Frontline healthcare workers' perspectives on interprofessional teamwork during COVID-19.

Effective interprofessional teamwork serves an important role in successful crisis response. Responses to past public health crises have relied on interprofessional communication and trust to support healthcare worker (HCW) resiliency. To understand interprofessional interactions and perceptions of teamwork during the COVID-19 response, we conducted in-depth semi-structured interviews with 18 inpatient HCWs (11 bedside nurses, 5 care coordinators, and 2 pharmacists) from one VA Medical Center between March and June 2020. Using thematic analysis, we identified four key themes that describe the strengths and challenges of interprofessional teamwork, communication, patient care, and organizational response during the initial COVID-19 surge. Interprofessional teams were fragmented. HCWs who transitioned to remote work lost their status on inpatient teams and struggled to provide pre-pandemic levels of quality of care. Conversely, interprofessional teamwork improved for HCWs who continued to work on inpatient units, where study participants described a decline in interprofessional hierarchies and an increase in mutual support. Participants described the need for timely, accurate, transparent communication as they faced new patient safety and communication challenges brought on by the pandemic. HCWs expressed a desire for sustained leadership support and inclusion in institutional decision-making. The challenges to teamwork, communication, and patient care reported in this study highlight the need for consistent, transparent communication and organizational response from hospital leadership during times of crisis.

Frontline healthcare workers’ perspectives on interprofessional teamwork during COVID-19

Effective interprofessional teamwork serves an important role in successful crisis response. Responses to past public health crises have relied on interprofessional communication and trust to support healthcare worker (HCW) resiliency. To understand interprofessional interactions and perceptions of teamwork during the COVID-19 response, we conducted in-depth semi-structured interviews with 18 inpatient HCWs (11 bedside nurses, 5 care coordinators, and 2 pharmacists) from one VA Medical Center between March and June 2020. Using thematic analysis, we identified four key themes that describe the strengths and challenges of teamwork, interprofessional communication, patient care, and organizational response during the initial COVID-19 surge. Interprofessional teamwork suffered for those who worked remotely, but improved for nurses who remained on inpatient units, who felt a noticeable decline in interprofessional hierarchies. Participants described the need for timely, accurate, transparent communication as they faced new patient safety and communication challenges brought on by the pandemic. HCWs expressed a desire for sustained leadership support and inclusion in institutional decision-making. These challenges to teamwork, communication, and patient care highlight the need for consistent, transparent communication and organizational response from hospital leadership during times of crisis.

Forgotten frontline workers: Environmental health service employees' perspectives on working during the COVID-19 pandemic.

BACKGROUND: Environmental Health Service employees (EVS) sanitize healthcare facilities and are critical to preventing infection, but are under-resourced during the COVID-19 pandemic and at risk of burnout. OBJECTIVE: Understand demands on EVS' work and strain on resources during COVID-19. DESIGN: Qualitative descriptive study conducted in winter 2020-2021. SETTING: One quaternary care academic medical center in Colorado. PARTICIPANTS: A convenience sample of 16 EVS out of 305 eligible at the medical center. Fifty percent identified as Black, 31% as Hispanic, 6% as Asian, and 6% as White (another 6% identified as mixed race). Sixty-nine percent were female, and half were born in a country outside the United States. MEASURES: Semistructured telephone interviews. Interviews were audio-recorded and transcribed, and thematic analysis was used to identify key themes. RESULTS: Four themes illustrate EVS experiences with job strain and support during COVID-19: (1) Needs for ongoing training/education, (2) Emotional challenges of patient care, (3) Resource/staffing barriers, and (4) Lack of recognition as frontline responders. Despite feeling unrecognized during the pandemic, EVS identified structural supports with potential to mitigate job strain, including opportunities for increased communication with interdisciplinary colleagues, intentional acknowledgment, and education for those who speak languages other than English. Strategies that can increase physical and emotional resources and reduce job demands have potential to combat EVS burnout. CONCLUSIONS: As the surge of COVID-19 cases continues to overwhelm healthcare facilities, healthcare systems and interdisciplinary colleagues can adopt policies and practices that ensure lower-wage healthcare workers have access to resources, education, and emotional support.

Post-Covid-19 Syndrome: Improvements in Health-Related Quality of Life Following Psychology-Led Interdisciplinary Virtual Rehabilitation.

Coronavirus disease 2019 (COVID-19) is increasingly recognized as having significant long-term impact on physical and mental health. The Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) is a psychology-led specialist interdisciplinary team of health professionals specializing in persistent physical symptoms (PPS) and Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) with an emphasis on holistic integrated care. The PCWBS quickly recognized the risk of the long-term effects of COVID-19, particularly for social, health and care staff, and developed a 7-week virtual rehabilitation course which was piloted in October 2020. The "Recovering from COVID" course takes a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue (PVF) and is delivered by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, assistant psychologist, and a personal support navigator with support from a team administrator. The course focuses on understanding PVF, sleep optimization, nutrition, swallowing, activity management, energy conservation, stress management, breathing optimization, managing setbacks, and signposting to appropriate resources and services. Since the pilot, PCWBS has delivered 7 courses to support over 200 people suffering from post-COVID-19 syndrome. One hundred and forty-nine individuals that enrolled on the "Recovering from COVID" course completed the EQ-5D-5L to assess Health-related quality of life (HRQoL) across 5 dimensions, including problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Subsequently, 76 individuals completed these measures at the end of the rehabilitation course showing that patient ratings were significantly improved. In response to the NIHR recommendation for rapid evaluation of different service models for supporting people with post-COVID-19 syndrome, this data offers hope that rehabilitation is effective in reversing some of the problems faced by people living with the long-term effects of COVID-19.