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How to manage secondary trauma among healthcare workers

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May 23 2022

How to manage secondary trauma among healthcare workers

The Covid–19 pandemic has complicated lives in healthcare organizations. A meeting at Luiss Business School Amsterdam Hub examines how leaders must face secondary trauma and its effects The Covid–19 pandemic has changed all the work life balance of healthcare workers and exacerbated the long–lasting phenomenon of post–traumatic stress symptoms (PTSS) in this field. Hospitals were reorganized. Treatments for patients have been stopped. Operations have been canceled. Nurses were relocated. Teams were not cohesive anymore. Managing these situations is a challenge worldwide as healthcare workers are likely to experience acute and chronic, often unpredictable, occupational stress leading to PTSS. Mental life wellbeing is a concept that more often returns in leadership discussions. During the event Secondary Trauma Challenges Impacting the Healthcare Ecosystem, Dr. Anthony Silard, Associate Professor of Leadership and the Director of the Center for Sustainable Leadership, Luiss Business School, explored effective approaches to identify and improve post–traumatic stress symptoms. Special emphasis has been given to the role that managers and leaders play in helping health employees to process secondary trauma and restoring a healthier working environment. What is secondary trauma and how to tackle it Secondary trauma is challenging the healthcare ecosystem. “Also known as vicarious trauma or compassion fatigue, secondary trauma refers to an emotional state in which a focal person experiences the pain, distress, sadness or other negative emotion of a second person” (Parker & Henfield, 2012). This happens at three levels: intrapersonal, interpersonal and organizational. Healthcare work can be challenging, especially in the domain of managing emotions. In healthcare organizations, employees might pay a considerable emotional toll in helping individuals living with primary or personal trauma emanated from life-threatening situations such as crime, violence, imbued clients poverty, illness and natural disasters. Over the past few decades, the term "secondary trauma" or "vicarious trauma" has evolved to depict the distressing emotional state an individual is likely to experience due to protracted interaction with a second person experiencing primary trauma. There are 5 primary emotions in human life: anger, sadness, joy, fear and love. Each of them leads to secondary emotions in the person who is experiencing the first one and in others. It requires deep resources to cope with these feelings. «Secondary trauma is our most toxic emotion because it arises from a loss of hope», said Silard. The emotion prototype approach provides a useful organization framework for discrete emotions. Whether related to primary trauma or secondary traumatic stress/vicarious trauma (STS/VT), stress symptoms and effects are very similar and can significantly impact individuals, teams and organizations. A large body of evidence exists which links such events to associated mental health issues among healthcare workers. As healthcare personnel perform their job duties – which might involve displaying care, empathy and compassion for trauma-affected clients – they put themselves at high risk of incurring secondary trauma. This challenges organizational lever for retention and recruitment. How do leaders manage changing emotions If a team is experiencing a primary trauma, then leaders can receive some of it and develop secondary trauma. At interpersonal level, they can manage it. The leader emotion management (LEM) is concerned with “the processes and behaviors involved in assisting employees in regulating their emotion experiences so as to facilitate the attainment of organizational objectives” (Kaplan et al., 2014:566). LEM behaviors will respond to the needs of employee with secondary trauma experiences. First, leaders must display empathy, and acknowledge and validate team member secondary trauma experience. «Secondary trauma exists, believe it or not», said Silard. LEM behaviors that improve secondary trauma consist of facilitating staff emotion regulation abilities; fostering follower post–traumatic growth; modeling emotion complexity. Still, there is a silver lining of secondary trauma: it may help both staff experience and the organizations for which they work. The Post-Traumatic Growth (PTG), such as the one experienced after Covid pandemic, leads to be more open to new experiences; value themselves more; reevaluate their life priorities, goals, relationships and spirituality; might prepare for future adversities. In a trauma–informed management strategy, leaders must be compassionate companions. Compassionate companionship behaviors support the trauma and encourage growth; help the other person back up from the tree and see the forest; don't fall into the problem person/solution person false dichotomy; meet their vulnerability with your own. The organization level is about policies and getting people together, around the trauma debrief. «Create an emotional processing culture, an authentic climate where people can express their emotions», suggests Silard. How to manage secondary trauma in healthcare organizations In a roundtable led by Luca Magni, Professor of Practice, Luiss Business School; Scientific Director of the Executive Programme in International Pharma and Healthcare Administration, Luiss Business School, has been discussed how to manage secondary trauma in healthcare organizations. «We had a huge global experiment: Covid pandemic – said J. A. Hans Romijn, Professor of Medicine, University of Amsterdam; Internist, Former Chairman and Dean of Amsterdam UMC, University of Amsterdam; Coordinator of the merger of the two UMCs in Amsterdam – It required a whole reorganization of hospitals. Treatments of patients have been stopped. Nurses were relocated. Teams were not cohesive anymore. There were running out of material, fear of getting sick. People were dying without their families. This has led to a large amount of stress». «Starting from secondary trauma, the question must be: is the world ready to create compassionate enterprises? – asked Laura Mckeaveney, Patient Advocacy Expert, with relevant experiences in multiple corporate roles, the latest being the one of Global Head of Patient Advocacy, Novartis – We have so much journey to travel to get to more humanistic organization, even if we need to do profit». «Language has an important task – says Daniele Raugi, Head Global HR Corporate Functions & Europe, Sanofi – We must normalize talking about feelings. Covid forces organization to look at the whole human being. Leadership has been evolving and the role of the leader is changing they must develop and grow people. It goes from empowerment to be authentic. As a leader, you create the right environment». 5/23/2022

