The European Patient Safety Foundation’s Fighting Fatigue Together campaign is raising awareness and educating professionals on practical approaches to understand and better manage fatigue.
Fatigue is a psycho-physiological phenomenon that occurs naturally after a prolonged or intense period of physical or intellectual activity, resulting in difficulty in continuing the effort or work. Fatigue is affecting the well-being and safety of healthcare professionals with greater intensity and on a larger scale than ever before. However, everyone is likely to be affected because of the fatigue of healthcare professionals (HCP) as it has a potential risk to patient safety. The campaign can play a crucial role in the science of Patient Safety because the affected HCP can cause harm to themselves and the patients. In the healthcare settings where Just Culture is the new normal, this campaign has a critical role, giving the HCP, stakeholders and leaders the possibility to learn and accept the importance of recognising and fighting fatigue. The campaign is promoting a safety culture. The protection of HCP is included in the WHO Global Safety Action Plan 1.
The feeling of fatigue seems to hinge on an equilibrium between external factors (e.g. workload demands, organisational culture, the presence of social support, societal expectations) and intrinsic factors (e.g. deriving a sense of purpose from work, personal ethics, value judgements), as well as on the degree of success in integrating one’s work with personal life 2. Some studies have investigated the association between timing (i.e. daytime vs nighttime), types of clinical activities (e.g. surgery, ICU admission, extubation) and clinical outcomes 3. The results of these studies demonstrate that patient outcomes are worse in nighttime and out-of-hours surgery, but do not identify the causes of differences in clinical outcomes 3.
Combatting Burnout
Chronic fatigue among healthcare workers may lead to work stress, physical or mental illness and burnout 3, 4. Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace 4. Burnout syndrome is often caused by an imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient performance recognition and prolonged exposure to stress 4. High-dependency departments such as critical care units are very stressful environments, and this can lead to a greater incidence of burnout, especially in the dimensions of emotional exhaustion and poor personal accomplishment 5. The shortage of doctors, especially anaesthesiologists, leads to increased workload and a high incidence of occupational burnout 6. Burned-out physicians were shown to be twice as likely to be involved in patient safety incidents than those without burnout, caused by deterioration in non-technical skills, increased medication errors, loss of sustained attention, and psychomotor decline 7, 8.
Raising awareness
In 2015, a trainee anaesthetist from the UK, lost his life while driving home exhausted after a night shift. Tragically, the relationship of sleep disturbance caused by working a night shift and decreased driving performance in UK anaesthetists has already been researched and published 9. His devastating death raised awareness of the consequences of fatigue among medical staff and sparked the national Fight Fatigue campaign in the UK in 2018. The European Patient Safety Foundation (EUPSF) backed the UK campaign in 2021. With the help of the UK campaign team, the EUPSF initiated the “Fighting Fatigue Together” campaign – – to accelerate change by sharing the experience and tools from the UK campaign across Europe.
EUPSF started the “Fighting Fatigue Together” campaign – – which is a significant initiative in Europe, dedicated to addressing the pressing issue of fatigue, particularly among healthcare professionals, doctors, nurses and others. This campaign was started by forming and educating national teams from Austria, Croatia, Georgia, Greece, Portugal, Slovakia and Spain.
The central aim of the campaign is to reduce fatigue and burnout among healthcare professionals, who are facing increasing challenges due to staff shortages, high-stress levels, and excessive workloads. These factors contribute significantly to fatigue, negatively impacting both their health and the quality of patient care they provide. By focusing on this critical issue, the campaign seeks to support HCPs and enhance the healthcare system’s overall resilience. The safety of workforce is a requirement for patient safety and healthcare quality.
Main Goals
- Raise Awareness: The campaign emphasises the importance of recognizing fatigue as a serious issue within the healthcare profession. By raising awareness, it aims to mobilize both public and institutional support for initiatives designed to mitigate this problem.
- Educate Healthcare Professionals: A major goal is to educate doctors, nurses and other healthcare professionals about the signs, symptoms, and consequences of fatigue. The campaign offers resources and training sessions to help healthcare workers understand and manage fatigue effectively at an individual level.
- Promote Healthier Work Environments: The campaign advocates for changes within healthcare institutions to create supportive work environments. This includes promoting balanced work schedules, ensuring adequate rest periods, providing access to mental health resources, and advocating for more human working conditions in healthcare facilities.
Key Activities
- Dissemination of information: the campaign uses various media channels to broadcast messages that highlight the importance of addressing fatigue in healthcare setting and provide practical management tips.
- Training and Workshops: Regular training sessions and workshops are organized to educate healthcare professionals on fatigue management techniques, stress reduction strategies, and the importance of self-care.
- Collaborations with Healthcare Institutions: The campaign collaborates with hospitals and clinics to implement policies aimed at reducing workload and stress, such as optimized shift scheduling and providing adequate resources and support systems.
Impact and Future Plans
Since its launch, the “Fighting Fatigue Together” campaign has received positive feedback from the healthcare community and has begun to make a meaningful impact on their well-being. In September 2023, it received the European Health Leadership Award 2023 from the renowned European Health Forum Gastein, recognized as the most inspiring grassroot initiative to transform healthcare.
Early feedback indicates increased awareness and proactive steps being taken by healthcare institutions to support their staff. Looking ahead, the campaign plans to expand its outreach through digital platforms, making educational resources and support more accessible. Future initiatives will focus on conducting detailed research to better understand the specific fatigue-related challenges faced by healthcare professionals in different regions and settings across Europe.
In conclusion, the “Fighting Fatigue Together” campaign represents a comprehensive effort to tackle a critical issue within the healthcare sector. By focusing on the well-being of healthcare professionals and promoting healthier work environments, the campaign aims to reduce fatigue and burnout, ultimately enhancing the safety and quality of care provided to patients across European countries.
Authors
Adriano Friganovic1,2,3,4, Dora Karmelic1,4, Panagiota Tsikala5, Nancy Redfern4,6, Emma Plunkett7, Zuzana Katreniakova8, Iveta Nagyova8, Marta Macías Maroto9, Simon Wickes10, Jose Joaquin Mira11, Susana Lorenzo12, Mirka Cikkelova4
1University Hospital Centre Zagreb, Croatia
2University of Applied Health Sciences Zagreb, Croatia
3Faculty of Health Studies University of Rijeka, Croatia
4European Patient Safety Foundation, Belgium
5University Hospital Vienna, Austria, Hellenic Open University, University of Thessaly, Greece
6The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
7University Hospitals Birmingham NHS Foundation Trust, UK
8Deptartment of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University in Kosice, Slovakia
9Quality and Patient Safety Department, Hospital Universitario Príncipe de Asturias, Spain
10Fatigue Risk Management Sciences Ltd, UK
11Universidad Miguel Hernández, Elche, Spain, Alicante-Sant Joan Health District, FISABIO, Alicante, Spain
12Quality & Patient Management Area. Hospital Universitario Fundación Alcorcón, Spain
