key: cord-0694365-d6xsjesm
authors: Kerketta, A.; A.N, R.
title: The HR Challenges: Building Workplace Resilience in the Healthcare Industry During the COVID-19 Pandemic - A Systematic Review
date: 2022-02-04
journal: nan
DOI: 10.1101/2022.02.03.22270380
sha: 3a218b0f737892343d591ded09e5b21a9a0ab1f9
doc_id: 694365
cord_uid: d6xsjesm

Abstract The COVID-19 outbreak has wreaked havoc worldwide, disrupting industries and life, posing hitches for organizations, stakeholders and common people. The viable workplace and smooth living have been challenged and forced the organizations to introduce an innovative, imaginative, and comprehensive approach to respond to the challenges. The companies have been striving hard to adjust to the new normal. At the same time, the government, on the other hand, is trying to normalize the situation for the general public. Industries have maintained their services by implementing a work-from-home strategy. However, for the healthcare industry, it was not an option. Though telemedicine/consultation was hailed as a solution, but in low-income countries, it was met with failure, forcing health personnel to contact patients personally. However, this has jeopardized health workers' lives and resulted in a human resource shortage. Nevertheless, the study aimed to identify HR challenges and interventions to create a resilient workplace. Nonetheless, following a systematic review from 17 databases, the HR challenges and strategic responses for a workable workplace have been highlighted. The results identified are shown in the table enlisting as challenges, manifestation, strategy, and different levels of the interventions. Furthermore, HR professionals devised a plan for the employees to rejuvenate and refresh themselves from stress and weariness by doing meditation yoga sessions that gave physical and mental support. All of these techniques contributed significantly to a stable working environment.

The COVID-19 pandemic has resulted in a significant loss of human life worldwide and has posed unexpected challenges to public health, the food system, and the workplace. and they deserve to be acknowledged. (6) On the other hand, the article provides a deep sense of recognition to non-clinical professionals who work in a healthcare organization, not as direct patient care providers but as indirect healthcare providers. Thus, the study narrows the field from non-clinicians to HR professionals, highlighting the challenges of building a resilient workplace in the healthcare industry, which is now undergoing severe disruption because of the COVID-19 outbreak.The healthcare organizationswere inundated with patients, and the shortage of infrastructure, human capital, and other resourceshampered the provision of healthcare services. The restructuring of the healthcare system to the requisite standard was a struggle, and this is where HR managers played a crucial role, albeit they aren't given as much credit as clinical doctors. In the present context, resiliency has become a new approach. (7) , and healthcare sectors are strongly obliged to adjust to this new normal. As a result, HR managers areladen with the responsibilityof engaging healthcare employees, embracing digitization, reducing costs while withstanding efficiency, and gaining access to new technologies thatstress and lead them to an apprehensive normal.The epidemic undoubtedly has troubled healthcare activities for nearly two years, and the existing strategiesare ineffective for ensuring the safety and protection of healthcare workers. However, HR personnel has a huge loadon their shoulder rebuilding a resilient workplace.Several studies have beendone on clinicians' psychological impact(7) physical and mental effects(8) of the COVID-19 pandemic. Not manystudieshave been found onHR personnel whowere equally exposed to the risk during a pandemic. Therefore, the study intends to recognize and give credit to HR personnel for their unwavering contributions to the healthcare industry. They have shown great courage and . CC-BY 4.0 International license It is made available under a perpetuity.

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The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint commitment in successfully establishing sustainable and resilient workplaces. The project took six months to complete; since then, there has been a lot of progress and growth and the possibility of more research.

The whole cosmos is confronted by unprecedented healthcare delivery challenges and a public health emergency. The COVID-19 pandemic has disturbed the healthcare system, putting pressure on healthcare providers to deliver high-quality, comprehensive care. HR strategy and the healthcare system have failed to meet demand, putting HR managers and healthcare professionals under a lot of stress. (8) It was challenging for HR managers to maintain existing strategies despite everyday problems, and remote healthcare delivery was not an option.It was challenging to motivate and engage healthcare professionals whose mental health and well-being had been affected and at an increased risk of stress, burnout, moral harm, depression, trauma, and other mental health issues. (9) The composite database incorporated numerous national and sub-national reports to provide the most up-to-date information for a country like India. Discrepancies such as date range overlap or disputes between the federal and sub-national levels resulted in inconsistent and unstable recommendations, posing another problem for administrations. (10) According to who guidelines on "Workplace Risk Assessment," the COVID-19 pandemic is mostly spread through respiratory droplets and contact with contaminated surfaces, according to WHO guidelines on "workplace risk assessment." As a result, occupational exposure can occur at any workplace. During work-related travel to and from a location with local community transmission.