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Why Luiss Business School Amsterdam Hub is the answer for your upskilling

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March 17 2022

Why Luiss Business School Amsterdam Hub is the answer for your upskilling

Choosing an executive programme abroad is the starting point to enhance one’s career. Here’s why Amsterdam is the place to be Health and pharma, sustainability, fashion and luxury, regional headquarters of global companies, an abundance of tech start-ups, and the international gateway to Europe: there are many reasons to start a programme at the Luiss Business School Amsterdam Hub. Enrolling for an executive programme is a way to improve your skills, expand your network and boost your career. Joris Ebbers, Full Professor of Entrepreneurship and Innovation and Academic Dean of the Amsterdam Hub, explains why in Amsterdam you can find the key to revolutionize your career. Work and education: what are the main trends in Amsterdam? A first trend regards data analytics and AI, which are important, especially in combination with business and statistical skills. Professionals need understand the value of data, how they can be analysed, and how they can support the business. A second trend is sustainability and circular economy management. Because of potentially irreversible environmental trends, such as resource scarcity and pollution, the challenge is how we can be as economic as possible with our planet’s resources, by using as little as possible and reusing as much as we can, and lower our dependence on non-renewable fossil energy. A third trend is health, pharma, and biotech, due to the large Covid crisis. After the Brexit, the European Medicines Agency (EMA) of the E.U. moved from London to Amsterdam. This has further accelerated the development of a strong health, pharma, and biotech cluster around Amsterdam, with companies originating from many different countries around the world. Which are the key points of the Luiss Business School Hub in Amsterdam? There are a couple of focus areas. One of them is creativity, which is of crucial importance in relation to artificial intelligence (AI). AI is very good at answering specific questions. However, we need creativity to produce valuable questions that we want AI to answer. For professionals, it is therefore very important to be aware of the need for human creativity, be more creative themselves, and learn how to manage creativity in organizations. That is why Luiss Business School in Amsterdam has a specific focus on creativity, creative skills, and creative leadership skills. But creativity also means entrepreneurship. In addition, we need entrepreneurship to translate and transform new questions into valuable business opportunities. It is all about developing winning new business models that can solve problems or satisfy (latent) needs. For this, professionals also need leadership skills: you must have these skills to be sure that the organization is aware of the opportunities and threats it is facing, and support the organization to continuously adapt. For this, you not only need to foster creativity and entrepreneurship but also organizational change management skills. What are other reasons for studying at Luiss Business School’s Amsterdam Hub? Amsterdam is a great city for business. The Netherlands is very well connected because of infrastructures like the harbour in Rotterdam (#1 in Europe) and Amsterdam airport (#3 in Europe).. In addition, but only few people know that Amsterdam is one of the biggest Internet exchanges in the world (#3 in Europe). A lot of the Internet traffic goes through the Amsterdam Internet Exchange (AMS-IX) . As a consequence, there are lots of economic activities around data and cloud computing In addition, Amsterdam has a strong start-up ecosystem and is rising quickly on global startup rankings of best places to start or locate new companies. Besides regulatory reasons, and the fact that many Dutch people speak English, this is also related to the presence of AMS-IX. This has facilitated a powerful mix between tech and start-ups, including local successes Adyen and Booking. Why choose an international executive programme to improve one's skills? Focusing on executive education is very important. The world changes, so you must improve your skills, increase your knowledge, and meet other people of your industry from who you can learn. A lot of the learning in executive educational happens through peers who share their experiences. Through that, you will automatically build a network, which a very important aspect. As regards the international aspect, it is important to cross borders and meet other cultures. Finally, because of the considerable number of big companies moving their regional (EMEA) headquarters to Amsterdam especially after Brexit, attending a programme here, at the Luiss Business School Amsterdam Hub, is an excellent choice which leads to new opportunities. Discover more about the executive education Luiss Business School at Amsterdam Hub.Join the Virtual Open Day on April 5th. REGISTER

