Preserving Organizational Resilience, Patient Safety, and Staff Retention during COVID-19 Requires a Holistic Consideration of the Psychological Safety of Healthcare Workers

Int J Environ Res Public Health. 2020 Jun 15;17(12):4267. doi: 10.3390/ijerph17124267.


During the COVID-19 pandemic, healthcare workers are fighting a lethal virus with acute shortages of Personal Protective Equipment (PPE). These unprecedented circumstances have amplified the sources of emotional distress and worker burnout. However, many healthcare organizations (HCOs) in the United States, have opted for a "stoic approach" to healthcare worker support, i.e., no additional support beyond federal and state policy protections for the licensing and liability of healthcare workers. In this scenario, a key public health concern is sustaining an adequate healthcare workforce, both by way of quantity (adequate numbers) and quality (maximizing clinician resilience to provide safe care to large volumes of patients under challenging conditions). Therefore, it is imperative for HCO leaders to recognize that a limited view of worker psychological safety, without due consideration for the broader emotional distress created by the pandemic, could have the effect of restricting organizational resilience and adversely impacting patient safety and staff retention during and beyond the pandemic. This paper uses the organizational resilience framework to discuss the potential impact of a stoic approach to healthcare worker support on patient safety and staff retention in a hospital intensive care unit (ICU) during COVID-19. The discussion in turn, helps to develop recommendations for HCOs to overcome these challenges.

Keywords: COVID-19; hospital intensive care; leadership; mental health; organizational resilience; patient safety; staff retention; worker psychological safety.

MeSH terms

  • Betacoronavirus
  • Burnout, Professional
  • COVID-19
  • Coronavirus Infections / psychology*
  • Health Personnel / psychology*
  • Health Workforce
  • Hospitals
  • Humans
  • Intensive Care Units / organization & administration*
  • Organizational Culture
  • Pandemics
  • Patient Safety*
  • Personal Protective Equipment / supply & distribution
  • Personnel Turnover
  • Pneumonia, Viral / psychology*
  • SARS-CoV-2