Managing COVID-19 in an Australian designated isolation facility: Implications for current and future healthcare crises based on in-depth interviews.

Health care workers' (HCWs) lived experiences and perceptions of the pandemic can prove to be a valuable resource in the face of a seemingly persistent Novel coronavirus disease 2019 (COVID-19)-to inform ongoing efforts, as well as identify components essential to a crisis preparedness plan and the issues pertinent to supporting relevant, immediate change. We employed a phenomenological approach and, using purposive sampling, conducted 39 semi-structured interviews with senior healthcare professionals who were employed at a designated COVID-19 facility in New South Wales (NSW), Australia during the height of the pandemic in 2020. Participants comprised administrators, heads of department and senior clinicians. We obtained these HCWs' (i) perspectives of their lived experience on what was done well and what could have been done differently and (ii) recommendations on actions for current and future crisis response. Four themes emerged: minimise the spread of disease at all times; maintain a sense of collegiality and informed decision-making; plan for future crises; and promote corporate and clinical agility. These themes encapsulated respondents' insights that should inform our capacity to meet current needs, direct meaningful and in situ change, and prepare us for future crises. Respondents' observations and recommendations are informative for decision-makers tasked with mobilising an efficacious approach to the next health crisis and, in the interim, would aid the governance of a more robust workforce to effect high quality patient care in a safe environment.

Using the Experiences and Perceptions of Health Care Workers to Improve the Health Care Response to the COVID-19 Pandemic.

BACKGROUND: We sought the opinions of health care workers (HCWs) at a designated COVID-19 facility receiving the first cases to identify workplace modifications and inform effective changes to maximize health and safety at the onset of a crisis. METHODS: A cross-sectional study utilized open- and close-ended questions gathered demographic and work details, experiences and perspectives on infection control, communication, support, and the workplace. Qualitative data were analyzed thematically and quantitative were analyzed using descriptive statistics. FINDINGS: Of 340 HCWs, most approved of the organization's response to minimizing risk (81.0%), infection control training (81.1%), and supplies (74.3%). Key actions included up-to-date guidelines (93.6%) and specialized infectious diseases clinics (94.9%). Conclusions: HCWs rated the organization's adaptive changes highly, noting areas for improvement such as transparency and timeliness of communication. Incorporating input from HCWs when responding to health crises was beneficial to maximize staff health and safety and consequently that of patients.

Detrimental changes to the health and well-being of healthcare workers in an Australian COVID-19 hospital.

BACKGROUND: Most studies examining the psychological impact of COVID-19 on healthcare workers (HCWs) have assessed well-being during the initial stages or the peak of the first wave of the pandemic. We aimed to measure the impact of COVID-19 and potential changes over time in its impact, on the health and well-being of HCWs in an Australian COVID-19 hospital. METHODS: An online questionnaire assessed current and retrospective physical and mental health; psychological distress (Kessler Psychological Distress Scale); lifestyle behaviours; and demographics, providing measures of health and wellbeing at three phases of the pandemic. Targeted staff were invited to participate via email and in-person. Additional promotional activities were directed to all staff. Changes in general health, mental health and psychological distress were examined using McNemar's Chi-square. Associations between other categorical variables were tested using Chi-Square or non-parametric equivalents as appropriate. Logistic regression explored risk factors for current distress. RESULTS: Four hundred thirty-three eligible HCWs answered all (74 %) or part of the questionnaire. Current self-rated health and mental health were significantly better than during the height of the pandemic, but had not returned to pre-pandemic levels. Psychological distress was significantly more common during the height of the pandemic (34.2 %) than currently (22.4 %), and during the height of the pandemic distress was significantly more common among younger than older HCWs. Females were significantly more likely to be distressed that males currently, but not during the height of the pandemic. High distress during the height of the pandemic was more likely to be maintained by HCWs who were less physically active than usual during the height of the pandemic (OR = 5.5); had low self-rated mental health before the pandemic (OR = 4.8); and who had 10 or more years of professional experience (OR = 3.9). CONCLUSIONS: The adverse effects of the pandemic on HCWs have lessened with the easing of pandemic demands, but health and well-being have not reverted to pre-pandemic levels. This indicates continued exposure to elevated levels of stress and/or a sustained effect of earlier exposure. Initiatives that provide ongoing support beyond the pandemic are needed to ensure that HCWs remain physically and mentally healthy and are able to continue their invaluable work.