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An Oxford researcher measured the effect of popular workplace mental health interventions, and discovered little to none.

[This is an excerpt.] A recent survey of 3,000 health care workers revealed that younger clinicians ages 18–29 — nurses, doctors, dentists, medical assistants, and others — were significantly more likely than older clinicians to report witnessing racial discrimination against patients. The survey reported on health care workers’ observations of discrimination against patients, how this discrimination impacts patient care, and how it affects the health care workers who witness it. [To read more, click View Resource.]

This resource is found in our Actionable Strategies for Health Organizations: Empowering Worker & Learner Voice (Psychological Safety).

Policing by its very nature has been widely recognised as being inherently stressful with little that can be done to prevent police officers' exposure to both primary and secondary trauma. Officers involved in the investigation of child abuse and sexual offences have been further recognised as working in some of the most stressful and demanding roles in policing. However, there has been little research within this high-risk group of officers which seeks to understand how they cope with both the organisational and occupational stressors they are exposed to, as well as which strategies help them to 'get up in the morning'. Data were collected through twenty-three (23) semi-structured interviews, with Straussian Grounded Theory used as a framework to develop a model of coping. This study highlighted that although some officers were affected by the traumatic nature of their work, there were other risk factors present which appear to have impacted on them more significantly including 'burnout', 'compassion fatigue' and 'moral injury.' Protective factors were identified as 'being in control', 'organisational, social and peer support' as well as 'having a purpose' all of which impacted on an officer's ability to cope with the work they do. The present findings extend our knowledge of key concepts relating to police officer coping which may help officers working in these high-risk roles to cope with challenges they face daily. Recommendations for further research on how to support this group of officers, as well as implications for practice are discussed.

Medical students are educated through two dichotomous curriculums, the formal, planned curriculum and the hidden curriculum unintentionally taught through socialization within the culture of medicine. As a consequence of shared trauma amongst the physician workforce during the COVID-19 pandemic, moral injury (MoI) and compassion fatigue (CoF) have become prevalent within the health care system, including palliative care medicine, with echoing ramifications on the observing trainee population. Thus, it is imperative to determine risk factors, protective factors and targeted interventions to offset MoI and CoF within the health care workforce and trainee population. Methods of strengthening personal and institutional resilience are vital to developing long-term structural change replacing the hidden curriculum of MoI and CoF with one of resilience and support. As palliative care providers are especially vulnerable to MoI and CoF, this article will examine the impact of the COVID-19 pandemic on MoI, CoF, and resilience within the hidden curriculum through the lens of palliative care.

Social work practice is not a highly paid or high-status occupation. The historical roots of social work lie in charity work directed toward social needs and poverty, with much of this work previously women’s unpaid work. This set the stage for a norm of unpaid labor in the predominantly female occupation. Women who are mature-aged, lone parents, carers and on low income have continuously been the numerical majority within social work. As such, the unpaid field placement disproportionately affects women. This article provides a gendered analysis of qualitative data obtained from women participants in a national survey of social work students from five Australian universities (n=409) following 1000 h of field education placement. Open-ended questions aimed to explore the experiences of financial stress from lengthy unpaid placements on the mental health and well-being of social work students. The findings contribute to a growing body of feminist literature critiquing the current field education model and argue for significant reflection,flexibility, and change. To meet the collective social work goals of social justice and dismantling systemic oppression, a new placement model is needed that is both inclusive and sustainable.

The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.

