Information about pandemic risks to health care workers and strategies being used to protect them from COVID-19, prevent and address burnout, and support their well-being.
(08/25/2022) Impact of COVID-19 on Initial Emergency Medical Services Certification in the United States
This study analyses the testing volume and first time passing rates of the national certification examination for emergency medical technicians and paramedics in 2019 to 2020 to determine the impact COVID-19 disruptions had on certifications. The study found a decrease in the total number of examinations administered by 13% (122,598), but first-time pass rates remained unchanged.
(08/18/22) Confronting Health Worker Burnout and Well-Being
US Surgeon General Vivek Murthy outlines the actions that need to be taken to fundamentally address health worker burnout in this recent article published in The New England Journal of Medicine. âBurnout manifests in individuals, but itâs fundamentally rooted in systems. And health worker burnout was a crisis long before COVID-19 arrivedâ says Murthy. Murthy notes that despite âyears of inactionâ there have been promising signs of change including the Dr. Lorna Breen Health Care Provider Protection Act of 2022 and the 2021 American Rescue Plan that provided resources to strengthen programs and infrastructure to address health worker well-being.
(08/18/22) Understanding Teamwork in Rapidly Deployed Interprofessional Teams in Intensive and Acute Care: A Systematic Review of Reviews
This systematic review examines current literature on teamwork in rapidly deployed interprofessional teams in intensive and acute healthcare settings to help inform future rapid team-based deployments. The network analysis identified 13 interconnected themes with 4 overarching factors including: internal procedures and dynamics, communication, organizational and team-extrinsic influences, and outcomes.
(08/18/22) CDC Director Orders Agency Overhaul, Admitting Flawed Covid-19 Response
Owing to the intense criticism of its handling of the coronavirus pandemic and, more recently, the growing monkeypox outbreak, the Centers for Disease Control and Prevention is launching an overhaul of its structure and operations in an attempt to modernize the agency and rehabilitate its reputation. CDC Director Rochelle Walensky shared a series of changes with CDC leadership and staff designed to âtransformâ the organization and its work culture by improving how the agency shares information, develops public health guidance and communicates with the American public. The CDC restructuring follows two reviews conducted in recent months, one by Health Resources and Services Administration official Jim Macrae into the CDCâs pandemic response and another by CDC Chief of Staff Sherri Berger into agency operations. The reviews concluded that the âtraditional scientific and communication processes were not adequate to effectively respond to a crisis the size and scope of the COVID-19 pandemic,â according to an agency statement.
(08/16/22) COVID-19 Lessons Fall Short for Monkeypox Response, Experts Say
According to experts, while responding to the monkeypox outbreak, the US is grappling with similar issues to COVID-19 around messaging to the public, data transparency and equitable access to vaccines and treatments, among other challenges. According to Saskia Popescu, an infectious disease epidemiologist and assistant professor at George Mason University’s Schar School of Policy and Government, as monkeypox began spreading globally public health officials failed to work with the LGBTQ community to effectively address the spread, similar to how the US failed to prevent COVID-19’s disproportionate toll on historically marginalized communities early in the pandemic and that we are seeing a lot of âGroundhog dayâ. The pandemic also pushed many public health officials to retire or resign, meaning the nation now has a much smaller public health workforce to address the monkeypox outbreak.
(08/08/2022) COVID-19 Symptoms and Deaths Among Healthcare Workers, United States
This study analyzed over 6 million laboratory-confirmed COVID-19 cases reported to the Center for Disease Control during January 1, 2020âOctober 12, 2021 and found 7.02% of cases were in healthcare workers (HCW). The fatality rate of HWC was 0.33% versus 24.64% for non-HCW. The findings, published in Emerging Infectious Diseases, found higher deaths for HCW over the age of 50, male, black, or Asian. In the general US population, there were 3 distinct peaks in deaths; the study found that deaths among HCW also peaked during the first stage but remained low after April 2020.
(08/06/2022) âWe Are on the Frontlines Tooâ: A Qualitative Content Analysis of US Social Workers’ Experiences During the COVID-19 Pandemic
The paper explores the experiences of US social workers as essential workers during the Covid-19 pandemic. A large cross-sectional survey of US-based social workers from June to August of 2020 found the desire for formal and informal recognition of social work as essential/frontline work, the evolving roles of social workers in responses to increased demands, and physical safety and resulting emotional distress were the top themes for respondents. The findings suggest that recognizing and supporting the role of social workers as frontline workers is crucial to the response and recovery from COVID-19.
(08/03/2021) The COVID-19 Pandemic and the Push to Promote and Include Nurses in Public Health Policy
In a recent paper published in the American Journal of Public Health, Jennifer Morone, a nurse and research fellow with the National Clinician Scholars Program at Yale School of Medicine, and colleagues explore the historical, and frustrating, phenomenon of exclusion of nurses from the conversation in debates around public health policy and their lack representation in media coverage, health care leadership, government, and academic publications. The paper called COVID-19 as âan exemplar of nursingâs invisibilityâ and gave recommendations and practical tools to tackle this underrepresentation and increase nursing visibility and influence in public health policy at the individual, community, systems, and national levels such as – embedding structural competencies, health policy curricula and value of media presence and visibility within nursing education; establishing interdisciplinary collaboration opportunities between schools of medicine, pharmacy, social work, and public health; leveraging of nursesâ existing leadership, communication, and advocacy skills by community health organizations and health systems; expanding pathways for nurses to conduct policy-relevant and action-oriented research and increasing the number of doctorally prepared nurses engaged in the health policy process.
(07/30/2022) Violence Against Health Workers Rises During COVID-19
A new joint study by the International Council of Nurses, the International Committee of the Red Cross, the International Hospital Federation, and the World Medical Association and published in The Lancet has found that the violence against the countryâs healthcare workers is endemic regardless of the countryâs security situation. Out of the 120 responses received to the 31-question poll from May to July, 2021, the report found that of those organizations who had received reports of violence, 58% respondents perceived an increase. International Council of Nurses Chief Executive Officer Howard Catton said concrete action was needed to end the impunity for those who are violent. The survey shows the importance of improving relations between health personnel and patients and family members, with most participants suggesting training in communication skills as an effective measure for de-escalating potentially violent situations. Despite the persistent presence of violence, practical solutions do exist. The report highlighted successful strategies from Bulgaria, Columbia, Italy, Portugal, and Taiwan which could be implemented globally.
