Executive Summary

The United Nations (2020) has described the COVID-19 pandemic as the defining global health crisis of our time and the greatest challenge we have faced since World War Two. The pandemic has created an unprecedented challenge for health care organizations and institutions. Health care providers (HCPs), teams, and organizations must simultaneously support efforts to contain the pandemic and manage care for patients with ongoing health and social needs while maintaining both continuity and redesign of delivery to protect patients and staff. In healthcare education, students and educators have experienced enormous disruption as courses and clinical education have been canceled or postponed, with classes being rapidly shifted from traditional face-to-face delivery to online or blended delivery formats.

Although epidemics are not new to health care, the lack of knowledge of the nature of this new highly contagious and deadly disease has been a major source of concern. COVID-19 poses unique challenges for HCPs – challenges of caring for vulnerable isolated patients, further compounded by the fear of contracting, spreading, and dying from the virus while managing staffing and personal protective equipment (PPE) shortages. Due to COVID-19, already 10-20% of HCPs have already fallen ill to COVID-19, and over 80% of HCPs and more than 70% of college level students experience anxiety, stress, and/or burnout (Amnesty International Organization, 2020; Cunningham, 2020; Hu et al., 2020; Son et al., 2020). If these challenges remain unaddressed, the anticipated impacts for providers, patients, and the health care system will be devastating (Bansal, et al, 2020; Reith, 2018). We need robust resilience and wellbeing programs/services that provide opportunities for individuals/teams as well as organizations/systems to connect, engage, and be synergized for resilient person-centered care.

In this Call to Action, we invite and urge the global health care community – in both practice and education – to take strategic actions, at all levels, to address burnout and develop resilience among HCPs, faculty, learners, healthcare organizations, and healthcare systems. We view resilience in health care as a whole of system adaptation (Sturmberg, 2018), and as the intrinsic ability of the health care systems to adjust its functioning before, during, or following changes and disturbances so that it can sustain required operations, even after a major mishap or in the presence of continuous stress (Nemeth, et al, 2011).

Leading health care during a crisis requires building resilience at all levels, from organizations and systems to individual and teams. Organizational and system resilience is closely linked to individual and team resilience of those who work at the organization/system. Thus, support for resilience has to be driven from individual, team, organizational, and system levels. 

Individual and Team Resilience

Individual and team resilience are dynamic, progressive, and interdependent processes that can mutually affect each other (while also influencing the organizational and system resilience) (Hartmann et al., 2019; Morgan et al., 2013). Team resilience is most critical during COVID-19 where the failure of collaboration can have serious consequences and impact on the lives and livelihood of millions of people (Hartwig, 2020). Team resilience requires distinct factors or collective characteristics also called enhancing resilience resources (Chen et al, 2015; Hobfoll, 2011), such as social support, quality of emotional expression among team members, high- quality relationships, collaborative leadership, and the ability to regulate and leveraging emotional expression (Morgan et al., 2017).

To build and promote HCPs individual and team resilience, there are some effective strategies that have been suggested as follows (Shanafelt, Ripp, Trockel, 2020):

• Hear: Listen and act on the lived experience of the team and its members to understand and address concerns to the greatest extent possible for organizations and leaders.
• Protect: Provide the essential resources to the team and its member to eliminate the risk of contamination, transmission, burnout, and mental health illness.
• Prepare: Provide ongoing training and support for high-quality care and services across different settings.
• Support: Acknowledge demands and human limitations in times of great patient need.
• Care for: Provide holistic support for the team, its members, and their families, if isolation is required (or other sources of distress occur).

To thrive and come back stronger from the pandemic, in addition to the above strategies two major areas need immediate attention:

1. Preventing a Parallel Pandemic of Burnout through Building individual and team resilience
2. Building Resilience among Current and Future HCPs in the Era of Virtual Health Education and Practice

Organization and System Resilience

This level of resilience refers to the capacity of organizations and systems to be resourceful and creative, to make strategic decisions, and to take effective action regardless of internal and external pressures. To be resilient, the health care system/organization should demonstrate the ability to (Hollnagel, 2013):

• Effectively respond to new stimuli, including global events such as COVID-19 Pandemic, through adaptation.
• Monitor and measure both internal and external factors affecting its performance.
• Learn from prior experience and change its performance accordingly.
• Anticipate and be ready to effectively address future stimuli that could affect its performance.

In addition to these strategies and to demonstrate and sustained enhanced system resilience to the pandemic, there are two other major areas that healthcare organizations and systems need to consider and improve on:

1. Equity in Healthcare
2. Healthcare Financial Structure and Payment Models

Full Publication

To review and download the full publication, please follow the link here: “Building Resilience in Health Care in the time of COVID-19 through Collaboration – A Call to Action“.  

About the Publication

This Call to Action is the latest publication of the IPR.Global COVID-19 Taskforce – Resilience Initiative with the goal to raise awareness and urge the global health care communities to act strategic and bold, by using system approach, to address the imminent threat of a parallel burnout pandemic through collaboration.