Unit 7 COVID-19 (Crisis Intervention Management)
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Overview
Welcome back to the healthcare stream of LDRS 617! We will spend time discussing the impact of COVID-19 on healthcare organizations in Unit 7 of the course. For healthcare organizations, we will focus on employee engagement and crisis intervention management (risk management). By analyzing this adverse event, we will determine how much healthcare organizations are affected, and what risk managers can do to ensure a plan for responding to crises like COVID 19 is in place. Let’s get started
This unit is divided into the following topics:
- Framework for Crisis intervention Management at Work;
- Mindfulness-based Interventions for Better Employee Engagement & Stewardship;
- Crisis Management – How to COVID Well?
Learning Outcomes
When you have completed this unit, you should be able to:
- Assess the practices of recognition and design a standard of practice to successfully create a culture of loyalty and recognition with organizations.
- Develop critical thinking skills and best practices application in relation to employee engagement and stewardship from the operational leader’s point of view.
- Understand the immediate impact of the Coronavirus disease on burn-out, work engagement and surgical training through research and studies.
- Examine ways to better manage crises.
- Understand what type of taker you are and what type of employee you are so that you can better understand what motivates you.
7.1 Framework for Crisis Intervention Management at Work
Definition and Types of Crises
A “crisis” involves a disruption of an individual’s/organization’s normal or stable state. More specifically, a crisis occurs when a person/organization faces an obstacle to important life goals that is, for a time, insurmountable through the utilization of his customary methods of problem-solving. Source: catholiccharitiesla.org
Crises are usually categorized as being either situational or maturational. Situational crises involve an unexpected event (such as COVID-19) that is usually beyond the individual’s/organization’s control. Examples of situational crises include natural disasters, loss of a job, assault, and the sudden death of a loved one. Maturational crises occur when a person is unable to cope with the natural process of development. Maturational crises usually occur at times of transition, such as when the first child is born, when a child reaches adolescence, and when the head-of-the-household retires.
Stages of Crises
A crisis situation involves a sequence of events that leads individuals from equilibrium to disequilibrium and back again. This sequence generally involves five components:
- The Hazardous Event: The hazardous event is a stressful circumstance that disrupts an individual’s equilibrium and initiates a series of actions and reactions. The hazardous event may be anticipated (e.g., divorce, retirement) or unanticipated (e.g., the sudden loss of a family member).
- The Vulnerable State: An individual’s reaction to the hazardous event is ordinarily linked to his/her subjective interpretation of the event. Most commonly, a hazardous event is perceived either as a threat, a loss, or a challenge. The vulnerable state is characterized by an increase in tension which the individual attempts to alleviate by using one or more of his/her usual coping strategies. If these strategies are unsuccessful, the individual’s tension continues to increase and, as a result, he/she eventually becomes unable to function effectively.
- The Precipitating Factor: The precipitating factor is the event that converts a vulnerable state into a crisis state. In some situations, the hazardous event and precipitating factor are identical; in other situations, the precipitating factor follows the hazardous event (i.e., the precipitating factor acts as the “last straw”). The precipitating factor may produce a variety of responses including, for example, a suicide attempt or, more constructively, a desire to seek help.
- Active Crisis State: The active crisis state is characterized by disequilibrium and normally involves the following: physical and psychological agitation (e.g., disturbed appetite and/or sleep, impaired concentration and problem-solving ability, anxiety, or depression), preoccupation with the events that led to the crisis, and, finally, a gradual return to a state of equilibrium. The individual ordinarily recognizes during the active crisis stage that his/her usual coping mechanisms are inadequate and, thus, is usually highly motivated to seek and accept outside help.
- Reintegration: Successful reintegration (restoration of equilibrium) is dependent on many factors including the individual’s ability to objectively evaluate the crisis situation and to develop and utilize effective coping strategies.
Crisis Management in Healthcare and Employee Engagement – Adapting to COVID-19
The Integrated Health Service Networks (IHSDNs) use four domains as a structure for their COVID-19 crisis management as indicated in this week’s assigned reading by the Pan American Health Organization (2020).