INTRODUCTION: A rise in the incidents of violence against Health Care Workers (HCWS) in recent years calls for improvement in modes of spreading awareness and educating the public. We aimed to conduct a large global cross-sectional survey called VISHWaS- Violence Study of Healthcare Workers and Systems in the departments of Anesthesiology, Critical Care Medicine, and Emergency medicine. METHODS: A global survey after tool validation, was created using REDCap forms and distributed from June 5th to July 24th, 2022. Communication tools including emails, phone calls, SMS, and social media applications like WhatsApp, Twitter, and Linkedin were used in securing responses. This study was deemed eligible for category-2 Institutional Review Board exempt status. RESULTS: Total of 598 responses from 69 countries, out of these 445 (749) were complete. The maximum responses were trom India (N-49), followed by the USA (N=44) and while those from the other 67 countries ranged from N1-30. Out of these, 221 (50%) were female, the majority (569) were in the 26-35 years category, followed by (199) in 36-45 years. The participants encompassed 156 (359) consultants, 97 (229) nurses and the rest were residents/fellows in training, auxiliary/ staff, advanced registered nurse practitioners (ARNP), physician assistants (PA), researcher and others. The vast majority (739) reported facing violence within the past year; Verbal (63%) and physical (3996) were the most commonly reported. Total 126 (28.3%) reported that patient and/or family member as the type of aggressor they/ their colleague encountered most frequently. A majority (7596) reported that the incidence of violence has either stayed the same (39%) or increased (36%) during COVID-19 pandemic. Because of violent episodes, 48% felt less motivated/ had decreased job satisfaction; an additional 259 were willing to quit. Whie half of respondents wore familiar with Occupational Safety and Health standards, only 20% felt prepared to handle aggressive situation. CONCLUSIONS: In this global cross-sectional survey, a majority of HCWs reported to have faced violence. They felt that it either increased or stayed the same during the COVID-19 pandemic. It has led to decreased job satisfaction. Majority of those, who responded, felt unprepared to handle the violence.

[This is an excerpt.] Health plans insist that PA is needed to eliminate unnecessary treatment and keep health care affordable. However, physicians report that PA can lead to overall increased health care resource utilization and can negatively impact patients’ productivity at work. Which begs the question: is PA really a “bargain”? [To read more, click View Resource.]

[This is an excerpt.] For the past decade, the CAQH Index has been a unique and important resource for government and industry decisionmakers, researchers and the media. By tracking automation along the healthcare administrative workflow and identifying opportunities for improvement, report findings have enabled health plans, providers, government, and vendor organizations to benchmark progress and set a course for greater efficiency and cost savings. Given the importance of the Index and the commitment to increasing automation, medical health plans representing204 million members, 60 percent of covered lives, now contribute data to the research. [To read more, click View Resource.]

This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Reducing Administrative Burdens) AND Actionable Strategies for Government: Optimizing Workload & Workflows (Reduce Administrative Burden).

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[This is an excerpt.] Prior authorization (PA) is a health plan cost-control process that requires health care professionals to obtain advance approval from the health plan before a prescription medication or medical service qualifies for payment and can be delivered to the patient.While health plans and benefit managers contend PA programs are necessary to control costs, physicians and other providers find these programs to be time-consuming barriers to the delivery of necessary treatment.To assess the ongoing impact the PA process has on patients, physicians, employers and overall health care spending, the American Medical Association (AMA) annually conducts a nationwide survey of 1,000 practicing physicians (400 primary care/600 specialists) from a wide range of practice settings. As this year’s findings demonstrate, the PA process continues to have a devastating effect on patient outcomes, physician burnout and employee productivity. In addition to negatively impacting care delivery and frustrating physicians, PA is also leading to unnecessary spending (e.g., additional office visits, unanticipated hospital stays and patients regularly paying out-of-pocket for care). [To read more, click View Resource.]

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This resource is found in our Actionable Strategies for Government: Optimizing Workload & Workflows (Reduce Administrative Burden).

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Recruiting and retaining quality staff remains the top healthcare issue. Last year, hospitals were able to recapture 5.65% of the talent lost during the “Great Resignation”, essentially adding 975,000 employees back to the rolls. Of this, 142,375 RNs returned which represents a 4.17% RN add rate. This slower rate begs the question, why are nurses hesitant to return? Although welcome news, the labor gap remains prevalent and hospital turnover continues to be elevated. Nationally, the hospital turnover rate stands at 22.7%, a 3.2% decrease from 2021, and RN turnover is recorded at 22.5%, a 4.6% decrease. Registered Nurses working in surgical services, pediatrics and women’s health recorded the lowest turnover rate, while nurses working in telemetry, step down and medical/surgical services experienced the highest. The cost of turnover can have a profound impact on diminishing hospital margins and needs to be managed. According to the survey, the average cost of turnover for a bedside RN is $52,350, a 13.5% increase, resulting in the average hospital losing between $6.6m – $10.5m. Each percent change in RN turnover will cost/save the average hospital an additional $380,600/yr. The RN vacancy rate remains critical and is 15.7% nationally. While 1.3% lower than last year, over seventy-five percent (75.4%) reported a vacancy rate in excess of ten percent. The RNRecruitment Difficulty Index jumped an extra eight (8) days to an average of 95 days. In essence, it takes over 3 months to recruit an experienced RN, with med/surg presenting the greatest challenge. Feeling the financial stress, hospitals are looking to decrease reliance on supplemental staffing. The greatest potential to offset margin compression is in the top budget line item (labor expense). Every RN hired saves $157,000. An NSI contract to replace 20 travel nurses could save your institution $3,140,000.