(07/27/22) Doctors with Disabilities Push for Change as Long COVID Affects Their Workforce
The Center for Disease Control found that nearly 1 in 5 American adults experience symptoms consistent with Long Covid. A study in 2020 found that health care workers (HCW) were 7 times as likely to experience severe Covid-19 than those in non-frontline jobs. The symptoms of Long Covid are poised to become part of the long list of wellness issues causing workers to leave healthcare. A new group, DocsWithDisabilities, is focusing on changing the culture, practices, and policy of healthcare to be more accessible to disabled HCW. By implementing disability inclusion healthcare organizations will increase the pipeline and help with retention of HCW.
(7/27/2022) Care For The Caretakers: Building The Global Public Health Workforce
A McKinsey article highlights the important role public health systems across the globe can play in addressing workforce shortages across the health ecosystem and makes policy recommendations for the governments. The article starts out by pointing out how the health workforce is marred by challenges such as understaffing, underfunding, and underappreciation, which were exacerbated after the COVID-19 pandemic. The report suggests that public health system leaders are optimally positioned to play a proactive role in defining and developing the talent pool needed to transform workforces across the entire health ecosystem. The report recommended four sets of critical shifts which can help rebuild the public health workforce. They are – supporting and retaining the current workforce by equally emphasizing mission and people, building for evolving capability needs by strategically hiring and training, innovating to flexibly extend the workforce by proactively scaling up and creating robust talent pipelines that are streamlined and user-friendly.
(7/24/22) The Unsung Heroes of Public Health
CBS News reports explores the public healthcare system and some of the challenges that the COVID-19 pandemic has presented including the collision of politics and public health and the toll the pandemic is taking on healthcare workers. The report ends on a positive note indicating the pandemic may have increased interest in making a difference with Harvard school of public health reporting a 50% year over year increase in applications.
(07/22/22) Rural Health Workforce Development – A Qualitative Study of Themes Related to Provider Shortages in West TexasÂ
This paper explores possible effective strategies to recruit healthcare providers to rural areas aimed at eliminating the healthcare professional shortage in rural communities. The West Texas Area Health Education Center (AHEC) program office set up four centers and each center focused on the four themes through group discussion: advantages, disadvantages, suggestions and requests, and overall strategies regarding recruitment and retention of rural providers. They found that preceptorships are a good way to help students understand the nuances of rural healthcare and recruit interested students to work in the rural communities of their temporary training.
(07/22/22) Staffing Patterns in US Nursing Homes During COVID-19 Outbreaks
This report from JAMA Health Forum studied the association between the COVID-19 pandemic and the changes in nursing home staffing by using daily individual-level staffing data- the National Healthcare Safety Network (NHSN) COVID-19 Nursing Home Data set from the Centers for Medicare & Medicaid Servicesâ Payroll Based Journal (PBJ) system. Although the shortage of nurses can be relieved by increasing hiring, use of contract staff, and overtime, they still found that certified nursing assistants (CRA) declined the greatest compared to the licensed practical nurses (LPN) and registered nurses (RN) because of a smaller amount increasing in new hires. They suggest that policymakers could consider providing better pay and benefits to nurses to address nursing shortages.
(07/22/22) Workplace Perceptions and Experiences Related to COVID-19 Response Efforts Among Public Health Workers â Public Health Workforce Interests and Needs Survey, United States, September 2021âJanuary 2022
The CDC has released findings from the 2021 Public Heath Workforce Interests and Needs Survey of the governmental public health workforce. Responses from over 41,000 surveys found that March 2020 thru January 2022, 72% of the workforce played a role in the Covid-19 response. Additionally, Nationwide, 27% of the governmental public health workforce considered leaving their organization within the next 5 years for reasons other than retirement. Seventy-six (76%) reported they began thinking about leaving since the start of pandemic. Workers identified additional funding, additional staff capacity, more community support, and more support from elected leaders as things needed to effectively respond to the pandemic in their jurisdiction.
(07/20/22) CMS Still Determining What COVID Waivers to Keep, Drop After PHE Ends
The Centers for Medicare & Medicaid Services (CMS) is making decisions about which COVID-19 regulatory waivers will remain permanent or will be terminated at the end of the public health emergency. The Department of Health and Human Services on Friday increased the public health emergency for 90 more days through Oct. 6 2022, which gives health workers more time for planning and preparation. CMS is committed to 4 areas to help support states and providers once the PHE ending happens. These include: maintaining health insurance coverage; providing coverage and reimbursement for testing, vaccines, and treatments; issuing new provider regulations and guidance to ensure patients and health workforce safety; and keeping the healthcare system accessible through federal state waivers.
(07/20/22) Racial Health Disparities Appear in Cancer Care Access During COVID-19
A new research study from JAMA Network Open, finds racial health disparities for cancer care access for black and Latin patients during COVID-19. Researchers found that Black and Latinix cancer care patients were 3 times more likely to experience delays in clinical visits, lab tests, imaging, and change of location of care, compared to White participants. Black adults were 6 times more likely and Latinix adults 3 times more likely to have cancer treatment delays for more than 4 weeks compared to adult White cancer care patients. Each month cancer treatment is delayed, can increase death by 10%. A survey from this research study found that Black and Latinix respondents had less trust in physicians and more trust in community and faith-based organizations.
(07/18/22) Childcare Stress, Burnout, and Intent to Reduce Hours or Leave the Job During the COVID-19 Pandemic Among US Health Care Workers
The COVID-19 pandemic has introduced many stressors that have put the healthcare workforce at risk. This study examined the effects of childcare stress (CSS) on burnout, intent to reduce hours (IRH), and intent to leave practice (ITL) on healthcare workers (HCW). The study, based on a survey of over 58,000 HCW from 208 organizations, found that high CCS was associated with 80% greater odds of burnout and 91% greater odds of ITR. The study suggests that addressing CCS may improve HCW retention and quality of life.
(07/18/22) Long COVID 3: Supporting Nurses With Long COVID in the Workplace
This Nursing Times article examines how to support nurses with long term COVID-19. This UK article looks at case studies of nurses and how best to protect the wellbeing of nurses experiencing high occupational risk. Due to the large vacancy rates, the industry cannot afford to lose more staff for extended periods of time due to long COVID. The article argues for a flexible approach and redeployment opportunities to decrease the loss of nurses and having a lead nurse in every organization for long COVID to help ensure effective support.