In the Pan American Health Organization’s report (p. 2), the key principles governing their COVID-19 emergency include:
- To Save Lives: through early identification, diagnosis, and appropriate management of cases;
- Containment of transmission by reducing secondary transmission to close contacts and health workers.
- Planning and preparedness for the progressive reorganization of health services in response to the emergency while maintaining the capacity to respond to other emergencies.
- Ensuring the health and protection of health workers by preventing stress and promoting their mental and physical health during and after the emergency.
- Progressive activation of the entire network of services from the first level of care, emergency services, specialized services, and hospitals; utilizing resources in the most efficient way to respond to the emergency while still meeting the needs of the population.
- Ensuring information and communication to authorities and other stakeholders involved to sensitize and train health workers and to empower the population in response to the emergency.
The Framework consists of four domains and four planning areas under each one of the domains:
- The four domains - Model of care: Interventions in response to COVID-19 outbreaks; Governance: Strategies for the Response to the epidemic; Organizational and management: Management capacity and conditions for the response to the epidemic; Financial allocations: Allocation of resources for the response to the epidemic. Under each domain, there would be four factors involved in the intervention planning.
- The four planning areas under each one of the domains
- Attributes adapted to the COVID-19 emergency.
- Essential actions for each attribute.
- Interventions according to the evolution of the emergency.
- Tools and instruments that support the verification of the implementation of actions and interventions for each attribute.
The framework is a useful reference for crisis management in any healthcare organization such as COVID-19. Please refer to this week’s assigned article for more details.
7.2 Mindfulness-based Interventions for Better Employee Engagement & Stewardship
In Mexico (2020), a National Mental Health Strategy was implemented to identify and find out the mental health repercussions of the COVID-19 pandemic. One of the treatment strategies was to provide compassion fatigue clinics.
During COVID-19, 5 national virtual clinics in Mexico provided daily online mindfulness sessions in two different evening schedules. The following article studies the effect of COVID-19 on healthcare workers in Mexico and discussed the impact of mindfulness sessions on the attendees of this special intervention during COVID-19.
Learning Activity: Read assigned article and Reflect “Post-traumatic stress symptoms in health workers”
- Read the assigned article by “Real-Ramirez et al.” entitled Well-being status and post-traumatic stress symptoms in health workers attending mindfulness sessions during the early stage of the COVID-19 epidemic in Mexico.
Real-Ramirez, J., Garcia-Bella, L., Rbles-Garcia, R., Martinez, M., Adame-Rivas, K., Ralderas-Pliego, B., Garcia-Alfaro, C., Perez-Cabanas, E., Sierra-Medina, S., Romero-Gonzalez, M., Alcocer-Castillejos, N. (2020). Well-being status and post-traumatic stress symptoms in health workers attending mindfulness sessions during the early stage of the COVID-19 epidemic in Mexico. Salud Mental, 43(6), 303-310.
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- Next reflect on the following questions.
Learning Activity: Crisis Management – How to COVID Well?
Please use the burnout and work engagement concepts to review the article.
What are the burnout symptoms before and during the COVID-19 pandemic, and what is the impact of burnout on work engagement before and during the COVID-19 pandemic?
- Read the assigned article by “Poelmann et al.” on The immediate impact of the Covonavirus disease 2019 (COVID-19) pandemic on burn-out, work engagement, and surgical training in the Netherlands.
Poelmann, F., Koceter, T., Steinkamp, P., Vriens, M., Verhoeven, B., Kruijff, S. (2021). The immediate impact of the Covonavirus disease 2019 (COVID-19) pandemic on burn-out, work engagement, and surgical training in the Netherlands. Elservier Inc. 170(3), 719-726.
- Read the assigned article by “Blake et al.” on Covid- well: Evaluation of the implementation of supported Wellbeing Centres for hospital employees during the Covid-19 pandemic.
Supported Wellbeing Centres have been set up in UK hospital trusts to mitigate the psychological impact of COVID-19 on healthcare workers, although the extent to which is utilized and the barriers and facilitators to access are unknown. The following study aimed to determine facility usage and gather insight into employee wellbeing and the views of employees towards this provision. The study included (i) 17-week service use monitoring, (ii) employee online survey with measures of wellbeing, job stressfulness, presenteeism, turnover intentions, job satisfaction, and work engagement, as well as barriers and facilitators to accessing the Wellbeing Centres. In the end, the study highlighted the need for strategies to address presenteeism and turnover intentions.
