The Initial Positive and Negative Impacts of the COVID-19 Pandemic on Rural Healthcare Providers: Associations With Team Culture and Leadership.
Journal
Journal of healthcare management / American College of Healthcare Executives
ISSN: 1096-9012
Titre abrégé: J Healthc Manag
Pays: United States
ID NLM: 9803529
Informations de publication
Date de publication:
Historique:
entrez:
8
9
2021
pubmed:
9
9
2021
medline:
26
11
2021
Statut:
ppublish
Résumé
This study aimed to use qualitative and quantitative methods to (1) understand the initial positive and negative impacts of the COVID-19 pandemic on rural healthcare providers; (2) explore associations between team culture and leadership and provider distress and job satisfaction after the initial impact of the COVID-19 pandemic; and (3) determine whether changes occurred in perceived stress and burnout. Participants included 213 providers working in rural Pennsylvania. The researchers administered an electronic survey to participants 10 days after the organization issued directives to cancel routine care appointments. Descriptive statistics were used to examine sample characteristics. The researchers used thematic analysis to assess open-ended responses. Correlational analyses were used to examine associations among perceived stress, team culture, job satisfaction, COVID-19 engagement, and team leadership. Most providers reported that the pandemic had the greatest effect on them psychologically, followed by professionally (i.e., changes in workload and conflicts with coworkers) and financially. Statistically significant positive associations were observed among leadership, provider distress, and team culture. Identification of the psychological impact highlights the need to support healthcare providers and address their psychological needs. Moreover, understanding ways in which leaders can effectively lead may help personnel better prepare for a public health crisis.
Identifiants
pubmed: 34495004
doi: 10.1097/JHM-D-20-00258
pii: 00115514-202110000-00011
doi:
Types de publication
Journal Article
Langues
eng
Pagination
396-406Informations de copyright
Copyright © 2021 Foundation of the American College of Healthcare Executives.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Adams J. G., Walls R. M. (2020). Supporting the health care workforce during the COVID-19 global epidemic. JAMA, 323(15), 1439–1440. https://doi.org/10.1001/jama.2020.3972
doi: 10.1001/jama.2020.3972
Amanullah S., Shankar R. (2020). The impact of COVID-19 on physician burnout globally: A review. Healthcare, 8(4). https://doi.org/10.3390/healthcare8040421
doi: 10.3390/healthcare8040421
American Psychological Association. (2020, March 20). How leaders can maximize trust and minimize stress during the COVID-19 pandemic. http://www.apa.org/news/apa/2020/03/covid-19-leadership
Association of American Medical Colleges. (2019). 2019 update: The complexities of physician supply and demand: Projections from 2017 to 2032. http://aamc-black.global.ssl.fastly.net/ production/media/filer_public/31/13/3113ee5c- a038-4c16-89af-294a69826650/2019_update_-_ the_complexities_of_physician_supply_and_ demand_-_projections_from_2017-2032.pdf
Bradley M., Chahar P. (2020). Burnout of healthcare providers during COVID-19. Cleveland Clinic Journal of Medicine. https://doi.org/10.3949/ccjm.87a.ccc051
doi: 10.3949/ccjm.87a.ccc051
Braun V., Clarke V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
doi: 10.1191/1478088706qp063oa
Centers for Disease Control and Prevention. (2020). Guidance for U.S. healthcare facilities about coronavirus (COVID-19). https://www.cdc.gov/ coronavirus/2019-ncov/hcp/us-healthcare- facilities.html
Cohen S. T., Kamarch R., Mermelstein R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.