(07/18/22) Childcare Stress, Burnout, and Intent to Reduce Hours or Leave the Job During the COVID-19 Pandemic Among US Health Care Workers
The Covid-19 pandemic has introduced many stressors that have put the healthcare workforce at risk. This study examined the effects of childcare stress (CSS) on burnout, intent to reduce hours (IRH), and intent to leave practice (ITL) on healthcare workers (HCW). The study, based on a survey of over 58,000 HCW from 208 organizations, found that high CCS was associated with 80% greater odds of burnout and 91% greater odds of ITR. The study suggests that addressing CCS may improve HCW retention and quality of life.
(07/18/22) COVID-19 Impact Assessment SurveyâThe First Year
The American Nurses Foundation has released the results of its âPulse on the Nation’s Nurses COVID-19 Survey Series: COVID-19 Impact Assessment Survey – The First Year, February 2021.â The survey included over 22,000 responses from US nurses in an effort to understand the personal and professional impacts of the pandemic. In the survey, issued between January 19 and February 16, nurses rated their optimism for the future as 6.2 out of 10. Additionally, 18% indicated they intended to leave their position within 6 months. The top reasons for leaving included their health/well-being and insufficient staffing.
(07/17/22) Three Key Strategies for Combatting Nurse Turnoverâ Nursing Industry Policies, Benefits, and Tech Are Ripe for Modernization
This Medscape article examines 3 key strategies for dealing with nurse turnover. According to research 900,000 registered nurses will leave the profession in the next 5 years which will lead to nursing shortages and will impact all stakeholders in health care. The three key strategies discussed in this article are new models of nursing care delivery, balance and mental health benefits, and technology-based care.
(07/16/22) A Rapid Review of the Impact of COVID-19 on Clinical Supervision Practices of Healthcare Workers and Students in Healthcare Settings
A rapid review of 8 English language papers published between December 2019 and March 21 has found initial evidence that the Covid-19 pandemic has negatively impacted the clinical supervision of students and healthcare workers in healthcare settings. Seven (7) of the eight studies found disruptions in reduced access to their supervisors, change in duration and frequency of supervisory meetings. Prioritizing and restoring the supervisory structure at the point of care will help ease pandemic stressors for students and healthcare workers, increase the quality of patient care, and improve organizational outcomes beyond the pandemic.
(07/14/22) Health Policy Journal: COVID-19 Special Issue Now Available
A special Health Policy journal issue analyzes 50 countries, mainly in the WHO European region, response to the pandemic and lessons learned to better help policy makers prepare for future challenges and pandemics/outbreaks. The papers examine health care responses across 5 main areas: preventing transmission, sufficient infrastructure and workforce capacity, adapting service delivery, financing systems, and governance.
(7/15/22) Fact Sheet: Biden Administration Outlines Strategy to Manage BA.5
The White House COVID-19 Team is announcing its strategy to manage BA.5, which is a subvariant of the Omicron variant. The administration will continue to work with healthcare workers and other stakeholders to ensure that Americans have easy and convenient access to and use vaccines, tests and treatments. The Administration will continue to make masks, which were earlier made available through Defense Production Act, for health care and other essential workers, through states, building on the over 75 million masks and respirators we already distributed to states, Tribes, and territories across the country. The Administration is also working to drive additional uptakes of booster shots including long-term care facility staff and residents. The Administration has purchased 20 million treatment courses of Paxlovid to make these treatments widely available and to educate health care providers and patients about their availability and efficacy.
(7/13/22) The Gender Pay Gap in the Health and Care Sector a Global Analysis in the Time of COVID-19
According to a joint report by the International Labor Organization (ILO) and World Health Organization (WHO), women in the health care sector face a larger gender pay gap, earning on average 24 percent less than men. The high degree of feminization in the health and care sector is a key factor behind the lower earnings for both women and men within the sector and contributes to overall prevailing pay gap in the economy. Much of the gender pay gap in health and care that is unexplained by labor market attributes, cannot be objectively explained by differences in the abilities of men and women to contribute productively to paid work. However, it could be attributed to conscious or unconscious discrimination in pay against women for the same work or work of equal value. Two important factors that contribute to the unexplained pay gap are âmotherhood gapâ and lower wages paid on average in highly feminized sectors. In addition, evidence indicates that the employment impact of COVID-19 in the sector disproportionately affected workers at the low end of the pay scale, most of whom are women.
(7/13/2022) White House: Over $40B in Coronavirus Relief Funds Going Towards Workforce Development
Out of the $40 Billion in American Rescue Plan funds committed to strengthening and expanding the U.S. workforce, the White House has earmarked $16 billion for strengthening the healthcare workforce at the Workforce Development Summit. An additional $3 billion will be invested at a later time to strengthen the future public health workforce including offering community health workers and others hired for COVID-19 response support in continuing their careers as public health professionals beyond the pandemic. Another $2 Billion in CDC grants have been allocated to fund the public health workforce, while $7 Billion in health workforce investments by HHS programs have been allocated to support the staffing needs to respond to COVID-19 pandemic and over $9 Billion of Home and Community Services Funds have been proposed for health workforce.
(07/11/2022) Feds Want a Policy That Advocates Say Would Let Hospitals Off the Hook for Covid-Era Lapses
Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS) have proposed a set of rules. Some of these rules propose suppression of the several measures in the Hospitals Acquired Condition (HAC) Reduction Program. Under the proposed rules, the hospitals will not receive penalties for HAC and the publication of PSI90, or âPatient Safety and Adverse Events Composite,â which allows the public to compare the safety records of hospitals, would be suppressed. Patient advocacy groups such as nonprofit U.S. Public Interest Research Group accused CMS of letting hospitals off the hook by waiving approximately $350 million in financial penalties for around 750 hospitals with the worst patient-safety track records and of hiding the safety record data from the public. CMS chief medical officer said that safety metrics were not designed to properly account for how a pandemic might affect hospital systems, that the data is skewed and inaccurate and CMS will make data available when it is credible. However, an OIG report which used data from 2018 and which was released in May 2022, found that even before the pandemic, 1 in 4 Medicare patients suffered HAC, with nearly half of such events being preventable.
