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Comment: More resilient health care will come from systems, not individuals

COVID. Monkey pox. Flu season. Opioid epidemic. Back-to-school germs. Simply following the latest healthcare news is exhausting; it feels like we are constantly and rapidly moving from one health care crisis to the next without respite. It’s even more exhausting for health care workers, who deal with these crises all day every day. We need systemic resilience efforts for these workers to prevent the next big layoff as we continue to face an onslaught of public health care.

Before we can create systemic resilience, we need to have a better concept of what resilience means and looks like in practice in healthcare settings, as well as understand where it comes from. The ability to plan for, deal with, and grow from unexpected events and crises is absolutely essential for healthcare workers.

Health practitioner burnout and the health professions workforce shortage were problematic even before the onset of the COVID-19 pandemic. When the pandemic hit, the issue of burnout and unsustainable strain and stress for health care workers—as with many issues such as racism and health disparity—came to the fore in a powerful way. Health care workers started leaving in droves. Coupled with the pre-pandemic workforce shortage in health professions, these mass layoffs have left the healthcare industry with a workforce crisis.

According to a 2021 Journal of Interprofessional Care article, moving beyond building resilience in individuals is essential to creating a sustainable health care workforce. The current levels of distress and despair cannot be tackled individually by individuals, but must be proactively addressed by systems, starting with destigmatizing help-seeking and developing infrastructure to support health workers.

Within the broader health care community, we need to move beyond the idea that resilience is individualized. This approach puts all the pressure on the individual workers rather than dealing with the wider circumstances. Wellness is becoming an additional burden for healthcare workers. What we need instead is a systemic approach for these workers who we already know are going to be under a lot of stress.

A number of institutions have begun surveying their vendors to determine what they are looking for in a support system rather than implementing something of a more C-suite, administrative model. The World Health Organization has issued policy recommendations for institutions to consider, as well as to build systemic support.

As we reflect on how best to design and deploy systems of resilience, we must also broaden support beyond physicians to extend across the entire healthcare workforce. The pursuit of collaborative practice and teamwork necessitates that workers in all roles have a voice in creating wellness systems and are given fair access to their benefits. While addressing such changes in increasingly complex care systems is undeniably difficult, the cost of remaining static will be devastating.

A major culture shift is needed to shift healthcare from corporate models to healthcare models with an emphasis on care, including for providers and workers. This shift would embody things like accessible, affordable entities within institutions to provide help when workers need it without being seen as a sign of weakness.

It is challenging to provide excellent patient care while struggling with personal health and mental health issues. It is time to implement what is known as health care’s quadruple aim, adding the well-being and satisfaction of health care workers as a priority, along with improving individual care, improving the health of populations, and reducing of costs. Promoting health equity as an additional priority will strengthen progress.

If institutions implement programs, policies, and protocols that support these goals, the health workforce can count on consistent institutional support that will provide a safety net for all workers and providers, across professions and levels. A systemic effort to support wellness will be transformative, bringing us closer to establishing a resilient culture and a workforce of caregivers who know they matter and will be cared for.


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