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The evolution of the pharmaceutical sector between digital transformation and new regulatory processes

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October 05 2021

The evolution of the pharmaceutical sector between digital transformation and new regulatory processes

We thank HBR Italia for the report about the two "CEO Round tables" which took place during the kick off of the “Executive Programme in International Pharma and Healthcare Administration” with the participation of: Pierluigi Antonelli, CEO Angelini, Silvio Belletti, Partner BCG, Elcin Barker Ergun, CEO Menarini Group, Ugo Di Francesco, CEO Chiesi, Deborah Dunsire, CEO Lundbeck, Eriona Gjinukaj, COO Dompé, Jens Grueger, Director and Partner BCG & President ISPOR, Jordi Llinares Garcia[1], Work Stream Head at European Medicines Agency, Gianfranco Nazzi, CEO Almirall, Guido Rasi, Professor of Microbiology, Tor Vergata University, chair by Luca Magni, Professor of Practice Luiss Business School. The full version of the article is now available in English. The new "CEO Round table" will be held with the start of the second edition of the programme on October 19, 2021. The Impact of the pandemic on the pharmaceutical sector and the relationship between innovation and regulation: two of the hottest topics on the table of the CEOs of the pharmaceutical sector were discussed in the two panels organized by the Luiss Business School to present the first edition of the Executive Program in International Pharma and Healthcare Administration. The debates, introduced by Silvio Belletti and Jens Grueger, Partner of the Boston Consulting Group, were attended by main exponents of the Italian and world industry, and moderated by Luca Magni, Professor of Practice Luiss Business School. During the first of the two panels, attended by Pierluigi Antonelli, CEO of Angelini, Ugo di Francesco, CEO of Chiesi and Deborah Dunsire, CEO of Lundbeck, as well as Guido Rasi, professor of microbiology and former director of AIFA and EMA, we discussed how the pandemic has impacted the operational dynamics of the pharmaceutical sector, focusing on three main themes, introduced by Silvio Belletti (BCG): the interaction between companies and doctors, the regulatory dynamics and clinical development, smart working. Company-doctor interaction: towards a new-generation Customer Engagement The pandemic first blocked and then reduced for several months the visits of scientific informants to doctors, forcing companies to reinvent the way to interact with prescribers, leveraging virtual instruments. If it is true that, as a BCG survey shows, more than 50% of doctors expects or hopes that the relationship between virtual and face-to-face interactions will remain the one seen during the pandemic, it is also true, as Deborah Dunsire pointed out, that "personal promotion and face-to-face interactions remain crucial, especially when it comes to promoting a new drug being launched". For this, Pierluigi Antonelli hoped for "the transition to a hybrid model", also stressing that it is "crucial that the development of digital skills is not limited to the sales force but involves the whole organization". Ugo Di Francesco is also on the same wavelength, highlighting how "the adoption of a digital-oriented business model has reached different levels of maturity depending on the geographical areas", much more advanced in China and the United States, than in Europe. Dunsire and Di Francesco also underlined how it is essential that pharmaceutical companies exploit the digital opportunity to promote contents that are as tailor-made and personalized as possible, in order to maximize the doctor's customer experience and to express the commercial resolve in greater returns for companies. Regulatory dynamics: new scenarios, but Europe risks being left behind Just as the pandemic has impacted the interactions between business and physician, the world of clinical development has also seen significant changes along at least two main directions. In the first place, with COVID the so-called virtual trials have doubled, that is to say those clinical studies where the recruitment of patients and/or the evaluation of the results take place remotely. Also, the pandemic and the vaccine rush have shown the possibility of significantly