(07/5/22) CoLab Algorithm Shows Promising Results in Efficient Screening of Health Care Workers with COVID Complaints
A study published in a peer reviewed journal PLOS ONE has demonstrated the successful use of the CoLab algorithm for efficient screening of health care workers (HCWs) with COVID complaints. Unlike the usual SARS-CoV-2 RT-PCR test which uses nasal and oral swabs, the CoLab algorithm is run using parameters obtained after analyzing blood samples, which give a CoLab score within one hour of collecting the samples. The study conducted on 726 HCWs showed that this methodology missed none of the 42 positive COVID-19 cases detected by RT-PCR, showing a sensitivity of 100%, and also ruled out COVID-19 in more than one-third of the 684 negative cases, showing a specificity of 34%. This has significant implications as those 34% workers could return to work much faster and the labor and reagent costs involved in RT-PCR tests could be saved.
(07/1/22) COVID-19 Inspired Creativity in Health Care: Lessons for Management and Policy
An article published in Health Affairs throws light upon the recent use of creative innovations and implementation strategies by the workforce in hospitals to address the negative externalities of the pandemic. The articles quotes various examples where creativity was demonstrated such as repurposing of equipment for COVID-19 care, turning closed Sears stores into vaccine centers or examples of creative solutions using industry partnership such as HPâs 3-D printers to create personal protective equipment. The policy and management lessons include but are not limited to recognizing Health Care Workforce as a ready source of creativity, understanding the complementarity between creativity and standardization, recognizing the advantages of cross-industry collaborations and supporting, incentivizing and rewarding creativity.
(06/28/22) Nurses and Midwives Feel Forever Altered by the Impact of COVID-19, Reports Study
New research from the University of Surrey finds that in England finds that nurses and midwives feel âforever alteredâ by the effects of the COVID-19 pandemic. Researchers assessing the impact of the pandemic on nurses in the UK, call for a national COVID-19 nursing workforce recovery strategy to help retain nurses and create a psychologically safe working environment to help with stress, burnout, and physical exhaustion.
(06/28/22) How to Help Medical Educators Further Stretched by COVID-19
A new AMA resource, with organizational steps to support medical educators, features seven key recommendations to help institutions support educators as they recover from the COVID-19 pandemic. These recommendations are: Monitor and support well-being of educators as well as learners, Refine workflows to support educational interactions, Protect time for educational activities, Provide ongoing training, Nurture educator career advancement, Build educational surge capacity, Advocate for systems change, locally and nationally.
(06/22/2022) AHA Report Helps Hospital and Health System Leaders Address Workforce Challenges
The American Hospital Association (AHA) last week released Strengthening the Health Care Workforce, the first of a three part series âto help hospital and health system leaders develop immediate, near- and long-term workforce strategies providing key considerations and questions to drive action, as well as resources and case studies.â Part 1 of the series focuses on: addressing well-being,supporting behavioral health, and workplace violence prevention.
(06/22/2022) How Burnout Impacts Healthcare Workers
The Covid-19 pandemic added new stressors and intensified the existing causes of burnout among healthcare workers. This article, published in Patient Safety & Quality Healthcare, explores some of those underlying stressors and identifies changes to workplace culture that can help prevent burnout.
(06/22/2022) The Changing Nature of Work: The Impact of COVID-19 on Our Health Care Workforce (VIDEO)
This video presentation is from Dr Lotte Dyrbye, the key note presenter for the 2022 NORA symposium. Her presentation, , âStrategies to Address Burnout Among Cliniciansâ includes new information on âthe prevalence of burnout and potential contributors, the consequences of burnout, and individual as well as organizational strategies to enhance clinician well-being.â
(06/17/2022) Experiences of Moral Distress in a COVID-19 Intensive Care Unit: a Qualitative Study of Nurses and Respiratory Therapists in the United States
By using a qualitative research method, this article, published in Nursing Inquiry, explores the experience of nurses and respiratory therapists working in the COVID-19 ICUs in the Northeastern United States during the first surge of the COVID-19 pandemic. Their experiences focuses on five aspects: a fear of the unknown, concerns about infection, perceived professional unpreparedness, isolation and alienation, and inescapable stress and distress.
(06/14/2022)Â Why We Need a Recovery Plan for Americaâs Physicians
A new article written by AMA President Jack Resneck Jr. discusses a 5-point strategy to strengthen the US physician workforce to better meet the needs of the nationâs patients. The 5 strategies include: supporting telehealth, reforming Medicare payment, stopping scope creep, fixing prior authorization, and reducing physician burnout.
(06/14/2022) ‘Something Has to Change’: Health Care Workers Who Cared For Us During COVID are Burning Out
âCOVID-19 has been a fully and uniquely traumatic experience for the health workforce and for their families. Burnout has reached crisis proportions among front-line clinical staff in hospitals and clinicsâ writes US Surgeon General Dr. Vivek Murthy in an opinion piece published in USA TODAY. Last month Dr. Murthy issued a Surgeon Generalâs Advisory to bring âattention and actionâ to the crisis identifying action items such as access to health insurance, mental health care, sick leave, adequate staffing, and reducing administrative burdens. Dr. Murthy points out that failure to address the crisis will result in the public being unable to access healthcare services, an increase in public health disparities, and a nation that will find it difficult to respond to future public health emergencies.
(06/13/22)Â COVID-19 Pandemic and Physician Burnout: Ramifications for Healthcare Workforce in the United States
This paper published in the Journal of Healthcare Leadership analyzed the possible reasons for physician burnout, especially during the COVID-19 pandemic, such as poor physical and emotional wellbeing, increased healthcare workersâ needs, and diminished labor supply because of quarantining due to seropositivity or staying away from work to provide care to children due to school closures or a sick relative. One of the consequences for the healthcare workforce is that 75% reported being overworked, with 50% considering an employment change during the pandemic, and 25% of women physicians considering early retirement.
(06/09/2022) Shoring Up the Frontline of Prevention: Strengthening Curricula With Community and Public Health Nursing
Published in the American Journal of Public Health, the article argues that nursing educationâs traditional focus on acute care has affected the ability to effectively address public health threats. The Covid-19 pandemic reinforced the need for community and public healthcare settings and a trained workforce. The authors advocate adding public health sciences and investments in community-academic-practice partnerships to nursing curricula will prepare and promote a nursing workforce for practice outside of the hospital setting.
