Burnout in mental health services in Ireland during the COVID-19 pandemic

Background Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic. Aims To examine personal, work- and patient-related burnout among MHS staff in Ireland during the COVID-19 pandemic, and explore the impact of work-related conditions on burnout. Method We conducted a cross-sectional survey of three MHS across Ireland utilising a study-specific questionnaire, the Copenhagen Burnout Inventory and the Effort–Reward Imbalance scale. Results Of 396 participants, 270 (70.6%) were female. Moderate and high personal burnout was experienced by 244 (64.1%) participants; work-related burnout by 231 (58.5%) participants and patient-related burnout by 83 (21.5%) participants. Risk factors for both personal and work-related burnout were female gender, urban service, time spent outside main responsibilities, overcommitment, high score on the Effort–Reward Imbalance scale and intention to change job. Being younger, with high workload and deterioration of personal mental health during the pandemic was associated with higher personal burnout, whereas a lack of opportunity to talk about work-related stress contributed to work-related burnout. Fewer factors were associated with patient-related burnout, namely overcommitment, working in urban services and poorer physical and mental health during the COVID-19 pandemic. Conclusions High levels of personal and work-related burnout were found among mental health workers. The weak association with COVID-19-related factors suggest levels of burnout predated the pandemic. This has implications for MHS given the recognised additional work burden created by COVID-19

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

How to Select Change Agents in Organizations? A Comparison of the Classical and Network Approaches

Dynamika rynku zmusza firmy do wprowadzania ciągłych zmian i dostosowywania się do potrzeb i wyzwań otoczenia. Proces ten może być prowadzony przy pomocy agentów zmian rozprzestrzeniających informacje i dostarczających wsparcie innym pracownikom. W artykule przedstawiamy podejście oparte na analizie sieci organizacyjnej. Proponujemy sposób wyboru pracowników do roli agentów zmiany pozwalający na optymalizowanie ich zasięgu w sieci, by przy jak najmniejszej liczbie wybranych osób maksymalizowany był ich łączny zasięg wyrażony liczbą pracowników, do których mogą bezpośrednio dotrzeć. W celach eksploracji i wstępnej weryfikacji zaproponowanego podejścia na trzech sieciach współpracy pracowników przedsiębiorstw średniej wielkości porównaliśmy kilka metod wyboru agentów. Wyniki sugerują, że agenci wybrani przy wykorzystaniu miary centralności sieciowej, jaką jest pośrednictwo (betweenness), uzyskują najlepszy i istotnie wyższy zasięg w sieci w porównaniu z agentami wybranymi na podstawie wysokiej pozycji w hierarchii. Także sam zasięg agentów wydaje się duży – w najlepszym testowanym przypadku 5% wybranych agentów jest w stanie dotrzeć do 70% wszystkich pracowników, w porównaniu z 40% zasięgiem uzyskanym przez agentów wybranych losowo. Duży zasięg komunikacji i wsparcia w zmianie organizacyjnej może zwiększyć szanse jej powodzenia dzięki kompleksowemu i ciągłemu dostarczaniu pracownikom rzetelnych informacji pochodzących z pierwszej ręki i wsparcia oraz zbieraniu od nich informacji zwrotnej. Jednocześnie zaangażowanie jak najmniejszej liczby osób w proces wsparcia zmiany pozwala na utrzymanie kosztów jej implementacji na relatywnie niskim poziomie.The dynamic business environment forces companies to change and adapt constantly. The process can be organized with help of change agents. We develop a simple network approach to spreading information and delivering feedback in organizations. We suggest selecting employees with a role of change agents, focusing on the coverage they can obtain in the network – minimize the number of involved agents and maximize the size of their overall communication area. To explore and pre-verify the proposed approach, we compared and examined several network and classical methods of selection. Data includes networks of collaboration from three medium-sized companies. Agents selected according to network betweenness centrality obtained the best and significantly broader reach than agents selected as employees with high hierarchy levels. Moreover, selected change agents reach impressive coverage; even 5% of company employees engaged as agents may directly reach up to 70% of company staff, compared to 40% for agents selected randomly. A large coverage of a company organizational network can increase the success of change initiatives as vital for spreading reliable, first-hand information and feedback about implemented change. On the other hand, engaging only a limited number of influential employees in a company’s network should keep costs of implementing change relatively low