January 25, 2022 - Parul Saini, Webmedy Team
The widespread impact of COVID-19 on healthcare has demanded new ways of working across many organization types and many forms of healthcare delivery while at the same time endeavoring to place minimal, or no, additional burden on already strained healthcare teams.
Front line healthcare workers are facing unusual stress as a result of the COVID-19 pandemic.
In the face of these pressures, teamwork has become both more important and more challenging. Fortunately, numerous examples of naturally occurring cooperation are appearing at healthcare institutions around the globe, including instances of people trying to work together during the crisis who may not have done so under 'normal' conditions. The widespread influence of COVID-19 on healthcare has demanded quicker designing, implementing, and learning about innovations across many organization types and many forms of healthcare delivery while at the same time endeavoring to place minimal, or no, additional burden on already strained healthcare staff.
COVID-19 creates stress on multiple levels - individual, team, organizational, and work-life.
During the pandemic, teams may be struggling to maintain collective effectiveness, which is having a shared sense that you can achieve your goals. In the healthcare context, this means helping patients get through COVID-19 and come out alive and healthy on the other side. It's really easy to lose collective efficacy when you are consistently confronted with failure, such as high patient mortality rates, but sharing successes boost morale and can lend perspective.
"Shared mental models" (SMM) are also called "team cognitions" and refer to a team's shared, accurate, and complementary understanding of their domain, which enables teams to adapt and coordinate together. This can be accomplished through regular huddles and debriefings, even if time is limited, as it is during the pandemic. During these often-brief meetings, roles and priorities can be clarified, and it can be determined who has the most expertise to take on a given need.
A major concern that we have seen is a narrowing of attention, which means that people on a team can over-focus on themselves and their jobs and not take a step back and see the larger team, so mutual team monitoring is critical. Some research has suggested that effective teams successfully monitor the situation itself, team performance as a whole, and each of the teammates.
Team members should be encouraged to provide backup to each other if one person seems overwhelmed or fatigued. Leaders might encourage situation monitoring, for example, if an individual has an excessive case volume or performance monitoring. More experienced team members can also lend support to less experienced team members.
Team members are not functioning in a vacuum. They have a "home team," so to say, in other words, their own family and friends. Thinking about family and friends can become a source of stress and distraction when team members are in their professional setting. Especially during the pandemic, concerns about potential contagion to family members or concerns about finances, childcare, or healthcare at home can compromise high-level vigilance.
Identifying and acknowledging these external stressors and perhaps offering financial, informational, practical, or emotional assistance can be helpful. Although the pressures are higher and resources lower than they are in ordinary times, senior leaders and crisis management teams should try to find ways, even small ones, to offer support and practical assistance, if possible.
The term "team resilience" refers to the capacity of a team as a whole to withstand and recover from adverse situations and is somewhat different from individual resilience. Individuals who personally withstand pressure may not necessarily monitor or support other team members who are under stress. Increasing team resilience involves anticipating and planning for stressful situations, providing mutual support, helping team members to move smoothly between "normal" and "emergency" modes, and between surges and more quiet times. It also involves identifying strategies that are not working or need improvement and apologizing for hurtful behavior that might have taken place during a time of stress and crisis.
Many of the healthcare professionals who are working with COVID-19 patients are visible and provide hands-on treatment. They are the face of the "healthcare heroes" and are justifiably lauded and appreciated. However, it is very easy to forget the number of people behind the scenes, including those who obtain supplies or monitor the need for supplies, those who answer phones, or those who are working with patients who do not have COVID-19. In this type of setting, communicating the wins and success of all members of the practice, including those in the background, allows a sense of collegiality. Sharing the workarounds people are coming up with for problems helps improve the learning of the entire team over time. All contributions to the functioning of the healthcare system or practice should be regularly acknowledged and commended.
Effective teamwork is one of the most important ways for us to continue navigating the unprecedented set of challenges posed by COVID-19.