(06/07/22) Fact Sheet: Biden-â Harris Administration Announces Action on COVID-â 19 Pandemic Response and Improving Health Systems and Health Security in the Americas
The Biden Administration announced a new âAction Plan on Health and Resilience in the Americasâwhich aims to improve health systems and health security. According to the press release from the White House, âThe Action Plan will help our partners prevent, prepare for, and respond to future pandemic threats and other public health emergencies while also expanding the equitable delivery of healthcare and public health services to remote, vulnerable, and marginalized populations.â In order to finance the Action Plan, the Biden Administration is creating the Americas Health Corps, a new initiative aligned with the recently announced Global Health Worker Initiative.
(06/1/22) Burned Out By COVID and 80-Hour Workweeks, Resident Physicians Unionize
Resident Physicians in California and other states are unionizing to demand higher wages, better working conditions and benefits due to burnout during the COVID-19 pandemic. They join a large group of health workers, across many professions, who are unionizing and threatening to strike as a result of low wages, workforce shortages, lack of sufficient COVID vaccines and low quantities of personal protective equipment.
(05/31/2022) Stress and the Psychological Impact of the COVID-19 Pandemic on Frontline Obstetrics and Gynecology Providers
Although there are many studies about mental health and burn out in the health workforce, there are less known about stress among Obstetrics and Gynecology providers. This report describes levels of stress, anxiety, depression and other mental health aspects among OB/GYN health care workers during the first surge of the pandemic.
(05/26/22 ) The Waltz: To Improve Nursing Home Care, Invest In The Workforce
This Health Affairs article evaluates some challenges of providing quality nursing home care during the Covid-19 pandemic. The article discusses various legislative, regulatory, and recommendations aimed at providing solutions and addresses key issues for healthcare workers such as wages/benefits, training, and staff-to-resident ratios.
(05/23/22) Harris, Surgeon General, Warn of Health Care Worker Burnout
Vice President Kamala Harris and US Surgeon General Dr. Vivek Murthery are warning of healthcare staff burnout, fearing severe workforce shortages in the future if this issue is not addressed. The Surgeon General’s Advisory Addressing Health Workforce Burnout estimates a shortage of â3 million essential low-wage health workersâ in the next five years and a shortage of 140,000 doctors by 2033. The Biden administration is calling for new steps to protect the mental health of health care staff by providing expanded counseling, reducing administrative burdens, and promoting work force safety.
(05/23/22) New Surgeon General Advisory Sounds Alarm on Health Worker Burnout and Resignation
The US Surgeon General has issued an advisory that highlights the need to address the health worker burnout crisis worsened by the pandemic. The Surgeon Generalâs Advisory Addressing Health Worker Burnout cites studies and statistics from the National Academies of Medicine (NAM), US Bureau of Labor Statistics, and the Association of American Medical Colleges (AAMC) and lists recommendations for stakeholders to make in the areas of healthcare workersâ health and mental wellbeing, workplace culture, and the nationâs public health infrastructure.
(05/19/22) Health Workforce âLeft Exposed and Vulnerableâ During Pandemic
A new BMA report finds that the UK government did a poor job protecting, promoting, and supporting the health workforce during the COVID-19 pandemic. The report showed evidence that health care workers were at risk of exposure to COVID-19 due to shortages of personal protective equipment (PPE), low staffing levels, and a deficiency of COVID tests. The report made several recommendations for future outbreaks including PPE stockpiles, adequate staffing numbers, and better preparation in case of future surges.
(05/16/202) Health Professions Education in the COVID Era â Focus on Communication
Covid-19 has changed the many facets of the healthcare landscape including how providers interact with patients and the ways in which healthcare is delivered. Telemedicine and pandemic safety measures present challenges to cliniciansâ ability to communicate and connect with patients. This poster suggests that training clinicians in the âRESPECTâ (Rapport, Empathy, Support, Partnership, Explanation, Cultural Competency, and Trust) model can assist in overcoming patient care challenges presented by the pandemic.
(05/16/2022) A National Study of Moral Distress Among US Internal Medicine Physicians During the COVID-19 Pandemic
The study published in PLOS ONE looked at the severity, determinants, and outcomes of moral distress in US internal medicine physicians during the pandemic. Based on a survey conducted during September and October 2022, this study finds âstrongâ correlations between high moral distress and negative mental health outcomes.
(05/16/2022) Hospital Groups Ask HHS to Expand COVID-19 Public Health Emergency
Twelve major US hospital groups are requesting The US Department of Health and Human Services (HHS) extend the public health emergency an additional 90 days past the July deadline. Although the COVID-19 numbers are low right now in hospitals, extending the PHE would help make sure that hospitals and the health system are better prepared to treat patients during future pandemic surges.
(05/12/2022) Around the World, Nurses Say Meaningful Work Keeps Them Going
A new McKinsey survey evaluates the impact of COVID-19 on the nursing workforce, asking frontline nurses in different countries whether they plan to stay in their current jobs. Between 28 and 38 percent of the nurses surveyed, stated they were likely to leave their jobs in direct patient care in the next year. This accompanying article to the survey, examines the findings of the survey, but also lists possible ways employers could provide better support to nurses.
(05/09/2022) The Perceived Work Environment and Well-Beingâa Survey of Emergency Healthcare Workers During the Covid-19 Pandemic
The study, published in Academic Emergency Medicine, surveyed 701 emergency medicine (EM) attending and resident physicians, EM nurses, and emergency medical service providers across 10 academic sites in the US to determine if there was a relationship between mental health and perceived work environment during a pandemic. The survey measured job stress, mental well-being, working conditions and organizational factors, participantsâ demographics and job characteristics, and perceived handling of pandemic by external groups.
(05/05/22) COVID-19 Impact on the Nursing Workforce
Emory Healthcare’s Chief Nurse Executive Sharon Pappas and epidemiologist Jodie Guest discuss the impact of the pandemic on the nursing workforce in this video interview. They discuss strategies for nursing shortages and how to ensure patients access to care. This conversation is part of the online video series hosted by Guest discussing questions related to the COVID-19 pandemic.
(05/03/22) Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce
This report from HHS Office of Assistant Secretary for Planning and Evaluation which combines data from the Census Bureau and the Bureau of Labor Statistics, spotlights how the COVID-19 pandemic has put âextreme stress on the healthcare workforceâ in the US, leading to burnout, workforce shortages, and exhaustion and trauma. The report also looks at an overview of federal interventions during the pandemic to help support the healthcare workforce.