shortening the development and approval times of drugs (typically above 5 years). It will now be essential to understand whether these accelerated development and approval timelines (which depend on various factors, including greater involvement of regulators in the development phases, parallelization of the same and the use of surrogate endpoints) can become the rule and not remain an exception due to the exceptional circumstances of COVID-19. In this regard, Professor Rasi underlined how it is "more difficult for this to happen in Europe than in the United States". The reason, however, would not be due to a more "conservative" approach by EMA compared to the FDA, but rather to the "difficulty in bringing together 27 member States in which a culture typically averse to risk prevails". Smart working: towards a hybrid model Finally, the round table focused on the issue of remote working, a particularly hot topic in this moment of transition from a due smart working to desired smart working. As Antonelli pointed out, "even before COVID, hypotheses for the introduction of remote work were being studied" and, from this point of view, "the pandemic represented a sort of forced test that highlighted the strengths but also the limits of this model ". While it is true that the logistical advantages are out of the question (provided that employees are equipped with adequate tools), it is also true that collaboration and innovation risk to be, if not compromised, at least limited. Consequently, as shared by Dunsire and Francesco, the need to "define hybrid models that allow you to benefit from the advantages of working from home without this translating into abandonment of the offices", which must remain the beating heart of the company's life, or the “backbone”, as Antonelli defined it. Keeping up is essential Rather than creating the need for a change, therefore, the pandemic has brought out needs that in a certain sense were already latent, imposing the need for companies in the sector to know how to reinvent themselves quickly and accelerating the introduction of new operating models, with a strong push on the digital element. The ability of companies to be able to seize this challenge in the required timeframes and in the best ways will be fundamental to obtain an advantage over competitors and, on the one hand, to capture market growth in the post "rebound" phase COVID and, on the other hand, be prepared for long-term challenges. The second roundtable hosted Elcin Barker Ergun, CEO of Menarini, Eriona Gjinukaj, COO of Dompé, Gianfranco Nazzi, CEO of Almirall and Jordi Llinares, Head of the Research and Innovation Department of EMA, spoke. The introduction by Belletti and Grueger focused on how innovation in the pharmaceutical sector has been the protagonist of the last decade. Just think, for example, that the drugs for rare diseases approved every year in the United States ranged between 50 to more than 300, or that the market for "novel modalities" (such as, for example, gene therapies), which currently has revenues of approximately $ 3 billion, should increase its value tenfold in less than 5 years. Despite a wave of innovation, which has made it possible to obtain results that were unthinkable until a few years ago from a clinical point of view, there are still several obstacles that complicate the approval processes or market access for new drugs. USA and Europe: the numbers and the reasons for the gap As shown by a study by the Boston Consulting Group, of the 220 drugs approved by the FDA in the United States between 2015 and 2019, only 97 were also approved in Europe and only in 22% of the cases this happened with shorter deadlines than in the United States. For Eriona Gjinukaj "especially small and medium-sized companies in Europe encounter difficulties in obtaining approval from the regulatory body". This requires a "greater flexibility in the evaluation of data relating to medicines that are administered to patients who often, without a cure, they would risk losing their lives”. Jordi Llinares was also on the same wavelength, underlining that in Europe there would be "a cultural reluctance to collaborate between regulatory bodies, pharmaceutical companies and key opinion leaders in the clinical development phase, attributable above all to fears of possible conflicts of interest