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Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

Abstract Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff.
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Authors

Mayor MeshTerms

Mental Health

Keywords
Journal Title plos one
Publication Year Start




PMID- 29200422
OWN - NLM
STAT- MEDLINE
DCOM- 20171229
LR  - 20171229
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Whole-system approaches to improving the health and wellbeing of healthcare
      workers: A systematic review.
PG  - e0188418
LID - 10.1371/journal.pone.0188418 [doi]
AB  - BACKGROUND: Healthcare professionals throughout the developed world report higher
      levels of sickness absence, dissatisfaction, distress, and "burnout" at work than
      staff in other sectors. There is a growing call for the 'triple aim' of
      healthcare delivery (improving patient experience and outcomes and reducing
      costs; to include a fourth aim: improving healthcare staff experience of
      healthcare delivery. A systematic review commissioned by the United Kingdom's
      (UK) Department of Health reviewed a large number of international healthy
      workplace interventions and recommended five whole-system changes to improve
      healthcare staff health and wellbeing: identification and response to local need,
      engagement of staff at all levels, and the involvement, visible leadership from, 
      and up-skilling of, management and board-level staff. OBJECTIVES: This systematic
      review aims to identify whole-system healthy workplace interventions in
      healthcare settings that incorporate (combinations of) these recommendations and 
      determine whether they improve staff health and wellbeing. METHODS: A
      comprehensive and systematic search of medical, education, exercise science, and 
      social science databases was undertaken. Studies were included if they reported
      the results of interventions that included all healthcare staff within a
      healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective
      activities to improve physical or mental health or promote healthy behaviours.
      RESULTS: Eleven studies were identified which incorporated at least one of the
      whole-system recommendations. Interventions that incorporated recommendations to 
      address local need and engage the whole workforce fell in to four broad types: 1)
      pre-determined (one-size-fits-all) and no choice of activities (two studies); or 
      2) pre-determined and some choice of activities (one study); 3) A wide choice of 
      a range of activities and some adaptation to local needs (five studies); or, 3) a
      participatory approach to creating programmes responsive and adaptive to local
      staff needs that have extensive choice of activities to participate in (three
      studies). Only five of the interventions included substantial involvement and
      engagement of leadership and efforts aimed at up-skilling the leadership of staff
      to support staff health and wellbeing. Incorporation of more of the
      recommendations did not appear to be related to effectiveness. The heterogeneity 
      of study designs, populations and outcomes excluded a meta-analysis. All studies 
      were deemed by their authors to be at least partly effective. Two studies
      reported statistically significant improvement in objectively measured physical
      health (BMI) and eight in subjective mental health. Six studies reported
      statistically significant positive changes in subjectively assessed health
      behaviours. CONCLUSIONS: This systematic review identified 11 studies which
      incorporate at least one of the Boorman recommendations and provides evidence
      that whole-system healthy workplace interventions can improve health and
      wellbeing and promote healthier behaviours in healthcare staff.
FAU - Brand, Sarah L
AU  - Brand SL
AD  - European Centre for the Environment and Human Health, University of Exeter
      Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, England,
      United Kingdom.
AD  - Y Lab Public Service Innovation Lab for Wales, School of Social Sciences, Cardiff
      University, Cardiff, Wales, United Kingdom.
FAU - Thompson Coon, Jo
AU  - Thompson Coon J
AD  - University of Exeter Medical School, South Cloisters, St Lukes Campus, Exeter,
      Devon, England, United Kingdom.
FAU - Fleming, Lora E
AU  - Fleming LE
AD  - European Centre for the Environment and Human Health, University of Exeter
      Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, England,
      United Kingdom.
FAU - Carroll, Lauren
AU  - Carroll L
AD  - Y Lab Public Service Innovation Lab for Wales, School of Social Sciences, Cardiff
      University, Cardiff, Wales, United Kingdom.
FAU - Bethel, Alison
AU  - Bethel A
AD  - University of Exeter Medical School, South Cloisters, St Lukes Campus, Exeter,
      Devon, England, United Kingdom.
FAU - Wyatt, Katrina
AU  - Wyatt K
AD  - University of Exeter Medical School, South Cloisters, St Lukes Campus, Exeter,
      Devon, England, United Kingdom.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20171204
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Burnout, Professional/*prevention & control
MH  - Delivery of Health Care/*organization & administration
MH  - Health Personnel/*psychology
MH  - Health Promotion/*methods
MH  - Humans
MH  - Leadership
MH  - *Mental Health
MH  - United Kingdom
MH  - Workplace/*psychology
PMC - PMC5714334
EDAT- 2017/12/05 06:00
MHDA- 2017/12/30 06:00
CRDT- 2017/12/05 06:00
PHST- 2017/06/14 00:00 [received]
PHST- 2017/11/07 00:00 [accepted]
PHST- 2017/12/05 06:00 [entrez]
PHST- 2017/12/05 06:00 [pubmed]
PHST- 2017/12/30 06:00 [medline]
AID - 10.1371/journal.pone.0188418 [doi]
AID - PONE-D-17-22702 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 4;12(12):e0188418. doi: 10.1371/journal.pone.0188418.
      eCollection 2017.