Coping and Caregiving: Leveraging Environmental Design to Moderate Stress Among Healthcare Workers in the Emergency Department Setting.

BACKGROUND: Due to exposure to overwhelming work stressors, approximately half of emergency department (ED) physicians and nurses experience burnout, leading to lower productivity, lower quality of care, higher risk of medical errors, higher rates of absenteeism, and eventually turnover. Growing evidence suggests that the physical environment can be leveraged to support healthcare workers' well-being. OBJECTIVES: This study aimed to identify (1) self-care behaviors that healthcare workers engage in to help them cope with job-related stress, (2) where they engage in those behaviors, (3) attributes of the built environment that may support coping behaviors. METHODS: A mixed-methods study was conducted in three EDs, using online questionnaires (n = 85) and interviews (n = 20). RESULTS: Job-related stress was derived from interruptions, workload and inability to take breaks, insufficient workspace, lack of privacy, unpredictability of EDs, and security concerns. Talking with a colleague, getting something to eat or drink, listening to music, and taking a walk were considered destressing activities. The bathroom was considered a place for destressing by the majority of participants, followed by outside areas, physician-only areas, and care team stations. Supportive environmental features included sufficient workspace, maximized privacy, reduced noise and clutter, controlled temperature and lighting, spaces for decompressing, spaces for documentation, close-by breakrooms with enough eating space and massage chairs, chairs with back support, standing desks, food options, and convenient bathrooms. CONCLUSIONS: Design decisions play an important role in supporting stress reduction among healthcare workers. This study provides several strategies to achieve this aim.

Nothing about us, without us: An inclusive preparedness programme for the whole community from inception to sustainment.

Nearly one fifth of the US population has a disability that impacts their communicative, mental or physical function. There are often not enough opportunities for people with disabilities to receive basic emergency preparedness training to help them be more resilient in times of crisis as preparedness education typically targets the general population. The Kent County Health Department, in collaboration with local disability advocates and preparedness educators, developed an inclusive preparedness programme to provide basic preparedness training for the whole community. This paper describes the evolution of the programme along with lessons learned by the participants and instructors.