for the latter”, which would result in an inevitable slowdown in the approval times for drugs. It is also interesting to note, as highlighted by Elcin Barker, that the gap between Europe and the USA is not only registered in terms of drug approval times, but also in the access times to individual national markets. In fact, if it is true that in some European countries, such as Germany, "it is preferred to allow patients immediate access to the drug, solving the issues related to price and reimbursement at a later time", there are other national realities where instead the opposite happens, and “a long negotiation on prices heavily slows down the entry on the market of even highly innovative drugs”. In this sense, Gianfranco Nazzi stressed "the need to work together to find a solution that has a financial basis and that allows the problem to be solved". Outcome-based models and the role of digital: a long but inevitable road The discussion then moved on to how satisfy the need for payers to keep costs under control and, at the same time, guarantee the highest level of quality of care, with outcome-based reward models, which provide a reimbursement linked to the success of the therapy. In this sense, Eriona Gjinukaj reiterated how for some time the industry has been trying to propose outcome-based models, which however "clash with the complexity of large-scale management even in countries - such as Italy - which have been the front line since several years". To this end, according to Grueger it is fundamental "to work on a common model among all European countries", which potentially leverages - as Llinares hypothesized - on a "federation of European databases that uses data of type real world” to facilitate the adoption of outcome-based payment systems. Emerging Countries: political instability undermines efforts towards advanced regulatory systems The final parenthesis on emerging countries is also very interesting: if for Europe the fundamental issue is to close the gap with the United States in terms of flexibility of regulatory processes and marketing access, in emerging countries " several drugs are not even available and the regulatory agencies are poorly structured and not very transparent”, underlined Gianfranco Nazzi. According to Jordi Llinares, "there have been efforts at a global level to create a sort of" African EMA "and the EMA itself has entered into bilateral agreements with various developing countries to strengthen the skills of local regulatory bodies". Political instability, however, weighs like a boulder on the attempts to carry out these projects and to bring emerging countries in step with the more economically developed ones. Renew regulatory processes to capture innovation A situation in which, as Silvio Belletti pointed out, innovation grows at a much higher rate than GDP, witnesses the difficulty in being able to capture the value of innovation itself. To reverse the trend, it therefore becomes essential to renew the regulatory processes, simplifying them and aligning them, as far as possible, with US best practice. Shorter approval and access times, collaboration between companies, key opinion leaders and regulatory bodies even during clinical trials, outcome-based models that reward products with the greatest impact on patients' health: the challenges are not lacking, it's up to Europe collect them and direct them towards creating a success story. [1] With great sadness we join the grief of family, friends and colleagues for the sudden and unexpected passing away of Jordi Llinares Garcia. 10/5/2021

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DBA in Higher Education Leadership and Management: A career booster to break the glass ceiling in university management

How to manage secondary trauma among healthcare workers

Why Luiss Business School Amsterdam Hub is the answer for your upskilling

The evolution of the pharmaceutical sector between digital transformation and new regulatory processes

DBA in Higher Education Leadership and Management: A career booster to break the glass ceiling in university management

How to manage secondary trauma among healthcare workers

Why Luiss Business School Amsterdam Hub is the answer for your upskilling

The evolution of the pharmaceutical sector between digital transformation and new regulatory processes