Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA
Stanford University School of Medicine, Stanford, California, USA.
BMJ Open. 2024 Jan 11;14(1):e075920. doi: 10.1136/bmjopen-2023-075920.
Employee Occupational Health ('occupational health') clinicians have expansive perspectives of the experience of healthcare personnel. Integrating mental health into the purview of occupational health is a newer approach that could combat historical limitations of healthcare personnel mental health programmes, which have been isolated and underused.
We aimed to document innovation and opportunities for supporting healthcare personnel mental health through occupational health clinicians. This work was part of a national qualitative needs assessment of employee occupational health clinicians during COVID-19 who were very much at the centre of organisational responses.
This qualitative needs assessment included key informant interviews obtained using snowball sampling methods.
We interviewed 43 US Veterans Health Administration occupational health clinicians from 29 facilities.
This analysis focused on personnel mental health needs and opportunities, using consensus coding of interview transcripts and modified member checking.
Three major opportunities to support mental health through occupational health involved: (1) expanded mental health needs of healthcare personnel, including opportunities to support work-related concerns (eg, traumatic deployments), home-based concerns and bereavement (eg, working with chaplains); (2) leveraging expanded roles and protocols to address healthcare personnel mental health concerns, including opportunities in expanding occupational health roles, cross-disciplinary partnerships (eg, with employee assistance programmes (EAP)) and process/protocol (eg, acute suicidal ideation pathways) and (3) need for supporting occupational health clinicians' own mental health, including opportunities to address overwork/burn-out with adequate staffing/resources.
Occupational health can enact strategies to support personnel mental health: to structurally sustain attention, use social cognition tools (eg, suicidality protocols or expanded job descriptions); to leverage distributed attention, enhance interdisciplinary collaboration (eg, chaplains for bereavement support or EAP) and to equip systems with resources and allow for flexibility during crises, including increased staffing.
员工职业健康(“职业健康”)临床医生对医疗保健人员的体验有着广泛的了解。将心理健康纳入职业健康的范畴是一种较新的方法,可以克服医疗保健人员心理健康计划的历史局限性,这些计划一直处于孤立和未充分利用的状态。
我们旨在通过职业健康临床医生记录创新和支持医疗保健人员心理健康的机会。这项工作是对 COVID-19 期间员工职业健康临床医生的全国定性需求评估的一部分,这些临床医生在组织应对措施中处于核心地位。
这项定性需求评估包括使用滚雪球抽样方法获得的关键知情人访谈。
我们采访了来自 29 个设施的 43 名美国退伍军人事务部职业健康临床医生。
该分析侧重于人员心理健康需求和机会,使用访谈记录的共识编码和修改后的成员检查。
通过职业健康支持心理健康的三个主要机会包括:(1)扩大医疗保健人员的心理健康需求,包括支持与工作相关的问题(例如,创伤性部署)、家庭问题和丧亲之痛(例如,与牧师合作)的机会;(2)利用扩大的角色和协议来解决医疗保健人员的心理健康问题,包括扩大职业健康角色、跨学科合作(例如,与员工援助计划(EAP)合作)以及流程/协议(例如,急性自杀意念途径)的机会;(3)支持职业健康临床医生自身心理健康的需求,包括通过充足的人员配备/资源解决过度劳累/倦怠的机会。
职业健康可以采取策略来支持人员心理健康:从结构上持续关注,使用社会认知工具(例如,自杀意念协议或扩展的工作描述);利用分布式注意力,加强跨学科合作(例如,牧师提供丧亲支持或 EAP),并在危机期间为系统配备资源并允许灵活性,包括增加人员配备。