Northwell Health at North Shore/Long Island Jewish Medical Center, Department of Emergency Medicine, Long Island, New York.
St. John's Riverside Hospital, Department of Emergency Medicine, Yonkers, New York.
West J Emerg Med. 2023 Mar 22;24(3):597-604. doi: 10.5811/westjem.57306.
Hospitals have implemented various wellness interventions to offset the negative effects of coronavirus disease 2019 (COVID-19) on emergency physician morale and burnout. There is limited high quality evidence regarding effectiveness of hospital-directed wellness interventions, leaving hospitals without guidance on best practices. We sought to determine intervention effectiveness and frequency of use in the spring/summer 2020. The goal was to facilitate evidence-based guidance for hospital wellness program planning.
This cross-sectional observational study we used a novel survey tool piloted at a single hospital and then distributed throughout the United States via major emergency medicine (EM) society listservs and closed social media groups. Subjects reported their morale levels using a slider scale from 1 (lowest) to 10 (highest) at the time of the survey and, retrospectively, at their respective COVID-19 peak in 2020. Subjects also rated effectiveness of wellness interventions using a Likert scale from 1 (not at all effective) to 5 (very effective). Subjects indicated their hospital's usage frequency of common wellness interventions. We analyzed results using descriptive statistics and t-tests.
Of 76,100 EM society and closed social media group members, 522 (0.69%) subjects were enrolled. Study population demographics were similar to the national emergency physician population. Morale at the time of the survey was worse (mean [M] 4.36, SD 2.29) than the spring/summer 2020 peak (M 4.57, SD 2.13) [t(458)=-2.27, P=0.024]. The most effective interventions were hazard pay (M 3.59, SD 1.12), staff debriefing groups (M 3.51, SD 1.16), and free food (M 3.34, SD 1.14). The most frequently used interventions were free food (350/522, 67.1%), support sign display (300/522, 57.5%), and daily email updates (266/522, 51.0%). Infrequently used were hazard pay (53/522, 10.2%) and staff debriefing groups (127/522, 24.3%).
There is discordance between the most effective and most frequently used hospital-directed wellness interventions. Only free food was both highly effective and frequently used. Hazard pay and staff debriefing groups were the two most effective interventions but were infrequently used. Daily email updates and support sign display were the most frequently used interventions but were not as effective. Hospitals should focus effort and resources on the most effective wellness interventions.
医院已经实施了各种健康干预措施，以抵消 2019 年冠状病毒病（COVID-19）对急诊医师士气和倦怠的负面影响。关于医院定向健康干预措施的有效性，高质量的证据有限，这使得医院缺乏最佳实践的指导。我们旨在确定 2020 年春季/夏季的干预效果和使用频率。其目的是为医院健康计划的规划提供循证指导。
本横断面观察性研究使用了一种新的调查工具，该工具在一家医院进行了试点，然后通过主要的急诊医学（EM）学会的电子邮件列表和封闭的社交媒体群组在美国各地进行了分发。受试者在调查时使用从 1（最低）到 10（最高）的滑块来报告他们的士气水平，并在 2020 年各自的 COVID-19 高峰期进行回顾性评估。受试者还使用从 1（一点也不有效）到 5（非常有效）的李克特量表来评估健康干预措施的效果。受试者指出了他们所在医院使用常见健康干预措施的频率。我们使用描述性统计和 t 检验来分析结果。
在 76100 名 EM 学会和封闭的社交媒体组的成员中，有 522 名（0.69%）被纳入研究。研究人群的人口统计学特征与全国急诊医师人群相似。调查时的士气（M 4.36，SD 2.29）比 2020 年春季/夏季高峰期（M 4.57，SD 2.13）更差（t（458）=-2.27，P=0.024）。最有效的干预措施是危险津贴（M 3.59，SD 1.12）、员工汇报小组（M 3.51，SD 1.16）和免费食品（M 3.34，SD 1.14）。使用最频繁的干预措施是免费食品（350/522，67.1%）、支持标志展示（300/522，57.5%）和每日电子邮件更新（266/522，51.0%）。使用频率较低的是危险津贴（53/522，10.2%）和员工汇报小组（127/522，24.3%）。
最有效和最常用的医院定向健康干预措施之间存在不一致。只有免费食品是既高度有效又经常使用的。危险津贴和员工汇报小组是最有效的两种干预措施，但使用频率较低。每日电子邮件更新和支持标志展示是使用最频繁的干预措施，但效果并不理想。医院应将精力和资源集中在最有效的健康干预措施上。
