PCORI Biweekly COVID-19 Scan: Mental Health Services and Reducing Stress for Health Care Workers (February 6-19, 2021)
The Briefing provides an at-a-glance view of some important developments in the information universe surrounding COVID-19. The views presented here are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders.
Attention is beginning to shift to future viral threats—including SARS-CoV-2—and how we can prevent them.
In a Nature survey of 119 immunologists, infectious disease researchers, and virologists from 23 countries, almost 90% think that SARS-CoV-2 might continue to circulate for years. At risk are regions with poor vaccine distribution or uptake and where viral mutations have evaded natural or vaccine immunity, as well as among those who have had COVID-19 or have been vaccinated against the current coronavirus but who experience waning immunity.
With an eye on the future, the current US administration’s COVID-19 strategy includes a plan to support a National Center for Epidemic Forecasting and Outbreak Analytics modeled on proposed improvements to “outbreak science.” The goal is to centralize prediction of viral threats the way the National Weather Service centralizes prediction of weather threats. Other emerging concepts include the creation of a global serologic surveillance system using blood samples collected during other routine lab tests and the use of metagenomics to spot novel pathogens early enough to perhaps prevent a future pandemic.
Here and now, people are still coping with the toll of this pandemic. Health care workers’ own words reflect the trauma and exhaustion that they are facing (see Topics to Watch for some systems changes that might help them manage) while COVID-19 is causing a global spike in depression and anxiety throughout society.
ECRI Horizon Scanning has selected the topics below as those with potential for impact relative to COVID-19 in the United States within the next 12 months. All views presented are preliminary and based on readily available information at the time of writing.
Because these topics are rapidly developing, we cannot guarantee the accuracy of this information after the date listed on this publication. In addition, all views expressed in the commentary section are solely those of ECRI Horizon Scanning and have not been vetted by other stakeholders. Topics are listed in alphabetical order.
Emotional PPE Project to Facilitate Healthcare Worker Access to Mental Health Services
At a Glance
- The Emotional PPE Project is a nonprofit organization that seeks to connect health care workers whose mental health has been negatively impacted by the pandemic with free licensed mental health professionals for services.
- Mental health professionals sign up on the project’s website to volunteer their services and are listed in a database on the website that is searchable by state.
- Health care workers connect with a mental health professional, and sessions are conducted via telehealth and under the liability and malpractice insurance already held by the provider.
- Providers available through the project include clinical psychologists, licensed professional counselors, marriage and family therapists, neuropsychologists, psychiatrists, and social workers.
The Emotional PPE Project is a nonprofit organization that began shortly after the onset of the ongoing COVID-19 pandemic. It connects health care workers whose mental health has been impacted by the COVID-19 crisis with licensed mental health professionals for services at no cost.
The Emotional PPE Project intentionally left the definition of a health care worker vague, considering the mental health impact that COVID-19 has had on many professions and populations. Health care workers can search their state in a database to find a mental health professional and their contact information. Sessions are conducted via telehealth and under the liability and malpractice insurance already held by the provider.
Mental health professionals sign up at the project website to volunteer their services. After license verification, they appear in the database on the project website. The mental health providers choose which clients they take on and how many. Health care workers search by their state to find participating providers available through the Emotional PPE Project, including clinical psychologists, licensed professional counselors, marriage and family therapists, neuropsychologists, psychiatrists, and social workers.
The COVID-19 pandemic has negatively impacted the mental health of health care workers. Unfortunately, health care workers often hesitate to seek mental health care due to stigma within the medical community or concerns that a documented mental health diagnosis might affect their medical licenses. The Emotional PPE Project aims to help provide mental health care to health care workers, fight stigmas, and encourage care in a community that often hesitates to seek it through more traditional routes.
Early feedback from ECRI internal stakeholders suggested the discreet, free, and telehealth-based aspects of the Emotional PPE Project give it substantial potential to improve the accessibility and decrease disparities for mental health care for health care workers. It's noteworthy that all health care workers can use the service, not just frontline personnel. Preserving the mental health of all health care workers through effective initiatives is important for treating patients who have COVID-19 during the pandemic as well as ensuring we keep an adequate workforce after the pandemic.
- Categories: Systems and management
- Areas of potential impact: Patient outcomes, population health, clinician and/or caregiver safety, health care delivery and process
Recharge Rooms to Reduce Stress in Frontline Health Care Workers
At a Glance
- Recharge rooms are spaces designed for rest and rejuvenation for frontline health care workers impacted by attention fatigue, burnout, and moral injury from the pandemic.
- Researchers at the Icahn School of Medicine, in collaboration with Studio Elsewhere, created recharge rooms to provide a multisensory experience. The rooms are outfitted with artificial plants, relaxing furniture, music, nature sounds and scenes projected on a wall, and calming scents diffused into the air.
