Workforce Wellbeing and Future Pandemic Preparedness in Emergency Departments: Lessons Learned While Caring for...

Background/Objective: Research has indicated that providing care during the COVID-19 pandemic negatively impacted healthcare providers' wellbeing and burnout. Much of the literature has focused on emergency department (ED) physicians and nurses, including the distinct challenges they faced caring for persons experiencing homelessness (PEH), including addressing unmet basic needs, limited discharge options, and disruptions to community-based health and social services during the pandemic. Comparatively little research has examined the experiences of other multidisciplinary team members caring for PEH. This study explored the shared experiences of multidisciplinary ED staff caring for PEH during the COVID-19 pandemic to inform workforce planning and future pandemic preparedness. Methods: Using inductive qualitative analysis, we examined self-reported experience, mental health impacts and solutions for workforce planning and pandemic preparedness of multidisciplinary ED staff caring for PEH. Three virtual focus group discussions involving 12 multidisciplinary ED staff (registered nurses, clerical staff, security staff, community support workers, and a clinical assistant) were conducted during the first two years of the COVID-19 pandemic, a period characterized by evolving public health restrictions, uncertainty, and disruptions to health and social services. Results: Inductive qualitative analysis identified four key themes: (1) emotional experiences of care provision (including gratitude, compassion fatigue, and moral distress), (2) hospital- and community-led adaptations to support care delivery, (3) strategies for wellness and resilience building among staff, and (4) recommendations for future workforce planning and pandemic preparedness. Conclusions: Caring for PEH during the intense pandemic period intensified staff distress by exposing them to unmet social needs and system-level resource gaps, while also fostering interprofessional collaboration and resilience. Staff collaborated to facilitate organizational adaptations that enabled continuity-of-care. Future pandemic preparedness should include targeted mental health supports for staff, flexible institutional contingency planning, and formalized hospital-community partnerships to sustain care for PEH and other socially vulnerable populations.