Based on an American Medical Association news article published April 6, 2020 and Sara Berg’s interview with Jonathan Ripp, MD, Professor of Medicine, Medical Education, and Geriatrics and Palliative Medicine and Chief Wellness Officer, Icahn School of Medicine, Mount Sinai Medical Center, New York City.
Learn how Mount Sinai focused on 3 areas to mitigate strain and stress among physicians and caregivers during crisis.
The well-being of physicians, nurses, and other health professionals is critical to help health systems and hospitals meet the growing needs of COVID-19 care. Keeping well-being in mind, a New York health system enhanced existing and created new resources to provide ongoing support for those on the front lines of care during the COVID-19 pandemic.
From basic needs like childcare and food to mental health and supportive counseling, Mount Sinai Health System in New York City maintains an up-to-date list of resources for all health professionals and employees, keeping their well-being at the center of focus.
When New York City had its first case of COVID-19, “very quickly we realized that we would have to put our ordinary work on pause to develop means of supporting well-being during this unfolding crisis,” said Jonathan Ripp, MD.
Developing the Intervention
“Through informal queries of our faculty and the observed stressors we realized that our well-being focus needed a new approach to address the enormous strain to our workforce,” he said. “We developed a new model based on Maslow's hierarchy of needs. From people on the ground we learned that their primary concerns were meeting basic daily needs, personal and family safety, and anxiety about redeployment to new settings where they might not have the skills.”
With these concerns in mind, Mount Sinai developed resources focused on 3 areas to improve well-being and reduce added stress on physicians.
Basic needs
“It is imperative that during this crisis the basic needs of our heroic workers are being met,” reads the resources page for basic needs. The page provides information about the ongoing efforts of Mount Sinai to address basic needs of physicians and other health professionals as they fight the COVID-19 pandemic together.
“Our first phase approach is to meet those basic needs for safety, childcare (especially in families with 2 health care workers), transportation (realizing the increased costs of taking a taxi rather than taking the subway), and food,” said Dr Ripp.
Some of the resources include low cost or free meal options, child and eldercare, transportation, and accommodations. The page also provides further guidance on personal protective equipment.
Psychosocial needs
“We've also learned that communication is an essential element in supporting our staff,” said Dr Ripp, adding that, “It is important to provide steady information about the state of the epidemic in our home institutions and what is being done.”
With a lot of the focus on addressing the uncertainty of the situation, the team has also provided “psychosocial support, collecting existing resources and finding ways to share those and scale them where need be,” he said. “A lot of our focus has been addressing the uncertainty of the situation.”
Psychosocial needs provided include supportive counseling, support groups, self-care activities, and confidential support.
Mental health evaluation
“Now we are at a phase where hospitals are at or near capacity, and expecting a rise in the next 2 weeks, with possible equipment shortages,” said Dr Ripp. “Health care workers are going to face circumstances that they weren't anticipating or necessarily prepared for.”
As needed, psychiatrists, psychologists, nurse practitioners, and social workers from the departments of psychiatry, social work, employee assistance, and the Office of Well-Being and Resilience are partnering to provide Mount Sinai health professionals and employees with psychosocial support and/or confidential psychiatric evaluation and treatment.
“One of the most inspirational things about this is how the entire workforce has mobilized,” said Dr Ripp, adding that, “it is amazing to watch this in action which has served as a beacon of hope in extraordinarily difficult times.”
DeVoe JE, Cheng A, Krist A. Regional strategies for academic health centers to support primary care during the COVID-19 pandemic: a plea from the front lines. JAMA Health Forum. April 8, 2020. Accessed May 4, 2020. http://jamanetwork.com/channels/health-forum/fullarticle/2764405
Well-being staff resources during COVID-19. Mount Sinai. Accessed July 7, 2020. http://www.mountsinai.org/about/covid19/staff-resources/well-being