The acute phase of COVID-19 was a time of cultural magnification and transformation in emergency medicine. It was a time when we could see who we are, recognized what aligned with those values and identified what conflicted with them. #ACEMWS21@Qemerg
A group of clinicians @Qemerg@KingstonHSC engaged in a rapid cycle collaborative ethnography by gathering >50,000 words in field notes and >40 interviews with staff during 12 week period (March-May 2020). Weekly we reported the "pulse" of the ED to department + hospital leaders.
This work highlighted aspects of pandemic reality that aligned with our core values, beliefs, and practices. For example, managing uncertainty is core to emergency medicine. Many thrived in doing so in the early days.
On the other hand there were significant threats to identity - the biggest of which was the ability to provide patient and family centred care. A mismatch between practice and values/beliefs is extremely problematic in the longterm.
As we move forward we must strive to align realities of practice with core values. Choices at individual, departmental, and organizational levels must strive to maximize overlap. This is relevant to ongoing COVID response but also in normal times. Try asking simple questions.
The impending disastrous efflux of staff from emergency and critical care in Canada is certainly complicated but I am confident mismatches (predating but magnified by Covid) between core values and realities of practice are at the heart of why good people are leaving.
Moments of crisis, like #COVID19, are moments of cultural compression...Moments when values and beliefs of a group are more easily identified and then shaped.
Moments that can tell organizations an awful lot about who we are, what matters most, and who we might become. #EDAC2020
It turns out that psychological safety, the ability for team members to take interpersonal risks, is critical for groups to do their work. In moments of crisis we can clearly see when psychological safety is intact....and...when it is not.
So...how might we shape an organizational culture that fosters psychological safety so that we can be our best during crisis, but perhaps even more importantly during normal times??? #EDAC2020