Contaminated objects or surfaces constantly expose a risk.COVID-19 could be transmitted to anyone who came into close contact with someone infected. Therefore, the probability of . CC-BY 4.0 International license It is made available under a perpetuity.

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The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint COVID-19 transmission in human contact is higher. (11) Accepting the danger of COVID-19 infection among medical professionals required administrative and HR strategies to address and thoroughly investigate the challenges. Another WHO recommendation combines human resources for health managers and policymakers at the national, sub-national, and facility levels to develop, manage, and sustain the health workforce required to combat the covid-19 pandemic, maintain vital health services, and safeguard the public.HR practitioners confront substantial difficulties in putting existing ideas into practice in this area. During the covid-19 epidemic, high turnover rates, staff shortages, record compliances, healthcare worker safety, training, and development were all issues in the healthcare industry.(12) Above all, HR staff had to deal with workplace stress, a problem at work, and a threat to physicians' lives, all while alleviating the COVID-19's dread at work. (13) The assurance of support and security instilled confidence in the medical personnel.Frontline healthcare workers who were victims of violence, mental stress, and verbal and nonverbal threats faced similar issues. People were frightened when they came into close contact with non-infected workers, and the general public labeled them as "newer untouchables." (14) To combat the pandemic, the government- is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint and emotional problems presented extra challenges for administrative and HR managers, who needed to address the issue right away.

 What hurdles were HR managers in the healthcare organization experienced during the COVID-19 pandemic?

 How did HR managers in the healthcare sector sustain organizational resilience?

 To determine the issues that hospital HR managers experienced during the COVID-19 epidemic.

 To examine how healthcare workers established workplace resilience in the face of the COVID-19 pandemic.

The research was carried out as a systematic review, with data extracted from 17 distinct databases and name these databases are: Google Scholar, BMC, WHO's BMJ Open, Springer, Elsevier, Emerald Insight, Wiley, MDPI, and ResearchGate is the most commonly utilized databases for mining. Reading the titles, which posed the COVID-19 epidemic as a challenge for HR managers, yielded the information. "HR challenges during the COVID-19 pandemic in healthcare industries," "workplace resilience in healthcare industries," "COVID-19

Pandemic: HR challenges and resilience in the healthcare sectors," and "what are the HR challenges during the COVID-19 pandemic and workplace resilience" were among the titles used in the data search.A PICO framework was employed for a quantitative study's design (P-Population, I-Intervention, C-Comparison, and O-Outcome). However, the studyis an intervention study; qualitative research was the best option, with 'P' denoting population, 'I' . CC-BY 4.0 International license It is made available under a perpetuity.

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The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint denoting interest, and 'CO' denoting context. In evidence-based healthcare, systematic qualitative reviews are becoming more prevalent. The PICO research tool was used to conduct qualitative literature searches; despite particular challenges, it showed higher sensitivity and equal or lower specificity than SPIDER searches. (17) 

The researcher omitted non-healthcare-related literature n= (81-60=21) from being screened for eligibility in inclusion because the study's goal was to review the literature on HR difficulties and workplace resilience in the healthcare field. After a full-text study, n= (60-28=32) were curtained, and n=32 was removed from the eligibility for the final literature is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint Exclusion However, the analysis eliminated studies published before the COVID-19 pandemic that dealt with HR difficulties, organizational resilience, and records available outside of the healthcare industry. Nonetheless, the analysis excluded non-healthcare-based publications published during the COVID-19 epidemic. As a result, the data was sparse and in small numbers.

The reviewer painstakingly imported material from each database into a single file using a sophisticated search method. Following that, two different files were created, one for healthcare and the other for non-healthcare. After that, all records were manually analyzed and filtered to remove non-healthcare-related and duplicated material. Finally, literature was imported that could be used in subsequent research. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

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A single investigator carried out all searches, browsed through titles and abstracts, and handpicked the data before entering them into the extensive database. The entire text was read comprehensively, and facts considered appropriate for usage were selected for further analysis.

The PICO model was employed to assess qualitative data in systematic review literature, is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint health system. As a result, healthcare companies must keep the public's faith in the system's ability to offer a safe and necessary employment environment while also reducing infection risk in health facilities. World Health Organization's vibrant advice is to ensure appropriate care-seeking behaviour and adherence to public and healthcare worker safety. (22) 

The global health sector faces a severe dilemma as the COVID-19 epidemic spreads rapidly among healthcare personnel. Managers ensure that the health workers are safeguardedand extended appropriate working conditions. WHO advisedto pay remuneration and incentives promptly on time. (22) 

To inform policy and make timely, evidence-based choices, the healthcare organization must implement surveillance systems and health information technology to track certain health workforce metrics. (22) 

Most organizations are operating on a digital platform during the COVID-19 pandemic; as a result, there is a lack of continuous business activities, employee safety, and consumer preferences, which HR managers are working hard to normalize.(23)The most complicated and crucial resilience-building component for maintaining a resilient workplace in any health system is administration and leadership, often known as stewardship. According to the World Health Organization, management and leadership are linked to the government's role in health and its relationships with other players involved in healthcare delivery. (24) . CC-BY 4.0 International license It is made available under a perpetuity.

