Addressing healthcare staff wellbeing amid a maelstrom of change

New and innovative approaches to workforce management are being demanded of our healthcare institutions to address unprecedented levels of worker stress created by covid, increased case volumes, workforce virtualisation, emerging technology and care model changes. 

In a landmark Australian survey of healthcare workers conducted in 2021 by Melbourne-based researchers, the extent of an emerging crisis in our healthcare workforce as a result of covid and other emerging change factors was laid bare[1]. 

Mental health symptoms across tertiary, primary and allied care workers were identified in nearly 60% of respondents, with 71% of this cohort reporting “moderate to severe burnout” and just over 57% reporting “mild to severe depression”. 

The authors of the study concluded that the pandemic was associated with “significant mental health symptoms in frontline healthcare workers” and that “crisis preparedness together with policies and practices addressing psychological wellbeing” were urgently needed. 

Not even one year on from this study, the situation in most Australian healthcare institutions is still deteriorating based on post-covid workforce shortages and increased work volume, along with the convergence of other workplace changes including workforce virtualisation, emerging technology and care model changes. 

Part of the issue is the balancing act that is the prioritisation of systems and strategies for workforce wellbeing in an environment where there are so many competing demands of management. 

Although most state and federal government organisations have developed recommendations and strategies in response to the problem, the day-to-day realities of running stressed healthcare organisations, from large hospitals to small to medium sized GP practices, is limiting implementation of effective interventions. 

The NSW Health adult intensive care workforce report on covid recommendations [2] include: 

• Providing assurance that when staff are needed to work beyond their usual scope of practice, they will be indemnified by NSW Health “where they act professionally and in accordance with the mandated guidelines, policy or lawful directions of their employer”.  
• Developing structures to allow staff to be able to work across local health districts through cross credentialing, to support rural and remote hospitals that depend on iterant workforces. 
• Providing telehealth support to the above units. 
• Flexible rostering and shift length where feasible to reduce potential fatigue and allow for extended time for meal and hygiene breaks. 
• Monitoring staff testing/screening of covid and absence due to illness, particularly covid acquired through employment. 
• Providing accommodation for staff who are unable to return home, supported under state and local health district and speciality network.   
• Debriefing and psychological support for staff mental and physical wellbeing where feasible. 

But these are recommendations only.  

Systemic integration of such policies and procedures aren’t always practical across what is an eclectic state-wide system that remains in stress on many fronts, particularly in rural and remote settings, where other priorities in patient management and safety are often still taking precedence over direct workforce concerns. 

Once you get below the hospital sector the problem becomes significantly more exacerbated by a primary and allied care ecosystem which largely relies on many small businesses to co-ordinate in managing their workforces. 

Primary care, consistently underfunded year to year, and facing a series of significant structural issues and other extraordinary circumstances (such as systematic payroll tax audits by state revenue offices), is facing off other stressors on its business model which often will prevent appropriate organisational attention to staff wellbeing. 

Writing recently for the RACGP, Dr Tammra Warby said the Federal Government needed to “establish a taskforce to develop universal national guidelines and policies for organisations to address and protect against healthcare worker burnout”[3]. 

“In turn, healthcare organisations need to be accountable for the burnout of their workforce and acquire data on the benefit of any interventions applied via adopted burnout guidelines,” she said. 
 
Without a systematic response to the issue of burnout in healthcare workers, Dr Warby warned that our entire system ran the risk of losing thousands of essential healthcare workers without any real plan to replace them. 

In the absence of a better organised and funded approach to the issue by governments, what strategies are available to healthcare providers, big and small, which are effective at tackling the issues of workforce burnout and stress, but not difficult to implement given all the competing priorities for management of these organisations in these times? 

Part of the solution might be available through emerging technology solutions designed to support crisis-fatigued organisations in the management of their workforce: professionally, personally and psychologically. 

A key issue in getting on top of a particular organisation’s stress points is understanding workforce data and behaviours better over time, something which some organisational software solutions are starting to address. 

Typically, this software is designed to enable a holistic understanding of capabilities and competencies within an organisation via taking stock of the skills and proficiencies of the overall talent pool and suggesting personnel based on identified skills and competencies. 

Optimisation of workforce management processes helps organisations do things more efficiently, enhances the employee experience and is ultimately better for patient outcomes. 

Solutions often aim to engage and support workers by offering professional development created and curated for varying levels of roles (including management), provision of easy-to-use tools so staff can access development in their own time and creating accessible resources for staff to use in real time. 

Speaking on the panel of a recent Frost and Sullivan webinar on the topic of staff wellbeing and resilience[4], Coppelia Rose, Global Human Experience Management and Healthcare Offering Leader DXC Technology, said that by using such technology, organisations can start to position learning and training more effectively to build capability. 

“Understanding the talent pool, skills and competencies, where those gaps are, being able to mentor and fill those gaps with learning on the job, role-specific training, or even training around [things like] mindfulness can help organisations unlock benefits from their workforce strategies”, Ms Rose told the panel.  

“Anything that supports during times of stress, keeps the employees engaged, and gives the organisation a view of those employees and how they can be used to the best of their capability, would really benefit the organisation, staff and ultimately, patients”, she said.  

These days the volume of full-time employees being overseen by a single manager within  provider institutions usually demands some sort of digital solution as part of the overall staff management already, so the addition of some more sophisticated digital tools focused on managing mental wellbeing and burnout don’t introduce the issue of being entirely new to a lot of managers. 

With staff shortages now impacting most healthcare providers in Australia, a key tactic and challenge for most organisations is to secure and retain talent.   

According to the Frost and Sullivan panel, leveraging advanced analytics to improve predictive abilities in healthcare workforce management is starting to benefit provider organisations around the world, not just by helping address burnout in provider workforces, but by helping organisations prepare for changes in patient demands. 

Frost and Sullivan expert panellist, Tiffany Lipscomb, Vice President, Human Resources at Intermountain Healthcare, concludes of the use of such tools: 

“Use technology to be as predictive as possible, so you can anticipate what is coming up, understand factors that are happening in the community, globally even,” Ms Lipscomb said.  

“Bring that into your workforce plan. Use educational opportunities to help support growth into areas that you will need.”  

“The peak in service demand could come from anything, but we are more prepared if we can retain those staff, look after them …and make them as important as patients,” Ms Rose added.  

If the topic of this article interests you Wild Health and DXC Technology are holding an expert panel-based webinar on the topic for Australian healthcare providers on March 2, 2023. You can register for the webinar for FREE HERE. 

References 

1. High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross-sectional survey, BMJ Journals: General Psychiatry, September 6, 2021 

2. Adult intensive care workforce report in COVID-19 pandemic, NSW Health, http://bitly.ws/xtwd  

3. Why Australia needs a systemic response to burnout, GPNews, August 2021, http://bitly.ws/xtwi  

4. Healthcare Staff Well-Being Is the New Top Priority, Frost and Sullivan Webinar, 2022, https://hub.frost.com/healthcare-staff/