Enhancing the well-being of front-line healthcare professionals in high pressure clinical environments: A mixed-methods evaluative research project

Abstract

Background: The last few years have witnessed a growing concern with the well-being of healthcare professionals internationally because of increasing recognition of its impact on patient outcomes and staff retention. The COVID-19 pandemic, which has placed additional and substantial pressure on frontline healthcare professionals, gives added urgency to the topic. While numerous, and successful, interventions have been developed to address compromised well-being among healthcare professionals, they have not always been able to support the needs of frontline staff, specifically those working in high-pressure environments.

Objective: This paper presents findings of an evaluative research study of an intervention, named the Resilience and Well-being Training Programme, developed and implemented within an Acute Assessment Unit in a hospital in the UK. The 8 week-long programme followed a combined approach (both person-directed and work-directed), with mindfulness training as well as lectures and discussions to deepen participants' understanding of organisational life. The training, delivered from January to July 2018, involved a total of 72 healthcare professionals from a wide range of levels (UK bands 2-8), trained in three cohorts.

Design: The research followed a pre-post design to explore participants' experiences of working on the Unit, the programme and its impact on themselves and their working life.

Setting: The study was conducted in a large NHS district general hospital in South London, UK.

Participants: Participants included healthcare assistants and nurses who had completed their preceptorship, worked in the hospital's acute assessment unit, and had undertaken the resilience and well-being training programme.

Methods: The study employed mixed methods (online questionnaire, face-to-face focus groups/interviews) to collect data.

Results: Findings showed participants' positive experience with the programme, however it had limited positive impacts on aspects of compromised well-being at the personal level and a statistically significant enhancement of the quality of relationships and communication on the Unit, with medium effect size (Cohen's D). The programme had a positive impact on the culture of the Unit.

Conclusions: Results highlight the demand for and value of programmes designed in ways that enable this group of professionals to take part, because these professionals are often not able to participate in such programmes. A strong commitment from the leadership to enable staff attendance in time-protected programmes is one approach that works well in the short-term. However, this may be challenging to accomplish and raises issues of sustainability.

Keywords: Acute care; Healthcare professionals; Nurse; Systems-psychodynamic organisational interventions; Well-being at work; Well-being interventions.