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One of the most critical factors affecting the healthcare system's performance is human resource management. HR's function in health and health funding is to ensure that local health organizations' human resources are adequate to satisfy the demands of healthcare reform. (25)

Maintaining an adequate healthcare workforce is critical to ensuring a safe working environment for healthcare professionals (HCPs) and safe patient treatment. Due to HCP exposures, illness, or the necessity to care for a family member at home as the COVID-19 pandemic proceeded, staff shortages (Centres for Disease Control and Prevention, 2021).

Staff recruitment, turnover, retention, training, and development were all negatively impacted during the pandemic. Other issues that wreaked havoc on health care employees were safety concerns, violence, stigma, and digitization. (26) The components for a health workforce resilience in low-resource management is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint 

Obtaining the key components of infection prevention and control (IPC) measures, such as personal protective equipment (PPE), as well as suitable equipment and personnel. To is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint prevent COVID-19 transmission at work, health staff must be well-trained in IPC procedures, have personal protective care equipment (PPE), and adhere to mandatory safety measures.

HR managers had to determine if there was a threat, discrimination, violence, attacks, harassment, stigmatization, weariness, or insecurity in the workplace. COVID-19claimed to address healthcare workers' occupational health and safety while delivering health services. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

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The data acquired on the frontline working in COVID-19 wards management revealed more depression symptoms. Responding to the COVID-19 epidemic was a team effort, and losing a co-worker or family member demoralized the team. Creating an enabling work environment, monitoring and reinforcing acceptable behaviour, and optimizing process organization and burden are all things that may be done. (28) Enhancing the availability of health workers Policymakers, executives, administrators, HR managers, and trainers should plan for surges in caseloads and determine how to mobilize additional health workforce capacity.Determine crucial COVID-19 workforce requirements by quantifying task and time expenditures and combining them with epidemiological context and demographic data. Identify where to obtain more health workers redeploy existing ones, and establish infrastructure and health personnel.However, providing training to assist health workers in developing skills or retooling for new normal, including exploring realistic options that help build a workable workplace. (29) Organizing the healthcare workforce

The health industries must identify the most important processes within their orgnizations geography and functional structure, for their futher re-evaluation involving both management and employees. (30)Because COVID-19 has varying degrees of impact on the global health system that may change over time and temporary staffing may be beneficial, most medical, nursing, and healthcare organizations trainedworkers and interns to replace the employment deficit, ensuring that vital health services were available not disrupted. Also, to respond to the COVID-19 pandemic, redeploying employees from non-affected or low-intensity areas and from inside the health facility field or other clinical fields. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

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Imagine something unpleasant and unexpected, and the healthcare organization must prepare and plan for it.

By providing financial incentives, medical professionals and health workers should be recognized for putting their health in danger, being exposed to the COVID-19 pandemic, and caring for transmitted and suspected patients (31) .

The COVID-19 mandated that the policy-making process be streamed, that hospital partners be identified, and healthcare professionals be promoted, and therefore that duties be distributed among them to decrease workloads.

One of the biggest challenges for HR managers was engaging health workers effectively in the current situation. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint the COVID-19 manifestation, and strategy to control the COVID-19, and the building and maintenance of a workable working environment revolve around these three variables.To the best of the reviewer's knowledge, this is the first study of its sort, focusing on HR-related problems during COVID-19, identifying threats, and assessing the measures employed by HR managers to create workplace resilience. No study protocol has been violatedeven though the COVID-19 outbreak and the pressing need for scientific researchhad a rapid demand. On the other hand, the author has not broken the protocol in any way, both published or unpublished protocol. The broader search method, which took into account preprint and grey literature, did, however, provide a comprehensive review of the present corpus of knowledge.

The review procedure followed the internationally agreed-upon protocol PICO model framework to ensure an evidence-based healthcare-related study. However, because this study did not critically evaluate the articles included, conclusions on the quality of evidence cannot be drawn. All phases of the scoping review, which was outsourced for a second review, included extensive data mining.

