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Review
. 2023 Jul;164(1):124-136.
doi: 10.1016/j.chest.2023.03.008. Epub 2023 Mar 11.

Critical Care Staffing in Pandemics and Disasters: A Consensus Report From a Subcommittee of the Task Force for Mass Critical Care - Systems Strategies to Sustain the Health Care Workforce

Charles L Sprung  1 , Asha V Devereaux  2 , Marya Ghazipura  3 , Lisa D Burry  4 , Tanzib Hossain  5 , Mitchell T Hamele  6 , Ramon E Gist  7 , Timothy M Dempsey  8 , Jeffrey R Dichter  9 , Kiersten N Henry  10 , Alexander S Niven  11 , Timur Alptunaer  12 , Meredith Huffines  13 , Kasey R Bowden  14 , Anne Marie O Martland  15 , Jamie R Felzer  11 , Steven H Mitchell  16 , Pritish K Tosh  11 , Jason Persoff  14 , Vikramjit Mukherjee  5 , James Downar  17 , Amado A Báez  18 , Ryan C Maves  19 ; Task Force for Mass Critical Care Writing Group
Affiliations
Review

Critical Care Staffing in Pandemics and Disasters: A Consensus Report From a Subcommittee of the Task Force for Mass Critical Care - Systems Strategies to Sustain the Health Care Workforce

Charles L Sprung et al. Chest. 2023 Jul.

Abstract

Background: The COVID-19 pandemic has led to unprecedented mental health disturbances, burnout, and moral distress among health care workers, affecting their ability to care for themselves and their patients.

Research question: In health care workers, what are key systemic factors and interventions impacting mental health and burnout?

Study design and methods: The Workforce Sustainment subcommittee of the Task Force for Mass Critical Care (TFMCC) utilized a consensus development process, incorporating evidence from literature review with expert opinion through a modified Delphi approach to determine factors affecting mental health, burnout, and moral distress in health care workers, to propose necessary actions to help prevent these issues and enhance workforce resilience, sustainment, and retention.

Results: Consolidation of evidence gathered from literature review and expert opinion resulted in 197 total statements that were synthesized into 14 major suggestions. These suggestions were organized into three categories: (1) mental health and well-being for staff in medical settings; (2) system-level support and leadership; and (3) research priorities and gaps. Suggestions include both general and specific occupational interventions to support health care worker basic physical needs, lower psychological distress, reduce moral distress and burnout, and foster mental health and resilience.

Interpretation: The Workforce Sustainment subcommittee of the TFMCC offers evidence-informed operational strategies to assist health care workers and hospitals plan, prevent, and treat the factors affecting health care worker mental health, burnout, and moral distress to improve resilience and retention following the COVID-19 pandemic.

Keywords: burnout; critical care; disasters; health-care workforce; mental health; moral distress; pandemics; resilience; staffing.

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Conflict of interest statement

Financial/Nonfinancial Disclosures None declared.

Figures

Figure 1
Figure 1
Description of process to develop the final evidence-based suggestions.
Figure 2
Figure 2
Sample staff retention implementation planning steps. HCW = health-care worker; RNS = registered nurses.
Figure 3
Figure 3
Minimal, essential suggestions that every institution should implement or work toward implementing for health-care workforce sustainment. PPE = personal protective equipment.
See this image and copyright information in PMC

References

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