INTRODUCTION

Healthcare workers are on the frontline to confront a medical crisis, especially when the nature of the crisis is strongly related to total societal well-being. They put themselves in the line of duty and spare no efforts to save lives and minimize human suffering. The coronavirus disease (COVID-19) pandemic is the perfect example of the dedication shown by healthcare professionals and their sacrifices to help others at such a critical time. Although healthcare workers are exposed to many job-related risks under normal circumstances, these risks are more prominent during a medical crisis. These risks include infections, exhaustion, mental and physical health, and social and family pressures. However, the two main risks of major concern during a pandemic are the exposure to infection and mental health.[13] Studying these concerns and potential solutions to prevent or alleviate them has been a subject of interest to many investigators[4,5]; however, there is no comprehensive plan to address the issues in totality. Such a plan should guide healthcare workers and management on how to manage services during a medical crisis while keeping in mind the well-being of staff as well as the quality and safety of patients receiving healthcare services.

HOW TO MANAGE HEALTHCARE STAFF DURING A CRISIS

The healthcare staff management plan should have a dual aim: the first is to protect the staff physically and mentally, and the second is to enable them to do their job well. This dual aim can be achieved by answering three specific questions. Each question drills down with further questioning to identify the specific components of each intervention. The Table summarizes actions that can be taken to address these questions and can be used as a checklist. The questions that need to be asked are as follows:

  1. Are staff protected from the risks posed by the crisis?

    To answer this question, we must answer the following questions:

    • Are healthcare workers equipped with reliable up-to-date knowledge pertaining to the disease, routes of transmission, and how to protect themselves?

    • Do they have the personal protective equipment (PPE) they require?

    • Are strict precautions implemented and enforced to prevent their exposure to the risk?

    It is important to prioritize the protection of the healthcare workers by providing the appropriate PPE to ensure they are not exposed to infection themselves or transmit the disease to patients, other healthcare workers, or even their own family members.

    Healthcare workers should self-screen and expect to be actively screened by other staff upon entry to work. Any healthcare worker suspected of having contracted the infection should be quarantined by the set guidelines. Healthcare workers should have adequate training to use PPE properly and implement all infection control recommendations including social distancing, traffic control, clustering, and any other evidence-based rules.[5]

  2. Are staff able to do the best job possible?

    The meaning of this question is as follows:

    • Do they have a clear planned approach as to what is expected of them?

    • Is there a clear communication plan to keep everyone updated on the situation?

    • Do they have all the resources (equipment, medications, and materials) to manage their patients?

    One of the golden rules of crisis management is to provide transparent timely communications to update staff on the situation, set expectations, and share the vision and strategy on how to contain the crisis.

    The second rule is to make sure that staff have what is needed to provide the best care to their patients. One concern during a crisis is critical staff shortage; because the workload has sharply increased, the staff has been reduced by illness or quarantine, or both. Plans to prevent or minimize staff shortage should be implemented proactively, including canceling nonemergency leaves, adapting the roles, working remotely, and workload rebalancing, thereby enabling the work to be covered by a fewer number of staff with specific priorities.

  3. Are staff supported to maintain their own well-being?

    • Is there an effective mental health support program for healthcare workers?

    • Are there mechanisms to help the healthcare workers overcome the challenges they are facing?

    Emotional disturbances are prevalent in major crisis situations, and serious steps should be taken to prevent, minimize, and manage them effectively. These interventions should be proactive, feasible, reliable, and consistent. These interventions should incorporate innovative ideas to face the new emerging challenges.

    To address the issue of protecting healthcare workers' mental health, proactive preventive measures such as early recognition, easy access to help, early intervention, and maintenance support should be available to all staff. In the Chinese experience, a set of proactive interventions consisted of the establishment of a psychological intervention medical team to provide online courses to guide medical staff on how to deal with common psychological problems, offer a psychological assistance hotline team, and offer practical psychological interventions, such as various group activities to release stress. Staff reluctance to seek help was a major obstacle when it came to the proper utilization of these services. It is critical for these interventions to be timely, feasible, and easy to access; this is why online support and a telephone hotline are good choices to provide convenient support to the healthcare workers.[5,6]

Table

Healthcare workers management options

Healthcare workers management options
Healthcare workers management options

References

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Competing Interests

Source of Support: None. Conflict of Interest: None.