title: Resilience training for hospital workers in anticipation of an influenza pandemic.
abstract: BACKGROUND
  Well before the H1N1 influenza, health care organizations worldwide prepared for a pandemic of unpredictable impact. Planners anticipated the possibility of a pandemic involving high mortality, high health care demands, rates of absenteeism rising up to 20-30% among health care workers, rationing of health care, and extraordinary psychological stress.
  
  
  METHODS
  The intervention we describe emerged from the recognition that an expected influenza pandemic indicated a need to build resilience to maintain the health of individuals within the organization and to protect the capacity of the organization to respond to extraordinary demands. Training sessions were one component of a multifaceted approach to reducing stress through effective preparation and served as an evidence based platform for our hospital's response to the H1N1 pandemic.
  
  
  RESULTS
  The training was delivered to more than 1250 hospital staff representing more than 22 departments within the hospital. The proportion of participants who felt better able to cope after the session (76%) was significantly higher than the proportion who felt prepared to deal confidently with the pandemic before the session (35%). Ten key themes emerged from our qualitative analysis of written comments, including family-work balance, antiviral prophylaxis, and mistrust or fear towards health care workers.
  
  
  CONCLUSIONS
  Drawing on what we learned from the impact of SARS on our hospital, we had the opportunity to improve our organization's preparedness for the pandemic. Our results suggest that an evidence-based approach to interventions that target known mediators of distress and meet standards of continuing professional development is not only possible and relevant, but readily supportable by senior hospital administration.
authors.affiliation: General Inpatient Psychiatry Unit, Mount Sinai Hospital, 600 University Ave, Toronto, Ontario, Canada. aaiello@mtsinai.on.ca
authors.forename: Andria
authors.initials: A
authors.lastname: Aiello
authors.forename: Michelle Young-Eun
authors.initials: MY
authors.lastname: Khayeri
authors.forename: Shreyshree
authors.initials: S
authors.lastname: Raja
authors.forename: Nathalie
authors.initials: N
authors.lastname: Peladeau
authors.forename: Donna
authors.initials: D
authors.lastname: Romano
authors.forename: Molyn
authors.initials: M
authors.lastname: Leszcz
authors.forename: Robert G
authors.initials: RG
authors.lastname: Maunder
authors.forename: Marci
authors.initials: M
authors.lastname: Rose
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Adam
authors.forename: Clare
authors.initials: C
authors.lastname: Pain
authors.forename: Andrea
authors.initials: A
authors.lastname: Moore
authors.forename: Diane
authors.initials: D
authors.lastname: Savage
authors.forename: Rabbi Bernard
authors.initials: RB
authors.lastname: Schulman
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D058873:Pandemics / Q000517:prevention & control / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000193:education* / Q000523:psychology; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D045169:Severe Acute Respiratory Syndrome / Q000523:psychology; D013315:Stress, Psychological / Q000517:prevention & control