with ethical advisors, establish guidelines and systems to ease the moral distress of your team.

Normalize help-seeking behavior. Historically, health care workers have been inculcated with a sense of duty, a need to be strong, and a belief that acknowledging distress is tantamount with weakness. As such, mental health stigma is one of the most pernicious barriers to health care workers seeking help. Providing mental health support services is not enough; help-seeking behaviors need to be reframed as a sign of strength. Consider expanding the core competencies for health care workers to include mental fitness so that all individuals are expected to engage.

Prioritize wellness. An effective wellness program sets the foundation for a culture of wellness. This includes cultivating environments where health care workers are not only productive and successful but also happy and healthy. Consider creating a Wellness Committee to oversee and coordinate system-wide efforts to improve organizational wellbeing. Educate your workforce on their physical and mental health status and high-risk behaviors, while providing them with a variety of resources and services to help them adopt a healthier lifestyle.

Design a formal peer support program. Social support is a key component of resilience; it helps organizations move away from a culture of blame and shame to one of trust and support. It also represents an organizational shift away from a culture of silence and stoicism towards one of shared experiences, vulnerability, and acceptance. Peer support is not mental health counseling; rather it is where health care workers are trained to offer support to colleagues. Design a peer support team that is diverse, respected, and has effective interpersonal skills.

Measure and share results. It is important to investigate who benefits from these resilience building initiatives and their causal effect on employee health care costs, health behaviors, wellbeing, productivity, and patient safety. Consider sending out routine surveys or holding quarterly meetings to gauge employees' responses. Determine what worked and what did not, then tailor the program as needed. Share the data with your workforce, so they feel seen and heard. Disseminating the findings may even help advance the science of resilience in health care.



1American Medical Association (2021). Coping with COVID-19 for Caregivers. American Medical Association, Chicago, IL.
 

Heather L Rusch, PhD

Heather L Rusch, PhD, is a Clinical Investigator at the National Institutes of Health and recipient of the 2020 Alies Muskin Career Development Leadership Award. Her research is mainly focused on developing innovative diagnostics and therapeutics for the treatment of trauma-related disorders, including PTSD. She investigates a range of psychological, neural, and molecular markers to better understand the factors that may increase human resilience in the face of traumatic stress. Dr Rusch’s research serves diverse trauma-exposed populations of civilians, military service members, medical students and residents, and healthcare professionals, including frontline healthcare workers that care for patients with COVID-19. Her work has been featured in the American Association for the Advancement of Science (AAAS), Anxiety and Depression Association of America (ADAA), JAMA, New York Academy of Sciences, MedScape, Mindful Magazine, New York Magazine, Psychology Today, and other media outlets. Dr Rusch is passionate about discovering evidenced-based interventions that foster human resilience, as well as expanding access to quality care through health science policy and implementation science.

Amanda Jiang

Amanda Jiang Headshot

Amanda Jiang is a Clinical Research Coordinator in the Youth Depression and Suicide Prevention Program at the University of Michigan. Amanda completed her A.A. at Wilbur Wright College and her B.A. at Smith College, where she majored in psychology with a specialization in eating disorders. Afterwards, she joined the National Institutes of Health as a UGSP Postbaccalaureate Research Fellow. There, she co-led studies examining the efficacy of mindfulness meditation and cognitive-behavioral interventions in populations with posttraumatic stress disorder and insomnia. Amanda is currently coordinating an NIH-funded study that investigates the feasibility of a just-in-time adaptive intervention for youth with suicidal thoughts and behaviors. In her present and future research, Amanda aims to develop accessible and personalized interventions to enhance wellbeing and quality of life among trauma-exposed populations.

Use of Website Blog Commenting

Use of Website Blog Commenting

ADAA provides this Website blogs for the benefit of its members and the public. The content, view and opinions published in Blogs written by our personnel or contributors – or from links or posts on the Website from other sources - belong solely to their respective authors and do not necessarily reflect the views of ADAA, its members, management or employees. Any comments or opinions expressed are those of their respective contributors only. Please remember that the open and real-time nature of the comments posted to these venues makes it is impossible for ADAA to confirm the validity of any content posted, and though we reserve the right to review and edit or delete any such comment, we do not guarantee that we will monitor or review it. As such, we are not responsible for any messages posted or the consequences of following any advice offered within such posts. If you find any posts in these posts/comments to be offensive, inaccurate or objectionable, please contact us via email at [email protected] and reference the relevant content. If we determine that removal of a post or posts is necessary, we will make reasonable efforts to do so in a timely manner.

ADAA expressly disclaims responsibility for and liabilities resulting from, any information or communications from and between users of ADAA’s blog post commenting features. Users acknowledge and agree that they may be individually liable for anything they communicate using ADAA’s blogs, including but not limited to defamatory, discriminatory, false or unauthorized information. Users are cautioned that they are responsible for complying with the requirements of applicable copyright and trademark laws and regulations. By submitting a response, comment or content, you agree that such submission is non-confidential for all purposes. Any submission to this Website will be deemed and remain the property of ADAA.

The ADAA blogs are forums for individuals to share their opinions, experiences and thoughts related to mental illness. ADAA wants to ensure the integrity of this service and therefore, use of this service is limited to participants who agree to adhere to the following guidelines:

1. Refrain from transmitting any message, information, data, or text that is unlawful, threatening, abusive, harassing, defamatory, vulgar, obscene, that may be invasive of another 's privacy, hateful, or bashing communications - especially those aimed at gender, race, color, sexual orientation, national origin, religious views or disability.

Please note that there is a review process whereby all comments posted to blog posts and webinars are reviewed by ADAA staff to determine appropriateness before comments are posted. ADAA reserves the right to remove or edit a post containing offensive material as defined by ADAA.

ADAA reserves the right to remove or edit posts that contain explicit, obscene, offensive, or vulgar language. Similarly, posts that contain any graphic files will be removed immediately upon notice.

2. Refrain from posting or transmitting any unsolicited, promotional materials, "junk mail," "spam," "chain mail," "pyramid schemes" or any other form of solicitation. ADAA reserves the right to delete these posts immediately upon notice.

3. ADAA invites and encourages a healthy exchange of opinions. If you disagree with a participant 's post or opinion and wish to challenge it, do so with respect. The real objective of the ADAA blog post commenting function is to promote discussion and understanding, not to convince others that your opinion is "right." Name calling, insults, and personal attacks are not appropriate and will not be tolerated. ADAA will remove these posts immediately upon notice.

4. ADAA promotes privacy and encourages participants to keep personal information such as address and telephone number from being posted. Similarly, do not ask for personal information from other participants. Any comments that ask for telephone, address, e-mail, surveys and research studies will not be approved for posting.

5. Participants should be aware that the opinions, beliefs and statements on blog posts do not necessarily represent the opinions and beliefs of ADAA. Participants also agree that ADAA is not to be held liable for any loss or injury caused, in whole or in part, by sponsorship of blog post commenting. Participants also agree that ADAA reserves the right to report any suspicions of harm to self or others as evidenced by participant posts.

Advertisement