(05/03/22) New Report Reveals COVID’s Toll on the Mental Health of Frontline Doctors and Nurses
This All Things Considered NPR podcast discusses A new report by The Department of Health and Human Services which âreveals the depth of distress throughout the health care system.â The podcasts details how burnout, anxiety, and ptsd have taken a toll on health care workers during the pandemic.
(05/02/2022) Impact of the COVID-19 Pandemic on the Hawaiâi Nursing Workforce: A Cross-sectional Survey
This article published in PMC examines the the effect COVID-19 has had on the nursing workforce in Hawaiâi. The authors did a cross-sectional online survey and found that nearly 20% of nurses considered leaving the workforce in late 2020. The main reason for leaving was an unsafe work environment, family/caregiving strain, and job fatigue. The results of this survey also indicate a potential nurse workforce shortage in Hawaiâi.
(05/02/22) Putting Health Workers at the Centre of Health System Investments in COVID-19 and Beyond
Published in the Family Journal of Community Health this paper outlines recommendations for sustained health workforce development and optimization based on current health workforce research, policy, and lessons learned from the Covid-19 pandemic.
(5/1/2022) Healthcare Workers With Long COVID are Having Their Careers Cut Short Due to Debilitating Symptoms As the Industry Struggles With Labor Shortages
This article from Insider highlights three healthcare workers whose careers were harmed by long COVID. Long COVID may deter health care workers from reentering employment in the face of substantial labor shortages.
(04/29/2022) Healthcare Worker Trauma and Related Mental Health Outcomes During the COVID-19 Outbreak in New York City
This new study analyzed mental health problems among Healthcare workers at a public health hospital in New York City during the COVID-19 pandemic. They found that healthcare workers are more likely to experience Burnout, Moderate or High Secondary Traumatic Stress, and High Compassion Satisfaction than Coronavirus Anxiety, PTSD, and Coronavirus Obsession. Also, females have a higher and more significant probability to have PTSD than males. Moreover, healthcare workers under Burnout are more likely with a prior behavioral or emotional health problem. Healthcare workers who report high compassion satisfaction are more likely associated with caring for patients dying from COVI-19, low burnout, and low STS.
(04/29/22) Critical Care Nurse Burnout, Moral Distress, and Mental Health During the COVID-19 Pandemic: A United States Survey
An article published in Family Medicine and Community Health (FMCH) studied 488 surveys of nurses who worked in intensive care units in the US during the Covid-19 pandemic between October 2020 and January 2021. The study found that workplace factors such as lack of PPE, excessive workloads, and perceived lack of administrative support were linked to higher risk of several types of mental distress and increased intent to leave practice.
(04/27/22) âUnsustainableâ Squeeze Grips US Hospitals on Covid Labor Cost
Healthcare wages have increased significantly during the pandemic because of the high demand for healthcare workers, especially in private hospitals. The increased wages for health care workers has led to profit loss in hospitals. Even as COVID hospitalizations have declined, hospitals are trying to find ways to âbuild a pipeline of workers and retain the ones they have.â
(04/22/22) Why Physician Well-being is a Two-way Street
A clinical psychologist spoke about warning signs for burnout among health professionals working through the COVID-19 pandemic in this article and video from the American Medical Association. The article outlines impact of burnout and strategies to address individual burnout among physicians.
(04/21/22) Healing the Wounded Healers
Physicians experience many barriers to getting needed care for mental health issues, with female physicians having significantly higher deaths from suicide compared to other professions. This article from Psychology Today examines issues like burnout and moral injury among health care workers, issues relevant in the current pandemic-era of health care.
(04/20/22) “Should I Stay or Should I Go?â Nursesâ Perspectives About Working During the Covid-19 Pandemic in the United States: A Summative Content Analysis Combined with Topic Modeling
This paper published in International Journal of Nursing Studies studied the perspective of the US nurses working in the frontlines of the COVID-19 pandemic ‘s first wave. They found that the retention rate of the nursing workforce can be used to measure the overall organizational performance. A good supportive organization usually performs well in following perspectives: communication, in-person contact quality with hospital administration, the frontline manager, the culture of the response as perceived by the nurse/midwife, and staff treatment during the first wave.
(04/20/22) Medical Workers Tend to Push Through Their Mental Health Trauma. COVID-19 is Changing That
This article from Gothamist highlights the long-standing issues of mental health trauma among health care workers, and how the COVID-19 pandemic is leading to systemic changes in the way this trauma is addressed.
(04/13/2022) Reported Exposure Trends Among Healthcare Personnel COVID-19 Cases, USA, March 2020âMarch 2021
An article in American Journal of Infection Control finds that many health care workers were exposed to COVID-19 in the workplace, especially during the COVID-19 surges. This study assessed exposure settings of health care workers from March 2020 to March 2021 by using 83,775 observations from a national COVID-19 surveillance data. The majority of reported exposures were workplace exposure (52%), followed by home (30.8%) and community exposures (25.6%). The findings contradict prior research that suggested COVID-19 cases among employees were predominantly due to non-occupational exposures.
(04/05/2022) Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers
A study from the Journal of General Internal Medicine compared moral injury experienced by combat veterans after Sept. 11, 2001, and healthcare workers during the COVID-19 pandemic. The study found combat veterans and healthcare workers reported similar patterns of moral injury.
(03/28/22) Rulemaking Continues on New OSHA COVID-19 Permanent Standard to Protect Healthcare Workers
Nearing the conclusion of the federal Occupational Safety and Health Administrationâs (OSHA) OVID-19 Emergency Temporary Standards, OSHA is working to develop a permanent standard for protecting the health workforce from exposure to COVID-19.
(03/18/22) Bill to Help Health Care Workers Struggling With Mental Health Signed Into Law
President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act. The law, which was introduced in July 2020, will fund grants, in-depth investigations, and public awareness campaigns to help encourage reform in the healthcare sector, where burnout, addiction, and suicide have become prevalent. This bill was named in honor of Dr. Lorna Breen, who died by suicide during the COVID-19 pandemic while working as a doctor.
(03/16/22) Clinician of the Future: a 2022 Report
Thirty-one percent of clinicians in a new global study said they were considering leaving their current position by 2024, according to a report released in March by analytics firm Elsevier Health. Of the 31 percent of clinicians who were considering leaving their current role by 2024, 33 percent plan to stay in a similar role but switch to a different health care setting. Twenty-one percent plan to retire and 13 percent plan to move to another job unrelated to healthcare.
