Collective Occupational Trauma, Health Care Quality, and Trauma-Informed Leadership Intersections and Implications

Managing stress, burnout, arid vicarious trauma is a long-standing issue for the health and behavioral health workforce, including those in case management. Yet, the recent novel coronavirus pandemic has amplified routine burnout to record levels. Practitioners and patients are amid a new dynamic of collective occupational trauma (COT). In this realm, health and behavioral health workers (HBWs) experience the same reality as their patients, families, and support systems; professional boundaries become blurred, leading to heightened levels of emotional vulnerability that can prompt the development of more pervasive psychopathology. This reality has put the Quadruple Aim in peril, with increased workforce turnover, staff shortages, costs, and quality challenges. Purpose/Objectives: This article: 1. Identifies the incidence and costs associated with COT for HBWs; 2. Distinguishes among terms associated with HBW burnout; 3. Describes the occupational stress-trauma continuum; 4. Defines COT; 5. Explains the connection between COT and health care quality; 6. Identifies why trauma-informed care (fIC) is relevant to address COT; 7. Applies TIC to leadership and supervision strategies; and 8. Identifies how established resources of guidance address workforce health, mental health, and professional self-care. Primary Practice Setting(s): Applicable to all health and behavioral health settings where case management is practiced. Findings/Conclusions: Organizational cultures must shift from a 'process and roll' mindset to one that is trauma-informed. Implementation of TIC has yielded successful outcomes for the workforce via enhanced patient engagement, treatment adherence, and successful outcomes. In tandem, TIC leadership and supervision models have had promising results and should be more readily utilized; they acknowledge and address workforce trauma while prioritizing staff health, mental health, and wellness. Failure to shift the culture will result in an ongoing exodus of practitioners, leaving insufficient numbers to render safe, cost-effective, efficient, and patient-centered care. Implications for Case Management Practice: The case management workforce comprises professional disciplines across health and behavioral health, employed in every setting. The expanding workforce presence has put them at risk of COT. Leadership strategies must shift to acknowledge workforce exposure to occupational trauma, address mental health and wellness, and address professional self-care. This shift is key to mitigating retention, sustainability, and quality challenges.