[This is an excerpt.] The more than 3,500 nurses who took part in the American Nurse Journal’s seventh annual Trends and Salary Survey helped paint a slightly more hopeful portrait of nursing in 2023 with regard to turnover rates, higher salaries, and personal safety. However, challenges still exist. For example, although a smaller percentage of nurse managers report more open positions in the past 12 months, they told us that recruiting to fill those vacancies has been harder this year than last. And most nurse managers say turnover increased in the past 12 months, though at a lower percentage than in 2022. [To read more, click View Resource.]

[This is an excerpt.] In October 2022, U.S. Surgeon General Vivek Murthy, MD, released the office’s first-ever Surgeon General’s Framework for Workplace Mental Health and Well-Being. The results of APA’s 2023 Work in America Survey confirmed that psychological well-being is a very high priority for workers themselves. Specifically:

• 92% of workers said it is very (57%) or somewhat (35%) important to them to work for an organization that values their emotional and psychological well-being.
• 92% said it is very (52%) or somewhat (40%) important to them to work for an organization that provides support for employee mental health.
• 95% said it is very (66%) or somewhat (29%) important to them to feel respected at work.
• 95% said it is very (61%) or somewhat (34%) important to them to work for an organization that respects the boundaries between work and nonwork time.

Fortunately, the majority (77%) of workers reported being very (36%) or somewhat (41%) satisfied with the support for mental health and well-being they receive from their employers, and more than half (59%) strongly (22%) or somewhat (37%) agreed that their employer regularly provides information about available mental health resources. Further, 72% of workers strongly (30%) or somewhat (42%) agreed that their employer helps employees develop and maintain a healthy lifestyle. [To read more, click View Resource.]

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This resource is found in our Actionable Strategies for Health Organizations: Meaningful Rewards& Recognition (Career Supports and Development)

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This resource is found in our Actionable Strategies for Government: Optimizing Workload & Workflows (Advance Team-Based Care).

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Despite professional commitment to wellness, supporting and addressing clinician mental health and professional sustainability has not been historically prioritized or well-understood within the occupational therapy profession. This paper discusses how to build a mentally strong, resilient, sustainable current and future occupational therapy workforce at the personal and systemwide levels to prioritize practitioner mental health. Specific barriers to and support for practitioner occupational balance and mental health as well as systemwide professional sustainability are discussed highlighting a Model of the Interplay of Occupational Balance and Professional Sustainability.

BACKGROUND AND PURPOSE: To better understand the effects of an intervention, Mindfulness for Healthcare Professional (MIHP), and how it may improve healthcare professional student (HCP) functioning, a constructivist grounded theory exploration was conducted. MATERIALS AND METHODS: Ten participants with the lowest or highest changes on quantitative measures of burnout and perceived stress at the end of MIHP were interviewed at a long-term follow-up. A theoretical framework was developed from the resultant themes to describe the mechanisms by which MIHP had effects on work-relevant functioning. RESULTS: Three overarching themes emerged as mechanisms of change both from their presence in those participants reporting an improvement in stress and their missingness from those participants who reported no change: developing a mindfulness practice, integrating practice into daily life, and enhanced awareness. These mechanisms led to optimized work-relevant functioning: 1) emotional competencies, including nonjudgement, emotion regulation, and burnout prevention; and 2) patient-centered care, including improved listening, patience, and efficiency at work. CONCLUSION: The resultant framework is discussed in the context of previous literature on MIHP and mindfulness theory more broadly. Implications for future disseminations of MIHP encourage the use of group interventions with emphasis on developing at-home practice and informal mindfulness integrated into daily work.