Most of the studies in this review took place during or shortly after the COVDI-19 epidemic broke out. After a thorough search, articles were selected precisely from published sources, periodicals, and grey literature. The rapid spread of COVID-19, on the other hand, has sped up the literature on the impact and problems of the outbreak on healthcare personnel, both clinical and non-clinical, with a focus on patient care. Even while the situation is returning to normal, the healthcare industry remains concerned about the threat of a third wave. During the pandemic, many studies were done on the impact of coronavirus outbreaks on healthcare personnel, specifically doctors, nurses, lab technicians, and those directly involved in healthcare delivery.However, HR managers' psychological, emotional, physical, and mental health concerns as they seek to establish and maintain workplace resilience have not been thoroughly examined.During COVID-19, a study was conducted on building and maintaining . CC-BY 4.0 International license It is made available under a perpetuity.

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The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint the strength of healthcare professionals. It is a more extensive study in which all healthcare workers are involved in creating a viable work environment, and it does not just focus on HR managers' contributions. (8) World Health Organization has published guidelines, including "Getting your workplace ready for COVID-19" pandemic.(34) "COVID-19: Occupational health and safety for health workers" (12), and "Health workforce policy and management in the context of COVID-19 pandemic response," (35)"Pandemic resilience and health system preparedness: lessons from COVID-19 for the twenty-first century" (36).Most studies have focused on workplace resilience in general rather than specifically on HR difficulties and initiatives to improve physician working conditions.

The current study brings to the attention of scholars and the general public the challenges HR managers encountered throughout the pick phase of the COVID-19 pandemic and how difficult it was to maintain a consistent healthcare workforce and resource management.

However, credit was given to medical professionals who worked directly with patients, while allied healthcare administrators were kept out of the picture. The current study focused on HR managers who worked hard to ensure human capital and healthcare resources to protect health workers and establish a resilient workplace for medical professionals. They deserved more credit for their contributions, but it was neglected since HR managers, administrators, and CEOs operated behind the scenes.They had a lower risk of developing the diseases but were mentally and physically exhausted, stressed, anxious, and tired. They were under a lot of pressure to prepare and coordinate with patients' and relatives' doctors and stay on top of national, subnational, and regional recommendations. On the other hand, the study aims to make us take a closer look at allied health workers and give them credit where it is due.A similar study can be conducted on other non-clinical health workers such as administrators, . CC-BY 4.0 International license It is made available under a perpetuity.

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The copyright holder for this this version posted February 4, 2022. ; https://doi.org/10.1101/2022.02.03.22270380 doi: medRxiv preprint quality managers, ambulance drivers, cleaning staff, and many others to investigate the challenges, mental, physical, and psychological impact went through during this pandemic.

The Covid-19 pandemic, raging for a long time, has shaken the healthcare system.The world had already been confronted by Ebola, SARS, and MERS, as well as COVID-19. Despite this, the healthcare system has been unable to contain the COVID-19 pandemic. The HR initiatives, management policies, and resource availability have failed at every level. As an ordinary citizen and a health provider, the health workforce was subjected to outcries. The COVID-19's outburst was so brutal that healthcare workers had to choose between saving themselves, their families, close relatives, or other patients.During the harsh COVDI-19 working conditions, the healthcare workers should be supported in a different method to prevent and mitigate any harmful repercussions. To rejuvenate and refresh from stress and exhaustion, the HR manager had to plan out meditation yoga sessions and provide; physical and mental backup that would continue for more extended periods on the job.

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Impact of COVID-19 on people's livelihoods, their health and our food systems. World Heal Organ

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Role of Non-Clinical Human Resources for COVID-19: Strategic Way Forward

Minding the Gaps: Creating Resilience in Health Care

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Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority

Challenges in reported COVID-19 data: Best practices and recommendations for future epidemics

COVID-19 : Occupational health and safety for health workers

WHO WHO. Doing What Matters in Times of Stress: An Illustrated Guide. Oms. 2020. 5-126 p

Current situation with doctors and healthcare workers during COVID-19 pandemic in India

COVID-19 pandemic: the effects of quarantine on cardiovascular risk

Office of Inspector General Hospital Experiences Responding to the COVID-19 Pandemic : Results of a National Pulse

SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews

Under the Weather: Climate, Ecosystems, and Infectious Disease

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Health workforce policy and management in the context of the COVID-19 pandemic response. World Health Organisation Interim Guidance

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Enhancing leadership and governance competencies to strengthen health systems in Nigeria: Assessment of organizational human resources development

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#:~:text=The variety of staffing needs,HR in the health industry.&text=Similar to other HR professional,industry-specific training and development

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Influence of Working From Home During the COVID-19 Crisis and HR Practitioner Response

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