WoWe@ED Interventions - Middlemore ED

Welcome to the interventions page for Middlemore Emergency Department. We are excited to participate in this research, to reduce burnout and lift the long-term wellbeing of our team!

Our ED participated in an earlier arm of this research in March/April 2020. For more information about the WoW@ED study please visit the About and Prior Research sections of this website. If you have any questions regarding the research or any of the interventions, please approach our local champions group:

  • Laura Presland

  • Elizabeth Mayo

  • Alice Kant

  • John Sawtell

  • Leonie Nicholls

  • Jodyanne Coverdale

  • Sandy Neva

  • Justine Tito

There are 3 “levels” of intervention that will be used simultaneously. These are:

  1. Individual-level

  2. Group-level

  3. System-level

This page has all the information and links you need to get started.

  1. Individual-level interventions

These are interventions that each individual staff member can use. There will be training available and staff can also access resources on their own to try and put into practice.

  • Try one at a time.

  • Practice until it becomes part of your usual day-to-day activity.

  • Try one out, stick to it, and see how you go. Once you have nailed that, you could try another.

  • Mindfulness-Based (MBI)

    • Mindfulness practices help us to stay in the present moment

    • A quality of awareness that allows a person to pay attention to actual experience, without any filters, in a purposeful and non-judgmental manner.

  • Three Good Things (3GT)

    • This is the simplest option, reminding ourselves to notice some of the good things in our lives

  • Cognitive Behavioural Therapy (CBT)

    • Cognitive reappraisal, part of CBT, involves consideration of thoughts as hypotheses that can be challenged

2.Team/Group/Whānau-level interventions

  • Clinical Event Debriefing (CED or "Hot Debrief")

    • “High performing teams are strengthened by reflecting on their performance.”

    • Embedding CED to make it business as usual may be a worthwhile challenge

    • We will be introducing training in CED to our ED in mid-2024, with the ideal that a hot debrief can be facilitated by nurses as well as SMOs

3.System-level intervention

  • Quality Improvement Learning System (QILS)

    • A means of systematically capturing and acting on insights from front-line staff to improve healthcare quality in EDs

    • Members of the champion group will be learning about QILS and implementing this methodology over time

A summary of the interventions

FAQs

FAQs

  • The components of the interventions may benefit yourself, your colleagues, your patients and their whānau.

    The intervention has been designed by and for our multidisciplinary NZ emergency department staff. We understand the challenges involved, and our aim is that they are “doable” for staff in NZ EDs.

  • These interventions are designed to be BRIEF, and doable within our normal work lives. For example, we envisage that a total of 100 minutes over 1 month may be required to make some of the individual interventions become habit. The system-level component of the intervention is intended to be done as part of our usual work.

    Check out each component of the intervention for more details.

  • Well… the answer to this is quite complex.

    There is some evidence of benefit for each component of the intervention. Each component has demonstrated some benefit to participants as a group. Like all research, though, the devil is in the detail… will this intervention help YOU? Maybe.

    As well, as far as we know, combining these components into an intervention has not been done before in healthcare. And certainly not in emergency departments in New Zealand post-COVID.

    If it were clear that this intervention worked, it would not be ethical to do this research…we should just get on and do it!

    See each intervention for further discussion about the evidence.

  • If it were clear that this intervention worked, it would not be ethical to do this research…we should just get on and do it!

    It is likely that some or all of the components of the intervention would be available in the study EDs, regardless of the research. The research offers some rigor and an opportunity to generate and share some knowledge that may be useful to participants, researchers, and colleagues outside our workplaces.

    The research “burden” for participants is fairly low… the main assessment that most participants will be asked to perform are pre- and post-intervention surveys. These will take <10 minutes.

    We do ask, please, that everyone in the participating EDs keep an open mind and consider getting involved with some or all of the components of the intervention. And participate in the surveys! Thank you!

  • These interventions will not directly target some the most important contributors to wellbeing for kaimahi in EDs in New Zealand. This includes pay rates. And having enough staff.

    We need to keep working on and advocating for these things.

    While we wait and advocate for these things to be fixed, we hope that the interventions will be a positive step towards improving some of the things that may be within our sphere of control.

    Collectively, over time, these interventions may improve our wellbeing at work so that we are able to manage and improve our workplace, and will be in the best position possible to retain staff.

  • We know that ED staff can look after themselves.

    Also, that ED staff are resilient.

    And, that soley focusing on improving our resilience misses the point, ignores the “elephant in the room”, and is insulting.

    And… there is always more we can individually do to maintain our own wellbeing

    The interventions do not replace the important things, like sleep, etc, and assume that we know the importance of these, and are able to focus on these fundamental things.

    There are many ways to improve these aspects of our lives…here’s one NZ-based resource.

  • We can keep advocating for things we think are important for a high functioning health system, and participate in this work.

    These are not mutually exclusive.

    As well, if we can empower staff to improve their roles and the system in which they work, this may improve culture and encourage staff retention.

  • Staff in NZ EDs consider 3 things may improve their wellbeing at work: a culture of wellbeing, professional development opportunities, and resources to provide high quality healthcare.

    This work may encourage all 3 of these.

    We will never be able to compete with, say, wages for nurses on short term contracts to Outback Australia. But if we can improve the work here, we may be able to retain staff who want to work here and see a positive future for themselves, colleagues and patients.