Langkamer-Smith, Hannah

Patruno, Joseph E, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Research Scholars Poster Presentation Strategies for Optimizing the Wellness of Physicians During the COVID-19 Pandemic: At Surge and Beyond Hannah Langkamer-Smith Joseph E. Patruno MD Follow this and additional works at: https://scholarlyworks.lvhn.org/research-scholars-posters  Part of the Medicine and Health Sciences Commons This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. © 2017 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaStrategies for Optimizing Wellness of Physicians During the COVID-19 Pandemic: At Surge and Beyond• Burnout among physicians is endemic and has been recognized as a work-related issue for more than two decades.1• Physician burnout, characterized by emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment is prevalent internationally.2• Coronavirus will be recognized as the most significant health crises of a generation, which invariably affects caregiver wellness.3• With the unique nature of COVID, it is important to identify the ramifications of the pandemic on wellness of clinicians. Before effective approaches to support health care professionals during COVID-19 can be developed, it is critical to understand their specific sources of anxiety and fear.4• The objective of this study was to examine the factors that cause physician burnout during COVID-19. • LVHN created a formalized strategy to limit burnout and maintain wellness during the stress of the pandemic. (1) Shanafelt, T., Dyrbye, L., & West, C. (2018). Physician burnout: Contributors,       consequences and solutions.T. Journal of Internal Medicine, 283(6), 516-529.(2) Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1). doi:10.1186/s12960-020-00469-9(3) Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and Addressing Sources of anxiety Among Health Care Professionals During the COVID-19 Pandemic. Journal of the American Medical Association, 323(21), 2133-2134.(4) Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review. Journal of Graduate Medical Education, 9(3), 294-301.(5) Singh, P. (2020, May 06). Abraham Maslow’s ‘Hierarchy of Needs’ Becomes Even More Relevant in the Era of COVID-19. Retrieved 2020.• The highest area of concern for both cohorts was the impact of COVID on the baseline culture and community.• The category “community and culture” includes: connections with colleagues, administrative tone, and fear of change. • Examples of responses for this category ranged from:– “the hard work and unity of my colleagues is inspirational,” to– “the forceful approach of administrators is difficult.” • Categories that decreased in concern between at surge and beyond were: personal protective equipment, financial implications, and community and culture. • Categories that increased in concern were: fear of contracting COVID, isolation, and exhaustion/sadness.• There was a significant increase in distress during both time periods (Figure 2). • The Well-Being Index (WBI) is a survey used at LVHN to measure the distress and wellness of its physicians; it also allows users to answer open-ended performance improvement questions. • The WBI performance question was customized to solicit the reception of physicians relating to COVID and its stresses. • Two questions included:– At surge: What can we do as an organization or what tools or resources can we provide for you to help keep you well during the COVID-19 pandemic? (March 18 – May 18)– Beyond surge: What has been your greatest personal and professional challenge with dealing with COVID-19? (May 19 –June 24) • Major categories of stress and concern were identified and evaluated during each of the noted time periods. • Responses were grouped according to category, as shown by Table 1 and Figure 1. • Physicians have key areas of concern while navigating the COVID-19 pandemic, notably, community and culture. Community and culture was identified as a major concern at the surge and continued to be a concern beyond. • When a crisis ensues, physicians fall back to basic needs like safety. These needs are lowest and fundamental to the survival of physicians. For example, concern for PPE was initially high, then decreased. • In time, higher-order needs demand fulfillment. This includes: belongingness, love, esteem, and self-actualization needs. For example, concern for exhaustion/sadness increased significantly as COVID progressed. • As shown by Figure 1, drivers of wellness and burnout prevention are largely rooted within the healthcare system. • Overall, COVID-19 is a significant and unique stressor. Improvements were made in certain areas (such as PPE), but other areas suffered, especially exhaustion/sadness. • Despite best efforts, certain areas cannot be easily controlled, and physician concerns will not be entirely eliminated. • This is why promoting a personal agenda of wellness during COVID-19 is especially critical.Research Scholar: Hannah Langkamer-Smith Mentor: Dr. Joseph Patruno, MDBACKGROUND / INTRODUCTIONMETHODSOUTCOMES RESULTSCONCLUSIONS“Having the ability to lead through this pandemic has been incredibly challenging and rewarding. I'm grateful to be a part of LVHN.”• Maslow’s Hierarchy of Needs is a theory in psychology which states that basic needs must be met first before the individual is able to achieve higher needs, like self-actualization.5• Initially, during the surge, physicians were mainly concerned with basic, physiological and safety needs, i.e., P.P.E.• As time progressed and the course of the virus leveled out, physicians became more concerned with higher-order needs, such as belongingness and esteem needs.• This is evidenced by the increase in concern with categories such as: “isolation” and “exhaustion/sadness.”• Hot spots of concern across both cohorts include: community & culture, financial implications, and disrupted work/life balance.0%5%10%15%20%25%30%35%40%Percent ResponsePhysician Areas of Concern At and Beyond Surge At Surge After SurgeCategories At Surge Percentage Beyond Surge PercentagePersonal Protective Equipment 26 22% 19 8%Disrupted Work/Life 16 13% 52 22%Fear of Contracting COVID 3 0.02% 25 11%Isolation 1 0.01% 10 4%Exhaustion/Sadness 3 0.02% 34 14%Financial Implications 25 21% 38 16%Community & Culture 45 38% 58 25%Total 119 100% 236 100%Figure 2: Highlighted: The Rise in the Percent of Scores Considered to be At-Risk for Burnout During COVID-19  Figure 1: Open-Ended Reponses to the WBI Grouped by Category of Concern Table 1: Raw Data of Tally of Physician Concern by Category Including Percentages

Strategies for Optimizing the Wellness of Physicians During the COVID-19 Pandemic: At Surge and Beyond

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Strategies for Optimizing the Wellness of Physicians During the COVID-19 Pandemic: At Surge and Beyond

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