PURPOSE: The objective of this study was to investigate the effect of work stress on job burnout and quality of life and the effect of moderating group factors (transformational leadership and group member interactions) on the relationship between work stress, job burnout, and quality of life. This study takes front-line border police as the research object, adopts a cross-level perspective, and takes work stress as a key factor affecting work efficiency and health indicators. METHODS: It collected data through questionnaires, with questionnaires for each research variable adapted from existing research scales, such as multifactor leadership questionnaire developed by Bass and Avolio. A total of 361 questionnaires were filled out and collected in this study, including 315 male participants and 46 female participants. The average age of the participants was 39.52. Hierarchical linear modeling (HLM) was used to test the hypotheses. RESULTS: First, it was found that work stress has a significant impact on job burnout and quality of life. Secondly, leadership style and group member interactions have a direct, cross-level effect on work stress. Third, it found that leadership style and group member interactions have an indirect, cross-level effect on the relationship between work stress and job burnout. However, these are not indicative of quality of life. The results of this study highlight the particular impact of the nature of police work on the quality of life, and further enhance the value of this study. CONCLUSION: The two major contributions of this study are: 1) it shows the original characteristics of the organizational environment and the social context of Taiwan’s border police and, 2) in terms of the research implication, it is necessary to re-examine the crosslevel impact of group factors on individual work stress.

BACKGROUND: Nationwide nursing shortages have led to higher patient-to-nurse ratios, nursing burnout, and decreased quality of care. LOCAL PROBLEM: Staffing challenges and nursing burnout were becoming growing concerns and success was contingent upon efficient use of existing resources. METHODS: Direct observation current state assessment was completed on medical-surgical specialty units to better understand work activities of registered nurses (RNs) and unlicensed assistive personnel (UAPs). RESULTS: RNs spent more time performing indirect care (eg, documentation) than direct patient care. Interruptions and problems consumed 17.4% and 5.6% of their time, respectively. UAPs performed more direct patient care but had a higher proportion of downtime. RNs underdelegated nonclinical tasks. CONCLUSIONS: Direct observation current state assessment offers a better understanding of workflow and workload inefficiencies. This information is critical to provide informed, evidence-based recommendations to develop future patient care models with more capacity to deliver high-quality care with greater efficiency and lessen nursing burden and burnout during the nursing shortage crisis.

BACKGROUND: Prior to the novel coronavirus (COVID-19) pandemic, nurses died by suicide more frequently than the general population. Antecedents prior to death include known job problems, such as disciplinary action; diversion of medications; inability to work due to chronic pain; and physical and mental illness. AIM: The aim of this study was to explore the suicide experience of nurses who died with known job-related problems during the early phase of the COVID-19 pandemic compared to what has been previously described. METHOD: Deductive reflexive thematic analysis was used to analyze narratives of nurses with known job problems who died by suicide from the Centers for Disease Control and Prevention's National Violent Death Reporting System. RESULTS: Forty-three nurses with known job-related problems completed suicide between March and December 2020. Factors associated with death were similar to previous findings with notable exceptions, increased prevalence of suicidal ideation and post-traumatic stress prior to the event. Pandemic-specific issues were noted including reduction in hours, fear of disease transmission, civil unrest, and grief-related trauma. LINKING EVIDENCE TO ACTION: Suicide prevention programs need to address both institutional and individual factors associated with nurse suicide. As previously recommended, transitions into retirement and job loss are vulnerable times warranting psychological support. Further, strategies to reduce the impact of stressors and increase support for nurses are needed at the organizational level. A systems level approach to hardwire coping strategies is indicated pre-licensure and throughout nurses' careers. A new focus on how to process personal and professional grief is warranted. Resources are needed for nurses traumatized by life (rape, childhood trauma) or work-related experiences.

A Guide to Relieving Administrative Burden is a series of supplements developed by the American Academy of Family Physicians (AAFP) to provide information about innovations proven to relieve administrative burden and optimize your family medicine experience. It is based on AAFP Innovation Labs conducted with physicians like you, as well as a comprehensive literature review. Whether you have a solo practice or are an employee of a large health system, the guide will help you consider and adopt proven innovations.

This is the first supplement in the series. Subsequent supplements will focus on other critical administrative burdens family physicians face, including prior authorization, quality measurement and reporting, and chart review.

This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Reducing Administrative Burdens).