Mary Elliott
Dr. Mary Elliott, a psychiatrist at Princess Margaret Cancer Centre, is lead author of the study showing the CREATE framework improves the emotional tone of teams. (Photo: UHN)

Team members supporting each other is key in preventing burnout and bolstering mental well-being of healthcare workers during the pandemic, according to new research.

Early results in a study published in NEJM Catalyst show an institutional framework that facilitates team-based intervention to foster connection and resilience positively impacts the emotional tone of teams over time.

"At the beginning of the pandemic, we observed a high state of anxiety driven by that 'fight, flight, freeze' response," says Dr. Mary Elliott, lead author of the study, and psychiatrist at Princess Margaret Cancer Centre. "Over time, sustaining that becomes next to impossible.

"It is crucial for people to not feel isolated as the pandemic goes on."

Healthcare workers have faced shifting stressors over the past year, from having access to personal protective equipment, fear of exposure to COVID-19, managing patient despair, concerns about exposing their family, and balancing increased workload if colleagues are off sick.

The framework, coined CREATE—Compassion, REsilience, And TEam-building— delivers psychological first aid support to teams, aiming to reduce the prevalence of anxiety, anger, depletion, while boosting feelings of engagement, confidence, or connection. The results also showed a reduction in requested sessions, indicating an increase in team resilience over time.

Gary Rodin
Dr. Gary Rodin is the inaugural Director of Cancer Experience at UHN, aiming to elevate the comfort and confidence of our staff, learners and patients. (Photo: UHN)

CREATE pairs psychosocial coaches (PSCs) – made up of volunteer providers from psychiatry, psychology, occupational therapy, music therapy, and spiritual care – with clinical managers to deliver tailored support to each team, with interventions including:

  • Addressing emotional needs by normalizing and validating the challenging emotions and stressors that have come with the pandemic
  • Delivering evidence-based calming strategies like meditation and breathing exercises
  • Institutional advocacy through confidential relay of concerns to hospital leadership
  • Providing psychoeducation resources relevant to team needs
  • Tripartite coping, incorporating strategies of emotion-focused, problem-focused, and meaning-focused coping
  • Expanding on an existing organization program BRITE, aiming to cultivate resilience through multiple micro-practices

When healthcare workers are mentally healthy and engaged, it translates to better quality care and a more positive patient experience.

"We know that the wellbeing of staff and the well-being of patients and their families are all interconnected," says Dr. Gary Rodin, Director of Cancer Experience at UHN. "Staff that are overwhelmed, distressed, or burnt-out are going to have difficulty providing their best care.

"We must think of ourselves and those we care for as all in it together."

The use of the CREATE framework is now expanding beyond the Princess Margaret; with a request to train PSCs for the Toronto Western Hospital's intensive care unit and interest from outside of UHN.

"We have a systematic approach to treating disease of all kinds," says Dr. Rodin. "We need to approach staff well-being and mental health in the same way." 

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