ABSTRACT
The SARS-CoV-2 pandemic (COVID-19) dramatically increased the number of stressors on healthcare workers, including palliative care practitioners. Restrictions and increased demands on time made it difficult for the UMass Memorial Health palliative care team to utilize preexisting wellness strategies. In response to team members' stress reactions, a buddy system intervention was conceived and implemented to restore a sense of connection and self-efficacy (Phase 1). Our objective with this quality improvement project was to assess the feasibility and effectiveness of the buddy system and evaluate staff attitudes toward this intervention. After four months, feedback from team members informed redesign to a more structured buddy system (Phase 2). A mixed-methods design of this project included a qualitative online survey along with quantitative data collection with the Professional Quality of Life Scale V (ProQOL V) and the Brief Resilience Scale (BRS) during Phase 1. Phase 2 was also evaluated quantitatively with ProQOL V and BRS. Semi-structured interviews were conducted at the end of this project to enhance qualitative data on staff attitudes and beliefs. Of the 12 study participants, 10 completed all phases of the study. Participants reported the buddy system was a useful, easy-to-implement intervention for mitigating personal distress and compassion fatigue (CF) by providing a strong sense of support and connection to team members.
ABSTRACT
Outcomes 1. Learn about the creation, implementation, and redesign of a palliative care buddy system adapted from other fields during the pandemic 2. Understand the impact of the buddy system on compassion fatigue, compassion satisfaction, and resilience among a palliative care team at a tertiary care center Background Studies show palliative care (PC) providers are at high risk of burnout. The COVID-19 pandemic placed additional and unprecedented levels of stress on frontline PC providers. A buddy system of peer support has been well studied in military and disaster relief workers. Aim Statement Evaluate the impact of buddy system on compassion fatigue (CF), compassion satisfaction (CS), and resilience on a PC team. Methods In response to team members’ stress reactions during COVID-19, a buddy system was created and implemented for PC team at a tertiary medical center in Massachusetts to support connection and self-efficacy (phase 1). After 4 months, feedback from team members via an online survey instrument prompted redesign of a more structured system to enhance participation and satisfaction (phase 2). The Professional Quality of Life Scale-V (ProQOL-V) and Brief Resilience Scale (BRS) were administered after phases 1 and 2 to measure participants’ levels of CF, CS, and resilience. Semistructured interviews were done after phase 2 to obtain qualitative data on staff attitudes and experiences with the buddy system. Results Among the 12 participants (physicians, affiliate practitioners, social worker, music therapist, and administrative assistant), 10 completed all phases of the study. ProQOL-V and BRS scores were unchanged between phases 1 and 2 and showed levels of CS as moderate to above average, CF as moderate to low, and resiliency within a normal range. The semistructured interviews strongly conveyed participants’ views of the buddy system as a useful intervention for mitigating personal distress via peer support and connection, and they overwhelmingly requested that it become a permanent part of the team wellness program. Participants preferred structured buddy system (phase 2), including text message reminders, protected time at team meetings, discussion topics, and a wellness resource guide. Conclusions and Implications The buddy system is a well-received intervention to support connection and mitigate stress among PC providers;it is adaptable and holds promise as a national model to counteract the prevalence of burnout, which threatens our field.
ABSTRACT
CONTEXT: Reports from patients and health care workers dealing with coronavirus disease 2019 (COVID-19) underscore experiences of isolation and fear. Some of this experience results from the distancing effect of masks, gloves, and gowns known as personal protective equipment (PPE). One approach to bridging the divide created by PPE is the use of PPE portraits, postcard-sized pictures affixed to PPE. OBJECTIVES: Our confidential electronic mail-based survey aimed to quantify provider attitudes toward PPE portraits. METHODS: PPE portraits were piloted at an academic safety-net health system experiencing a COVID-19 patient surge during April-May 2020, necessitating use of full PPE for COVID-positive patients and surgical masks in all hospital settings. Our survey assessed staff exposure to PPE portraits, attitudes toward PPE portraits, and potential program expansion. For staff wearing PPE portraits, we also assessed perceptions of interactions with other staff and patients/families and impact on personal well-being. The University of Massachusetts Medical School's Institutional Review Board designated this as a quality improvement project (#H00020279). RESULTS: More than half of survey respondents (n = 111 of 173; 64%) reported exposure to PPE portraits. Attitudes toward PPE portraits were positive overall, with agreement that PPE portraits were a good idea (89%), improved provider mood (79%), enhanced perception of team connection (72%), and more positive among those who reported exposure. Open-ended responses (n = 41) reinforced positive survey data and also raised concerns about infection control (n = 6), cost/logistics (n = 5), and provider vulnerability (n = 3). CONCLUSION: Providers report that PPE portraits may represent a positive patient-centered idea that helps reassure patients, is well received by interdisciplinary staff, and may enhance patient and team interactions. Potential adaptations to address concerns include photo pins and donor/patient and family experience department support for costs.