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护理的脆弱核心:将卫生专业人员的福祉重新界定为关键基础设施。

The fragile core of care: reframing the well-being of health professionals as critical infrastructure.

作者信息

Xames Md Doulotuzzaman

机构信息

Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, United States.

出版信息

Health Aff Sch. 2025 Jun 14;3(7):qxaf123. doi: 10.1093/haschl/qxaf123. eCollection 2025 Jul.

Abstract

While global health policy often centers patient outcomes, a dangerous oversight persists: the neglect of healthcare professionals' well-being as foundational to system effectiveness. Burnout, attrition, and moral injury are mounting across countries, yet health systems continue to treat their workforce sustainability as peripheral. Drawing on evidence from workforce trends, burnout statistics, and systems engineering, this commentary argues that healthcare professionals' well-being must be reframed as critical infrastructure. The piece contends that sustainability in healthcare depends on policy architectures that embed protections for health professionals, including structural supports like real-time workload monitoring, enforceable staffing ratios, and integrated mental health services. The neglect of health professionals' well-being is not just a human resource challenge-it is a design flaw that compromises the viability of care delivery itself. Without urgent recalibration, health systems risk brittleness, inequity, and collapse under surging demands. This commentary urges a paradigm shift in how we conceptualize, design, and govern health systems, beginning with the foundational recognition that care cannot be sustainable if its health professionals are not.

摘要

虽然全球卫生政策通常以患者结局为核心,但一个危险的疏忽依然存在:忽视医疗保健专业人员的福祉是系统有效性的基础。各国的职业倦怠、人员流失和道德伤害都在加剧,但卫生系统仍将其劳动力的可持续性视为次要问题。基于劳动力趋势、职业倦怠统计数据和系统工程的证据,本评论认为,必须将医疗保健专业人员的福祉重新界定为关键基础设施。文章认为,医疗保健的可持续性取决于政策架构,这些架构应包含对卫生专业人员的保护措施,包括实时工作量监测、可执行的人员配备比例和综合心理健康服务等结构性支持。忽视卫生专业人员的福祉不仅是人力资源方面的挑战,更是一个设计缺陷,它损害了医疗服务本身的可行性。如果不进行紧急调整,卫生系统在需求激增的情况下可能面临脆弱性、不公平性和崩溃的风险。本评论敦促我们在如何构思、设计和管理卫生系统方面进行范式转变,首先要从根本上认识到,如果卫生专业人员的状况不可持续,医疗服务就不可能可持续。

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