(03/15/22) High Housing Costs Preventing Some Workers From Taking Healthcare Jobs
In addition to health workforce shortages from workers experiencing emotional exhaustion, taking a traveling nursing job, or retiring early, the other factor leading to shortages is high housing costs, which is preventing some health workers from taking healthcare jobs. As a result, some hospitals are taking this issue seriously and are helping finance housing for their health workers.
(02/25/22) New Analysis Highlights the Changes in U.S. health Care Workforce During COVID-19 Pandemic
A new analysis from Indiana University, Rand Corp, and the University of Michigan spotlights the changes in the US health care workforce during the pandemic and finds that the average wages for US health care workers increased less than wages in other industries during 2020 and the first six months of 2021. The report was published in the Journal of the American Medical Association Health Forum. Researchers said that their findings are vital for planning and responding to ongoing and future public health crises.
(02/28/2022) HHS to Distribute $560M in Phase 4 COVID-19 Provider Relief Funds
The United States Department of Health and Human Services (HHS) will distribute 560 million to 4,100 providers who faced revenue loss during the pandemic as part of the third batch of Phase 4 COVID-19 Provider Relief. The money will also help providers serving vulnerable populations.
(02/11/22) 5 Ways to Restore Depleted Health Care Workers
This article looks at various approaches to deal with burn out in the healthcare industry. Approaches include: make the most of extended teams, be a reliable advocate, lead with kindness, offer access to emotional support resources, and allow time for what matters. This âmulti-pronged approachâ can help the health care system deal with physical and emotional depletion, reduce burnout, and improve patient care.
(02/10/22) Health Care Workers Increasingly Think We’ve Passed the Worst of the Pandemic
A recent survey from Axios finds that just under half of health care workers believe the worst of the COVID-19 pandemic has already occurred. This writeup from The Morning Consult looks at how the attitudes of health care workers have changed throughout the pandemic, including how they feel about who they work with and where they work.
(02/09/22) A Tranquil Virtual Reality Experience to Reduce Subjective Stress Among COVID-19 Frontline Healthcare Workers
New research published in PLOS ONE studies the impact of a three-minute Tranquil Cinematic virtual reality simulation of a nature scene on health care workers on the frontlines treating COVID-19 patients. The researchers found that participants experienced immediate reductions in subjective stress following viewing the simulation.
(02/08/22) For Burned-out Health Workers, Exhaustion From COVID-19 Surges Mixes With a Sense of Betrayal
This article from STAT covers a recent event on burnout in the health workforce, featuring experts from Moral Injury of Healthcare, American Association of Critical Care Nurses, Texas Cardiac Arrhythmia Institute, and University of Pittsburgh School of Medicine. Health care workers continue to experience high rates of burnout and need continued support to address staffing shortages, harassment, and protective equipment shortages.
(02/07/22)Â Health Workers Weighing Their Options
Many health care workers are considering other industries, including to a new Axios survey. 22% of health workers surveyed are considering leaving health care and 16 percent are considering a different health care role. Those health workers caring for COVID-19 patients are most likely to report wanting to leave the healthcare industry. Another survey found the percentage of health care workers who reported being stressed or experienced mental health issues has worsened during the pandemic.
(02/07/22) As COVID Persists, Healthcare Worker Mental Health Must Be Prioritized
Throughout the COVID-19 pandemic, nurse practitioners and other health care personnel have been under great stress while trying to treat patients. Kapu, president of the American Association of Nurse Practitioners (AANP), highlights the significance of having mental health services easily available to healthcare professionals so that they may use them, as well as healthcare workers being proactive in seeking assistance and decompressing from their job.
(02/06/22) Factors Associated With Depression and Anxiety Symptoms Among US Physicians During the First Phase of the COVID-19 Pandemic
This new study examines the effect the COVID-19 global pandemic has had on the mental health of health workers. The main purpose of this research article was to examine the protective and risk factors associated with depression and anxiety of physicians practicing in the US during the early part of the pandemic.
(01/20/22) The Watershed Of Practice-Based Research: Lessons And Opportunities From The COVID Pandemic
Practice-based Research Networks (PBRNs) are promoted as perfect vehicles for learning lessons from the COVID-19 pandemic in this piece published by Health Affairs. The authors provide recommendations for changing PBRNs from a reactive system to a more responsive system, as the COVID-19 pandemic provided significant challenges to the funding and operation of these networks.
(01/19/22) The COVID-19 Pandemic Is Breaking the US Healthcare System â but Thatâs Only a Symptom of the Underlying Disease
In this Forbes article, Dr. Stephen Thomas, an infectious diseases physician at the State University of New York Upstate Medical University, discusses how the pandemic makes apparent the many overarching problems in Americaâs healthcare system. Dr. Thomas argues we are heading towards a breaking point for American healthcare âand without an immediate and meaningful intervention, the damage will be significant and take years to undo.â
(01/18/22) Experiences of Black and Latinx Health Care Workers in Support Roles During the COVID-19 Pandemic: A Qualitative Study
This research article published in PLOS One investigates the effect of the COVID-19 pandemic on Black and Latinx health care workers in support roles. The authors conducted two group interviews and eight individual interviews with health care workers between December 2020 and February 2021. Participants included members of a high-risk workforce and communities that bore a disproportionate share of the pandemic’s brunt. Overall, the interviewees reported disruptive changes in job duties and positions. These changes were even exacerbated by the persistent dread that they might get COVID-19 and infect their family members. Health care workers with direct patient care reported having less opportunity to engage with patients.
(01/11/22) Youâd Expect Health Care Workers on the COVID Frontlines to Be Tested Regularly. Youâd Be Wrong
This opinion piece published in STAT highlights concerns over the lack of regular testing for health care workers and the impact this has on the resiliency of the health workforce as a whole. Currently the health workforce in the United States is experiencing high rates of burnout and shortages of staff, with new guidelines recommending even health care workers with COVID-19 who are symptomatic return to work in some situations.
(01/08/22) CA Health Care Workers Raise Concerns Over New State COVID-19 Protocols
The extremely infectious omicron variant has increased the number of persons admitted to California hospitals, prompting the California Department of Public Health to release new recommendations to ensure that there is enough staff to manage the surge. According the new guideline, health care workers who test positive for COVID-19 will no longer be required to isolate or test negative and will be able to return to work immediately if they are asymptomatic. Advocacy groups say the move is a critical error that puts patients at danger.