Deckard G., Meterko M., Field D. (1994). Physician burnout: An examination of personal, professional, and organizational relationships. Medical Care, 32(7), 745–754. https://doi.org/ 10.1097/00005650-199407000-00007
doi: 10.1097/00005650-199407000-00007
Dinibutun S. R. (2020). Factors associated with burnout among physicians: An evaluation during a period of COVID-19 pandemic. Journal of Healthcare Leadership, 12, 85–94. https://doi.org/10.2147/JHL.S270440
doi: 10.2147/JHL.S270440
Dyrbye L. N., Shanafelt T. D. (2011). Physician burnout: A potential threat to successful health care reform. JAMA, 305(19), 2009–2010. https://doi.org/10.1001/jama.2011.652
doi: 10.1001/jama.2011.652
Grumbach K., Bodenheimer T. (2004). Can health care teams improve primary care practice? JAMA, 291(10), 1246–1251. https://doi.org/10.1001/jama.291.10.1246
doi: 10.1001/jama.291.10.1246
Hartnett K. P., Kite-Powell A., DeVies J., Coletta M. A., Boehmer T. K., Adjemian J., Gundlapalli A. V. (2020). Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020. MMWR Morbidity and Mortality Weekly Report, 69(23), 699–704.
Jha A. K., Iliff A. R., Chaoui A. A., Defossez S., Bombaugh M. C., Miller Y. R. (2018). A crisis in health care: A call to action on physician burnout. https://www.massmed.org/Publications/Research,-Studies,-and-Reports/Physician-Burnout-Report-2018/
Karam F., Bérard A., Sheehy O., Huneau M.-C., Briggs G., Chambers C., Einarson A., Johnson D., Kao K., Koren G., Martin B., Polifka J. E., Riordan S. H., Roth M., Lavigne S. V., Wolfe L. the OTIS Research Committee. (2012). Reliability and validity of the 4-item perceived stress scale among pregnant women: Results from the OTIS antidepressants study. Research in Nursing & Health, 35(4), 363–375. https://doi.org/10.1002/nur.21482
doi: 10.1002/nur.21482
Lai J., Ma S., Wang Y., Cai Z., Hu J., Wei N., Wu J., Du H., Chen T., Li R., Tan H., Kang L., Yao L., Huang M., Wang H., Wang G., Liu Z., Hu S. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976–e1203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
doi: 10.1001/jamanetworkopen.2020.3976
Lambden J. P., Chamberlin P., Kozlov E., Lief L., Berlin D. A., Pelissier L. A., Yushuvayev E., Pan C. X., Prigerson H. G. (2018). Association of perceived futile or potentially inappropriate care with burnout and thoughts of quitting among health-care providers. American Journal of Hospice and Palliative Medicine, 36(3), 200–206. https://doi.org/10.1177/1049909118792517
doi: 10.1177/1049909118792517
Leung D. Y., Lam T., Chan S. S. (2010). Three versions of Perceived Stress Scale: Validation in a sample of Chinese cardiac patients who smoke. BMC Public Health, 10(1), 513. https://doi.org/10.1186/1471-2458-10-513
doi: 10.1186/1471-2458-10-513
Liu Q., Luo D., Haase J. E., Guo Q., Wang X. Q., Liu S., Xia L., Liu Z., Yang J., Yang B. X. (2020). The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. Lancet Global Health, 8(6), e790–e798. https://doi.org/10.1016/S2214-109X(20)30204-7
doi: 10.1016/S2214-109X(20)30204-7
Maslach C., Jackson S. E. (1986). Maslach Burnout Inventory. Consulting Psychologists Press.
