When one thinks of the impact that the COVID-19 pandemic had on healthcare workers, the first thought that comes to mind is the frontline worker. This is not a surprise, considering they are the direct care givers and the recognized staff that is most greatly impacted by the patient experience. This is also reinforced with most of the research regarding mental health and the pandemic focusing on frontline staff. It may surprise you to know that the impact of COVID-19 patients and outcomes, has also greatly affected non-clinical workers – particularly the health information management (HIM) staff.
Health Information Management staff includes those in medical records, clinical documentation specialists, medical coders, auditors, etc. These are the people behind the scenes that organize the medical records, ensuring that clinical documentation is accurate and complete. They ensure that the patient’s story is clearly expressed in the medical record to support coding, billing, and even regulatory compliance. They experience the patient story through codes, forms, and documentation.
Even though they are not face to face with the patients, research studies have shown that these healthcare workers are feeling the weight of not only the COVID-19 diagnosis, but also the impact of all diagnosis and care provided. The HIM staff reads the traumas, the cancer diagnosis, the code blues, the fetal demise and more. What the frontline staff lives through, the HIM staff reads through. COVID-19 has also brought a new, more isolated work environment, with many positions transitioning to working remotely. The transition to remote work, also brought up stress incurred with rapidly changing expectations of a work from home environment, including home office needs, no separation of work and home life, as well as procrastination, ineffective communication, and social isolation. This has resulted in increased anxiety, depression, burn-out, insomnia and a decrease in support as well, as for many, there is no outlet to share the emotions of the weight of patient care experiences that are processed by these staff members.
There has been an increased focus on mental health support for frontline workers. Organizations have created and presented support groups, counseling, quiet rooms, and more innovative support programs, not to discount the value of comradery on a day-to-day basis. This allows for frontline staff to debrief with each other, to have someone to share feelings and release stressful experiences, without HIPPA violations. Non-clinical staff is often not the focus of mental health support programs and debriefs. Their exposure to the depth of the patient care experience is often not acknowledged, because of the lack of understanding of the positions, impact the job requirements on the staff and the reality that these staff members are not seen day to day.
Weibelzahl, S et al, in their article “Depression and Anxiety in Healthcare Professionals during the COVID-19 Pandemic”, noted that anxiety and depression was significantly increased when compared to non-clinical staff pre-pandemic. While the psychological effects of the pandemic were notable, these professionals indicated that they would not seek help for their new or increased psychological concerns.
Unfortunately, these psychological effects of the pandemic may continue for a time after the pandemic ends. “Disaster models predict continued stress, exhaustion, and burnout. This can increase the risk of depression, anxiety, sleep disturbances, and even substance abuse, particularly for employees who have poor coping strategies such as self-blame or avoidance. This can impact employee work, causing reduced productivity or increased absences. While some stressors related to the early days of the pandemic with higher uncertainty and more extreme isolation are becoming less relevant, those related to morale distress, personal safety, economic uncertainty, and a sense of powerlessness still linger.” (Sand, J.) This is an indication for all organizations to be aware of and pay greater attention to the mental health of all staff, including non-clinical team members.
References
Sand, J. “Impact of the COVID-19 Pandemic on HIM Professionals in a Rural State.”, Perspectives in Healthcare Management, vol.19, issue 2, online edition.
Sand, J. “Impact of the COVID-19 Pandemic on HIM Professionals in a Rural State.”, Perspectives in Healthcare Management, vol.19, issue 2, online edition.
Sovold, Naslund et al. “Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority.” Front. Public Health, 07 May 2021, https://doi.org/10.3389/fpubh.2021.679397
Sun, Ping et al. “The Psychological Impact of COVID-19 Pandemic on Health Care Workers: A Systematic Review and Meta-Analysis.” Frontiers in Psychology vol. 12, 626547. 8 Jul. 2021, doi:10.3389/fpsyg.2021.626547
Weibelzahl, S et al. “Depression and anxiety in healthcare professionals during the COVID-19 pandemic.” Epidemiology and Infection, vol. 149 e46. 9, Feb. 2021.