Becker's Hospital Review

39 Executive Briefing Sponsored by: C OVID-19 has taken a tremendous emotional and physical toll on clinicians. Throughout the pandemic, clinicians have grappled with daily changes in clinical knowledge, high volumes of patients, limited resources and anxiety about the health of their families, friends and themselves. Becker's Hospital Review recently spoke to Heather Owen, MD, TeamHealth's chief clinical officer for emergency medicine, about challenges clinicians continue to face and steps that healthcare leaders can take today to support their clinicians during the current public health crisis and beyond. The pandemic has pushed the healthcare sys- tem to the brink in all regions The COVID-19 pandemic has generated a variety of stresses. First and foremost, clinicians have been "learning on the job" about how to care for patients suffering from a novel, emerging disease. "At times, it felt like we were sitting on the shore waiting for a tsunami," Dr. Owen said. "We knew it was coming and we recognized that it would be devastatingly overwhelming. Yet, our preparation seemed like it was really never going to be enough. Our clinical work became more stressful and the complexities of preparing for the unknown started to wear on us." Simultaneously, the global sense of insecurity outside the hospital walls has been unrelenting. As a result, many healthcare professionals feel there is no reprieve from the stress they are experiencing. Although clinicians are trained to be resilient, the current situation has presented them with unimaginable circumstances. "One of the things that is unique to this pandemic is an overwhelming sense of hopelessness as our healthcare system has been pushed to the brink in all regions," Dr. Owen said. "Nationally we've seen physician substance misuse increase by 18 percent during COVID-19, compared to 13 percent in the general public. Clinicians by nature want to help and feeling helpless is a very uncomfortable place for us." Health system leaders know clinician wellness results in improved patient-clinician relationships, high-functioning care teams and an engaged workforce. The pandemic has highlighted that clinicians need improved balance in their lives and that each person reacts to stresses differently. In response, many healthcare organizations are trying to foster resiliency among clinicians more intentionally than they have done in the past. One of the challenges, however, is that clinicians don't necessarily feel empowered to ask for help. "Clinicians feel a greater sense of stigma about accessing mental health treatment and are much less likely to engage in counseling or therapy," Dr. Owen said. "There's a strong professional and business case to reduce physician burnout and to promote wellness. When leaders publicly address these issues, it's very powerful and can lead to significant change." Intentional, focused initiatives are needed to support clinician well-being Even before the pandemic, TeamHealth took a proactive stance on clinician well-being. In early 2019, the organization created a Clinician Well-being Strategic Advisory Group with four subcommittees. Each subcommittee is tasked with developing initiatives to support clinicians. This structure has promoted open and transparent conversations about the importance of clinician wellness and has led to significant efforts to identify and reduce burnout. "We quickly realized that you must provide a steady stream of communication around well-being and support resources," Dr. Owen said. "When clinicians need those, they know what's available and applicable to them." When TeamHealth started a dialogue around resilience and wellness, the responses across the board were powerful. Many of the experienced physicians had valuable insights to share. Meanwhile, some of the younger clinicians came out of their training with a different perspective on work-life balance. "It's been rewarding to talk about these issues and to recognize that it's OK to struggle," Dr. Owen said. "It's just something that we need resources and support to get through." Over the past year, as TeamHealth has navigated the pandemic, it has expanded its programs to support clinicians. The organization has addressed issues related to PPE and provided analytical summaries of newly released clinical information. In addition, TeamHealth has recognized the need for personal connection and regular touchpoints with clinicians. "We expanded our best practice of wellness calls during hurricanes and other local or regional disasters nationally to every clinician in the organization to check on wellness throughout the pandemic."" Dr. Owen said. "The power of that personal touch is so valuable. Those personal phone calls have had an unbelievable impact on morale within the organization." COVID-19 and the clinician wellness crisis — Dr. Heather Owen shares best practices and lessons learned

• Cover