Department of Paediatrics, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
Adult Emergency Department, Te Toka Tumai Auckland City Hospital, Auckland, New Zealand.
BMJ Open. 2024 Oct 29;14(10):e087328. doi: 10.1136/bmjopen-2024-087328.
The well-being of healthcare workers (HCWs) is critical to providing excellent care. Recent evidence concerns the well-being of emergency department (ED) HCWs in New Zealand, with high levels of burnout found in a 2020 survey. This threat to providing high-quality acute care warrants improvement interventions. The causes of burnout are complex and multifactorial, the solutions are not straightforward.
A prospective, multisite, before and after, mixed methods study assessing a multicomponent intervention, adaptable to local context, that targets three organisation levels (the individual, the group and the system levels) and meaningfully involves frontline HCWs may reduce HCW burnout and improve HCW well-being. Individual HCWs will choose from three individual-level psychological interventions and participate in those most appropriate for them. Local champions will decide which group-level intervention their ED will use. The system-level intervention will build capacity and capability for quality improvement (QI) with QI training and the establishment of a Quality Improvement Learning System. This system-level intervention has several important features that may ultimately empower HCWs to contribute to improving the quality of ED healthcare.We will enrol nine EDs, from which there will be at least 900 HCW participants. EDs will be enrolled in three waves from March 2023 to April 2024, with interventions taking place in each ED over 12 months.Methods of assessment will include baseline and repeat survey measures of burnout and well-being. Process evaluation at each ED will provide details of context, the intervention and the fidelity of the implementation.
Ethics committee approval was provided, with locality approval at each site.Individual site feedback will be provided to each ED and executive leadership. Dissemination of findings will be through publication in peer-reviewed journals, presentation at national and international scientific meetings and through national healthcare quality bodies.
Australia New Zealand Clinical Trials Registry (ACTRN12623000342617).
医护人员（HCWs）的福祉对于提供卓越的医疗至关重要。最近的证据涉及新西兰急诊科（ED）HCWs 的福祉，2020 年的一项调查发现他们的 burnout 水平很高。这种对提供高质量急症护理的威胁需要进行改善干预。burnout 的原因复杂且多因素，解决方案并不简单。
一项前瞻性、多地点、前后对照、混合方法研究评估了一种多组分干预措施，该措施适应于当地情况，针对三个组织层面（个体、群体和系统层面），并让一线 HCWs 有意义地参与其中，可能会降低 HCW 的 burnout 程度并提高 HCW 的福祉。个体 HCWs 将从三种个体层面的心理干预措施中进行选择，并参与最适合他们的干预措施。当地的领导者将决定他们的 ED 将使用哪种群体层面的干预措施。系统层面的干预措施将通过 QI 培训和建立质量改进学习系统来提高能力和能力。该系统层面的干预措施具有几个重要的特点，最终可能会赋予 HCWs 权力，使他们能够为改善 ED 医疗保健质量做出贡献。我们将招募 9 个 ED，每个 ED 将至少有 900 名 HCW 参与者。ED 将在 2023 年 3 月至 2024 年 4 月期间分三批招募，每个 ED 的干预措施将持续 12 个月。评估方法将包括基线和重复调查 burnout 和福祉的测量。每个 ED 的过程评估将提供有关背景、干预措施和实施保真度的详细信息。
已获得伦理委员会的批准，并获得了每个地点的地方批准。每个 ED 将获得当地的反馈和执行领导。研究结果将通过在同行评议的期刊上发表、在国家和国际科学会议上展示以及通过国家医疗保健质量机构进行传播。
澳大利亚新西兰临床试验注册中心（ACTRN12623000342617）。