Blake, H., Yildirim, M., Wood, B., Knowles, S., Mancini, H., Covya, E., Cooper, J. (2020). Covid-well: Evaluation of the implementation of supported Wellbeing Centres for hospital employees during the Covid-19 pandemic. International Journal of Environmental Research and Public Health. 17(24), 1-23.
- Next reflect on the following questions.
Learning Activity: Watch and Reflect – Ted Talk: Are You a Giver or Taker?
To begin this learning activity, watch the following video (Note: this video is 13 minutes in length)
Watch: Are you a giver or a taker? | Adam Grant
- After completing the activity above, reflect and respond the following questions. Please include your answer and your reasoning in your submission of assignment 2.
Note that this question will help you prepare for session discussion.
Summary
Hospitals and healthcare institutions must manage crises effectively. When handled well, patients’ safety and service quality can be maintained (Blake et al.). The COVID-19 pandemic is an extreme crisis for the healthcare industry. Hospitals and intensive care units (ICUs) have been challenged and, in many cases, have exceeded their capacity. Despite fatigue, risk of infection, fear of transmission to family members, death of friends and colleagues, and the loss of many patients, health care workers have continued to provide care for patients. This unit’s topics focused on the crisis management framework provided by the Integrated Health Service Networks (IHSDNs), as well as approaches and strategies that can improve employee engagement and stewardship outcomes during extreme crises such as COVID-19. The three assigned articles (Blake et al., Polemann et al., Real-Ramirez et al.) for this unit provide ways to support healthcare workers/employees and help them cope with many additional sources of stress and anxiety.
How can healthcare institutions maximize employee engagement and stewardship during COVID-19? Briefly, “Healthcare organizations are urged to mobilize access to high-quality rest spaces and psychological first aid, but this should be localized and diversified. Strategies to address presenteeism and staff retention should be prioritized, and the high dedication of healthcare workers should be recognized” (Blake et al., 2020, p.1); “Online mindfulness sessions” (Real-Ramirez et al., 2020, p. 304); “Need for adequate guidance and clear communication” (Polemann et al., 2021, p. 1).
References
- Blake, H., Yildirim, M., Wood, B., Knowles, S., Mancini, H., Covya, E., Cooper, J. (2020). Covid- well: Evaluation of the implementation of supported Wellbeing Centres for hospital employees during the Covid-19 pandemic. International Journal of Environmental Research and Public Health. 17(24), 1-23. https://pubmed.ncbi.nlm.nih.gov/33333913/
- Bridger, E. (2018) (Chapter 8) - Employee engagement: A practical introduction.
- Pan American Health Organization (2020). Framework for the response of
integrated health service delivery networks to COVID-19. https://iris.paho.org/bitstream/handle/10665.2/52269/PAHOIMSHSSHSCOVID-19200021_eng.pdf?sequence=1&isAllowed=y
- Peters, J. (2019). Employee Engagement: Creating High Positive Energy at Work (eBook).
- Poelmann, F., Koceter, T., Steinkamp, P., Vriens, M., Verhoeven, B., Kruijff, S. (2021). The immediate impact of the Covonavirus disease 2019 (COVID-19) pandemic on burn-out, work engagement, and surgical training in the Netherlands. Elservier Inc. 170(3), 719-726. https://doi.org/10.1016/j.surg.2021.02.061
- Real-Ramirez, J., Garcia-Bella, L., Rbles-Garcia, R., Martinez, M., Adame-Rivas, K., Ralderas-Pliego, B., Garcia-Alfaro, C., Perez-Cabanas, E., Sierra-Medina, S., Romero-Gonzalez, M., Alcocer-Castillejos, N. (2020). Well-being status and post-traumatic stress symptoms in health workers attending mindfulness sessions during the early stage of the COVID-19 epidemic in Mexico. Salud Mental, 43(6), 303-310. http://doi/10.17711/SM.0185-3325.2020.041