What factors lead to resilient healthcare teams?

Psychological resilience, “the human ability to adapt in the face of tragedy, trauma, adversity, hardship, and ongoing significant life stressors,”[1] is thought to be a state of internal balance where “we are at our best, able to learn, solve problems, and work effectively with others”, resulting in better patient outcomes, and less employee burnout and turnover.[2]

Leadership techniques for team resilience training have been researched. One study found that managers addressed difficult situations by “facilitating teamwork through goalsetting, problem-solving and circumventing the technical systems’ limitations”, noting that increased team collaboration is supported by “team members’ abilities to predict the behavior of each other.”[3] Other strategies include “those that: a) foster connections within the team; b) provide education and training to develop behaviors that assist in controlling or limiting the intensity of stress, or aiding recovery; and c) assist in processing emotion and learning from experiences.”[4]

Additionally, in workshops, medical residents found greater personal strength from the group experience when they reflected on difficult cases and discussed them as a group, along with reviewing the “4 S’s” of resilience (Supports, Strategies, Sagacity [what wisdom did they gain], and Solutions to the problem).[5]

Resiliency is a factor for team success outside of healthcare as well. A Harvard Business Review survey[6] of 2,000 National Collegiate Athletic Association (NCAA) basketball coaches found that,

The “characteristics of a resilient team are:

  • They believe they can effectively complete tasks together.
  • They share a common mental model of teamwork.
  • They are able to improvise.
  • They trust one another and feel safe.”
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What strategies can hospital administrations take to alleviate and prevent psychological issues encountered by clinicians on the Covid-19 frontlines?

Clinicians caring for Covid-19 patients have shown multiple signs of stress including anxiety, depression and sleep disturbance.1 Predictors of these adverse effects include young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support.2

Issues in COVID-19 care that may provoke these problems include “limited information about COVID-19, unpredictable tasks and challenging practices, insufficient support, concerns about family, and emotional and psychological stress”3, as well as “working in an isolated environment, concerns about personal protective equipment shortage and usage, physical and emotional exhaustion, intensive workload, fear of being infected, and insufficient work experiences with COVID-19.”4

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