(01/06/22) Hochul Proposes $10B to Bolster Health Care Workforce in New York
New York governor Kathy Hochul has announced plans to invest $10 billion to improve the health workforce in New York State. This investment seeks to grow the health workforce by 20 percent over the next five years, and includes $4 billion meant to support wages and bonuses for health care workers exhausted by the COVID-19 pandemic.
(01/04/22) We Must Practice What We Preach: a Framework to Promote Well-being and Sustainable Performance in the Public Health Workforce in the United States
Research during the COVID-19 pandemic has found an increase in anxiety, depression, and burnout among health care professionals. This article provides a framework to âprioritize the well-being and sustainable performance of the public health workforce to foster resilience and mitigate stressors.â
(01/04/22) Health Care Workers Concerned by Shorter Isolation After COVID Infections
This article from NBC News covers the recently changed recommendations from the Centers for Disease Control and Prevention reducing required isolation time from 10 days to 7 days with a negative test, or fewer days with staffing shortages.
(01/04/22) Union Calls on OSHA to Restore COVID Safety Standards for Health Care Workers
The largest union representing federal health care workers in the United States, the American Federation of Government Employees, is calling for the Occupational Safety and Health Administration to restore the temporary COVID-19 emergency workplace standards, which were rescinded in part in December 2021.
(12/26/21) Healthcare Workers Say Some COVID-19 Patients and Their Families Are Demanding Unapproved Therapies
Some healthcare workers report that some COVID-19 patients and their families are requesting unproven treatments and, in some instances, threaten healthcare workers. Healthcare workers say that there is still a lot of misinformation among patients, and it’s really difficult to communicate with patients who are unvaccinated, have caught COVID-19, and are looking for some instant relief.
(12/24/21) CDC Shortens Isolation Time for Health Care Workers With COVID-19
In response to the Omicron variant, the CDC is shortening the isolation period for healthcare workers who test positive for COVID-19. According to a new guideline released Thursday, healthcare workers with COVID-19 may return to work after seven days if they are asymptomatic and test negative. The agency says that the isolation period can even be shorter if there are staffing shortages. To return to work after the infection, healthcare workers should obtain a negative test result within 48 hours.
(12/21/21) First Health-care Worker COVID-19 Rule Ends as OSHA Goes Mum
The Occupational Safety and Health Administrationâs COVID-19 Emergency Temporary Standard rule for health care workers has lapsed, with no word yet on a replacement. No permanent regulation change has been implemented, even as COVID-19 infection and hospitalization continue to plague health care systems.
(12/21/21) ‘Great Resignation’ Could Be Coming for Healthcare as Clinicians Face Mounting Burnout and Stress, Study Finds
As the COVID19 pandemic continues to surge, data suggests that the US is on the brink of a turnover wave in the health workforce. A recent study published by American Medical Association (AMA) found that one in 5 physicians and 2 in 5 nurses plan to leave their current practice within 2 years. Another recent study by the Mayo Clinic found that about one-third of physicians and nurses plan to work fewer hours in the next year.
(12/20/21) âA True Tragedyâ: New England Hospitals Battle Staffing Problems As Doctors Prep for COVID-19 Surge
As the omicron variant surges in the US, New England hospitals are dealing with staffing shortages as many health workers are leaving the profession due to burnout and some nurses are seeing lucrative offers in other states. In Massachusetts state data states that 83 percent of ICU beds are occupied and 93 percent of non ICU beds were occupied as of December 16. In Rhode Island staffing shortages have led to emergency physicians seeing patients in the hallways of the hospital and in waiting rooms, performing the tasks of nurses and medical technicians.
(12/12/21) Perceptions of Inequitable Compensation Reductions Among Healthcare Workers During COVID-19
This research article published in the Journal of Health Care Finance examines the implications of pandemic-related reductions in pay, staffing, and other cost-saving measures health care organizations implemented throughout the United States. The study focuses on the perceptions of staff to these changes, and offers suggestions to improve outcomes and avoid perceptions of inequity.
(12/09/21) Frontline Health Care Workers of Color Bridge Racial Gap in Time of COVID-19
Lack of trust and access to health care services caused extensive damage on Utah’s communities of color during the COVID-19 pandemic. The Utah Department of Health and Intermountain Healthcare attempt to address this challenge by collaborating with local health workers by launching the COVID Communities Partnership. The community health workers bridge the language and cultural gap and mitigate vaccine hesitancy among people in communities. The Utah Department of Health reports that, âsince the program began last March, they have referred 19,875 to COVID testing and 40,704 to vaccine clinics.â
(12/09/21) Healthcare Workers Face Increasing Violence From Patients Amid COVID-19 Surge
A spike in COVID-19 cases and workforce shortages have strained Michigan hospitals. On top of those concerns, hospitals say that they are currently dealing with an uptick in violence directed at their employees. According to health officials, the situation is escalating as hospitals get overcrowded and wait times lengthen.
(12/03/21) New Survey Reveals the Significant Impact of COVID-19 on Nurse Satisfaction Levels
A recent survey conducted by Florida Atlantic Universityâs Christine E. Lynn College of Nursing and Cross Country Healthcare Inc found that nearly 37 percent of nurses feel they are burned out, stressed and overworked. Only 32 percent of nurses surveyed feel that they are very/completely satisfied with their occupation, which is an 20 percent decrease from before the pandemic. 29 percent of nurses desire to leave the profession due to the the nursing shortage and inadequate staffing. 85 percent of nurses believe national licensure would be a benefit to the country during the pandemic.
(12/02/21) The Psychological Toll of the COVID-19 Pandemic has Hit Mental Health Providers Hard, Too
A new Penn Medicine study finds that the COVID-19 pandemic has effected mental health providers noting a concerning trend of burnout, secondary traumatic stress, and financial strain. The study surveyed 49 public mental health clinicians in Philadelphia. All the clinicians surveyed specialize in trauma-focused cognitive behavioral therapy.
(12/02/21) Marshfield Leaders Tackle Pandemicâs âBrutalâ Impact on Morale
After surveying their staff and finding widespread reports of burnout and exhaustion,
leadership at Marshfield Clinic Health System in Wisconsin has taken great measures to boost morale and provide financial and mental support. Marshfield now offers more flexible working options to cut back on physician burnout and focus on the well being of their staff