Implementation of initiatives designed to improve healthcare worker health and wellbeing during the COVID-19 pandemic: comparative case studies from 13 healthcare provider organisations globally.

BACKGROUND: Healthcare workers are at a disproportionate risk of contracting COVID-19. The physical and mental repercussions of such risk have an impact on the wellbeing of healthcare workers around the world. Healthcare workers are the foundation of all well-functioning health systems capable of responding to the ongoing pandemic; initiatives to address and reduce such risk are critical. Since the onset of the pandemic healthcare organizations have embarked on the implementation of a range of initiatives designed to improve healthcare worker health and wellbeing. METHODS: Through a qualitative collective case study approach where participants responded to a longform survey, the facilitators, and barriers to implementing such initiatives were explored, offering global insights into the challenges faced at the organizational level. 13 healthcare organizations were surveyed across 13 countries. Of these 13 participants, 5 subsequently provided missing information through longform interviews or written clarifications. RESULTS: 13 case studies were received from healthcare provider organizations. Mental health initiatives were the most commonly described health and wellbeing initiatives among respondents. Physical health and health and safety focused initiatives, such as the adaption of workspaces, were also described. Strong institutional level direction, including engaged leadership, and the input, feedback, and engagement of frontline staff were the two main facilitators in implementing initiatives. The most common barrier was HCWs' fear of contracting COVID-19 / fear of passing COVID-19 to family members. In organizations who discussed infection prevention and control initiatives, inadequate personal protective equipment and supply chain disruption were highlighted by respondents. CONCLUSIONS: Common themes emerge globally in exploring the enablers and barriers to implementing initiatives to improve healthcare workers health and wellbeing through the COVID-19 pandemic. Consideration of the themes outlined in the paper by healthcare organizations could help influence the design and deployment of future initiatives ahead of implementation.

Allelic variation in class I HLA determines CD8(+) T cell repertoire shape and cross-reactive memory responses to SARS-CoV-2

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Cybersecurity in health is an urgent patient safety concern: We can learn from existing patient safety improvement strategies to address it

Introduction Cybersecurity is a patient safety concern. Recent cyberattacks on healthcare institutions around the world have shown the risks to patients: from delayed treatment as hospitals and clinics are shutdown, to the threat of harm from the theft of personal data, to patient death. The recent Covid-19 pandemic has further increased cyber-attacks on health organisations. In low- and middle-income countries (LMICs) digital health, including the use of health informatics systems and electronic health records, is an increasing part of the health agenda as national governments move to scale up healthcare on the path to achieving Universal Health Coverage. Frontline healthcare workers are often warned of the dangers of data mismanagement and are advised to take precautions to ensure data is safe. However, as many workers are already overstretched with conflicting administrative priorities, cybersecurity risks are going unnoticed. Discussion In this commentary we argue that future education and training interventions for frontline healthcare workers on cybersecurity in LMICs can benefit from lessons learned from other areas of patient safety. Validated interventions, including education and awareness programmes and other simple tools, exist which can offer guidance on how cybersecurity awareness and education may be scaled up in frontline healthcare facilities, without adding an unacceptable burden to staff. Conclusions Efforts to develop frontline interventions on cybersecurity that can be easily implemented and sustained are essential to ensure patient safety is a top priority in a digitally reliant health system.

Developing a globally applicable cybersecurity framework for healthcare: A Delphi consensus study

Background: Cybersecurity in healthcare has become increasingly important as the COVID-19 pandemic has increased the use of digital technologies in healthcare provision around the world, while simultaneously encouraged cybercriminals to target healthcare organisations in greater numbers. Despite the threat of cyberattack to patient safety and the provision of healthcare, cybersecurity in the health sector lags behind other industries. Additionally, no adequate cybersecurity framework exists which considers the unique needs of the health sector. Methods: An online Delphi was carried out to develop a globally relevant and applicable readiness framework to guide cybersecurity planning in healthcare. Experts (n=42) in the areas of cybersecurity, information communications and technology and health informatics were invited to list the components they felt were essential to a framework and subsequently agree with consensus on a final framework based on the identified components. Results: After two rounds, the Essentials of Cybersecurity in Healthcare Organizations (ECHO) framework with 51 components, grouped into six categories, was regarded by the experts as an acceptable planning tool to guide cybersecurity in healthcare at the global level. Conclusions: The ECHO framework, designed based on components chosen by international experts to meet the challenges of cybersecurity scale-up in the health and care sector globally, can help guide policymakers and health and care organisations in strengthening their cybersecurity infrastructure and deliver safe and effective care. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.