Mitchell A. M., Crane P. A., Kim Y. (2008). Perceived stress in survivors of suicide: Psychometric properties of the Perceived Stress Scale. Research in Nursing & Health, 31(6), 576–585. https://doi.org/10.1002/nur.20284
doi: 10.1002/nur.20284
Papathanasiou I. V. (2015). Work-related mental consequences: Implications of burnout on mental health status among health care providers. Acta Informatica Medica, 23(1), 22–28. https://doi.org/10.5455/aim.2015.23.22-28
doi: 10.5455/aim.2015.23.22-28
Ranney M. L., Griffeth V., Jha A. K. (2020). Critical supply shortages—The need for ventilators and personal protective equipment during the Covid-19 pandemic. New England Journal of Medicine, 382(18), e41. https://doi.org/10.1056/NEJMp2006141
doi: 10.1056/NEJMp2006141
Rohland B. M., Kruse G. R., Rohrer J. E. (2004). Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians. Stress and Health, 20(2), 75–79. https://doi.org/10.1002/smi.1002
doi: 10.1002/smi.1002
Salyers M. P., Bonfils K. A., Luther L., Firmin R. L., White D. A., Adams E. L., Rollins A. L. (2017). The relationship between professional burnout and quality and safety in healthcare: A meta-analysis. Journal of General Internal Medicine, 32(4), 475–482. https://doi.org/10.1007/s11606-016-3886-9
doi: 10.1007/s11606-016-3886-9
Shanafelt T. D., Boone S., Tan L., Dyrbye L. N., Sotile W., Satele D., West C. P., Sloan J., Oreskovich M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. JAMA Internal Medicine, 172(18), 1377–1385. https://doi.org/10.1001/archinternmed.2012.3199
doi: 10.1001/archinternmed.2012.3199
Shanafelt T. D., Hasan O., Dyrbye L. N., Sinsky C., Satele D., Sloan J., West C. P. (2015). Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clinic Proceedings, 90(12), 1600–1613. https://doi.org/10.1016/j.mayocp.2015.08.023
doi: 10.1016/j.mayocp.2015.08.023
Shanafelt T. D., Noseworthy J. H. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings, 92(1), 129–146. https://doi.org/10.1016/j.mayocp.2016.10.004
doi: 10.1016/j.mayocp.2016.10.004
Shreffler J., Petrey J., Huecker M. (2020). The impact of COVID-19 on healthcare worker wellness: A scoping review. Western Journal of Emergency Medicine, 21(5), 1059–1066. https://doi.org/10.5811/westjem.2020.7.48684
doi: 10.5811/westjem.2020.7.48684
Sinsky C. A., Willard-Grace R., Schutzbank A. M., Sinsky T. A., Margolius D., Bodenheimer T. (2013). In search of joy in practice: A report of 23 high-functioning primary care practices. Annals of Family Medicine, 11(3), 272–278. https://doi.org/10.1370/afm.1531
doi: 10.1370/afm.1531
Society of Critical Care Medicine. (2020, May 5). Clinicians report high stress in COVID-19 response. https://sccm.org/Blog/May-2020/SCCM-COVID-19-Rapid-Cycle-Survey- 2-Report
Tawfik D. S., Profit J., Morgenthaler T. I., Satele D. V., Sinsky C. A., Dyrbye L. N., Tutty M. A., West C. P., Shanafelt T. D. (2018). Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors. Mayo Clinic Proceedings, 93(11), 1571–1580. https://doi.org/10.1016/j.mayocp.2018.05.014
doi: 10.1016/j.mayocp.2018.05.014
Terry, D. L., & Mathews, D. (in press). Technology-assisted supplemental work among rural medical providers: Impact on burnout, stress, and job satisfaction. Journal of Healthcare Management.
Terry D., Woo M. J. (2021). Burnout, job satisfaction, and work-family conflict among rural medical providers. Psychology, Health & Medicine, 26(2), 196–203. https://doi.org/10.1080/13548506.2020.1750663
doi: 10.1080/13548506.2020.1750663
Valentine M. A., Nembhard I. M., Edmondson A. C. (2015). Measuring teamwork in health care settings: A review of survey instruments. Medical Care, 53(4), e16–e30. https://journals.lww.com/lww-medicalcare/Fulltext/2015/04000/Measuring_Teamwork_in_Health_Care_Settings__A.15.aspx
Willard-Grace R., Hessler D., Rogers E., Dube K., Bodenheimer T., Grumbach K. (2014). Team structure and culture are associated with lower burnout in primary care. Journal of the American Board of Family Medicine, 27(2), 229–238. https://doi.org/doi:10.3122/jabfm.2014.02.130215
doi: 10.3122/jabfm.2014.02.130215