With another nationwide spike in Covid-19 cases upon us, provider organizations continue to look for guidance on how to help their staff deal with the emotional burden of providing care during an epidemic. We spoke with Dr. Cal Paries and Dr. Di Thompson, two of the leaders of Centura Health's employee support programs to learn about how Centura is managing this work.
Centura's comprehensive approach offers four lessons for how organizations should think about supporting their people both during Covid-19 and beyond:
Be nimble with your service offerings
"A big part of this is being flexible. Every day we review what our team is seeing and hearing, then we develop our next approach based on what we find. We're going to keep trying different things."
In response to Covid-19, Centura has adjusted and readjusted its service offerings to meet evolving staff needs.
At first, counseling offered by the employee assistance program (EAP) went virtual, much like primary care visits. Then, the EAP introduced open virtual group support sessions facilitated by licensed EAP therapists to provide a space for staff to communally process their experiences.
After the first few weeks, the EAP team identified common themes emerging from the sessions and curated topic-specific, closed (i.e., registration required) group psycho-education sessions. Topics included moral injury; basics for normal living during a pandemic; fear, anxiety, and anger; adjusting expectations; managing stress; emotional protection and 'grieving the old normal;' and challenges of working from home. They also offered role-specific groups (e.g., for nurses, physicians).
Next, the EAP will offer a therapy curriculum to address issues that are on the rise as a byproduct of the pandemic: domestic violence (physical and emotional), substance abuse, and suicidal ideation.
But group therapy is just one avenue of offerings Centura has rolled out through different employee support teams. The health care system also introduced text-based behavioral health support, broadcast regular webinars on topics related to emotional resilience and wellbeing, and provided more individually targeted support. For example, after a group of nurses traveled to a New Jersey hospital to provide emergency surge staffing, Centura offered counseling to the nurses and their families and conducted sensitivity training for their teammates and leadership to help ease the transition back. As the pandemic evolves, so will the support mechanisms.
'Silo bust' to get the most of your internal resources
Close collaboration among Centura's teams dedicated to employee support has enabled the system to create a durable safety net for its staff and iterate on the services it offers. Employee support is offered through several channels: human resources (HR), EAP, physician wellness, spiritual care, occupational health, and teams dedicated to people and culture, work life, and wellness. Throughout the Covid-19 crisis, leadership over the different offices have maintained open lanes of communication, which allowed leaders to identify opportunities to work together to provide needed services.
For example, Thompson, head of physician wellness and a trained psychiatrist, raised her hand to facilitate a group session with a group of physicians struggling with a matter related to Covid-19. She coordinated the HR, EAP, and people and culture teams to assist. And when EAP expressed interest in piloting a peer support group for nurses, an advanced practice provider trained through the physician wellness' peer-coaching program offered to take the lead.
Expand support beyond clinicians
"A lot of times we focus solely on nurses and doctors, but we need to remember to help those who help everyone else—our spiritual care teams need to know we're there for them."
A few weeks after the epidemic hit Colorado, chaplains approached Paries, the director of Centura's EAP, asking for help. "Some of our chaplains…said they were struggling," Paries said."They were trying to support families, but they couldn't do it in the same way. They couldn't be there when the babies were born, or even when patients were dying. And they were having a hard time with that."
In response, EAP created a series of behavioral wellness seminars for the spiritual care team. EAP also worked with Centura's integrated behavioral health team to set up a weekly virtual support group for chaplains. Each week had a different theme to ground the conversation—resilience, emotional support, psychoneuroimmunology—but participants were free to guide the conversation to other topics of interest. And Paries pointed out, because the group was virtual, they were able to include staff from all of Centura's markets. While most staff are located in Colorado, the virtual support group included chaplains from its hospitals in western Kansas (including itshospital in Garden City, which dealt with a Covid-19 outbreak from a local meatpacking plant).
As the epidemic wore on and Covid-19 case volumes dropped, the group decided to change the cadence of its meetings to every-other week. But regardless of cadence, the peer-support group remains a safe, healthy, trusting place for chaplains to process their experience and take comfort in the shared experience of others.
Use all avenues to get the word out
Employee-support leaders work closely with individuals across Centura to make sure staff are aware of the resources and services available to them. The marketing team advertises services in the various hospital newsletters and on the intranet and system website. System leadership offers Thompson a standing slot at Covid-related leadership meetings (of around 200 system leaders) to talk about physician wellness and plug available resources. Physician groups and department leaders also host Thompson for virtual rounds to discuss wellness with frontline staff and raise awareness of the resources available to them and their teams.
Next, employee support leaders are looking to use social media to directly reach even more of their staff.