- Health care workers who spent a single 15-minute stay in a recharge room reported a 60% decline in stress levels, and the rooms were highly regarded via net promoter score.
- Studio Elsewhere is continuing to develop recharge rooms, and some hospitals are creating their own versions (eg, Baptist Health Hardin).
Recharge rooms are spaces designed for rest and rejuvenation. The Abilities Research Center at the Icahn School of Medicine at Mount Sinai, in collaboration with Studio Elsewhere, created nature-inspired recharge rooms for frontline health care workers impacted by the COVID-19 pandemic. Decorated with artificial plants and relaxing furniture, the rooms provide a multi-sensory experience of soothing nature scenes projected on a wall, relaxing music paired with nature sounds, and calming scents diffused into the air. The rooms are intended to alleviate stress that contributes to attention fatigue, burnout, and moral injury experienced by frontline health care workers.
Researchers found that health care workers who spent a single 15-minute stay in one of their recharge rooms experienced an average 60% decline in self-reported stress levels, and the rooms were highly regarded via net promoter score. Studio Elsewhere is continuing research, development, and piloting of its recharge rooms and is interested in connecting with organizations looking to implement them. Some hospitals are creating their own version of recharge rooms (eg, Baptist Health Hardin).
Frontline health care workers have shouldered a large mental health burden during the COVID-19 pandemic due to supply shortages, the burden of witnessing severe disease and death with little recourse, and concerns about their own health and that of their families. Recharge rooms might help reduce the mental health burden on frontline workers and benefit the health care organizations that implement them. Mitigating employee fatigue, burnout, and turnover might help hospitals maintain the efficient, quality health care delivery needed to optimize patient outcomes through the pandemic.
Early feedback from ECRI internal stakeholders suggested that controlled studies are needed to determine the extent to which recharge rooms truly reduce stress, “recharge” health care workers, and improve overall mental wellbeing. Still, recharge rooms are relatively simple and quick to implement and could significantly improve health care workers’ mental health, improve patient care, and reduce stress on other clinical staff. Giving workers the time and space to breathe and release acute stress, rather than staying overwhelmed, could offer substantial mental health benefits.
- Categories: Systems and management
- Areas of potential impact: Patient outcomes, population health, clinician and/or caregiver safety
Horizon scanning is a systematic process that serves as an early warning system to inform decision makers about possible future opportunities and threats. Health care horizon scanning identifies technologies, innovations, and trends with potential to cause future shifts or disruptions—positive or negative—in areas such as access to care, care delivery processes, care setting, costs of care, current treatment models or paradigms, health disparities, health care infrastructure, public health, and patient health outcomes.
The PCORI Health Care Horizon Scanning System (HCHSS) conducts horizon scanning to better inform its patient-centered outcomes research investments. Initially, PCORI defined the HCHSS project scope to focus on interventions with high potential for disruption in the United States in 5 priority areas: Alzheimer’s disease and other dementias, cancer, cardiovascular diseases, mental and behavioral health conditions, and rare diseases. In addition, the system captures high-level disruptive trends across all clinical areas, which may lead PCORI to expand the project scope to include other priority areas in the future.
In early 2020, the COVID-19 pandemic created a fast-moving, widespread public health crisis. In May 2020, PCORI expanded its HCHSS to elucidate the landscape of potentially impactful applications for COVID-19. The HCHSS COVID-19 supplement scans for, identifies, monitors, and reports on emerging and available COVID-19-related treatments, diagnostics, preventive measures, management strategies, and systems changes with potential for high impact to patient outcomes—for individuals and populations—in the United States in the next 12 months.
The HCHSS COVID-19 supplement produces 3 main outputs:
- Biweekly COVID-19 Scans (eg, this document) provide ECRI Horizon Scanning with a vehicle to inform PCORI and the public in a timely manner of important topics of interest identified during ongoing scanning and topic identification or through the ECRI stakeholder survey process.
- Status Reports (quarterly) briefly list and describe all COVID-19-related topics identified, monitored, and recently archived.
- High Impact Reports (every 4 months) highlight those topics that ECRI internal stakeholders (eg, physicians, nurses, allied health professionals, public health professionals, first responders, health systems experts, clinical engineers, researchers, business and finance professionals, and information technology professionals) have identified as having potential for high impact relative to COVID-19 in the United States.
Commentary in this COVID-19 Scan reflects preliminary views of ECRI Horizon Scanning and internal ECRI stakeholders.
The information contained in this document has not been vetted by other stakeholders.
We welcome your comments on this Scan. Send them by email to [email protected].
Posted: February 24, 2021
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