Table 4.

Overview of suggestions for better teamwork, team integration, and mental health from the evidence provided.

Overview of suggestions
Organizational and institutional support	Integration of pandemic/crisis response into non-intensive care personnel’s education and periodic training modules prior to deployment in basic skills required.	Pandemic/Crisis preparedness
	Development and maintenance of a staff roster, including prior pandemic, infectious disease, or intensive care experience as well as specialized training and skill sets by staff to quickly allocate and deploy during outbreak.
	Utilization of skill signifiers, using stickers or badges on HCWs PPE aids in signifying specific skillsets during high pressure situations and with reduced facial recognition due to PPE (e.g., CPAP trained, intensive care family liasion).
	Wide-spread involvement of IP/ID teams into handovers/ rounds and usage of virtual communication tools to ensure widespread information exchange and development of shared mental models.	Pandemic /Crisis Response
	Simplicfication and access of health records, to provide clearly accessible and visible health records in patients rooms to ensure every member of the team can access and contribute to them.
	Provision of intra-group debriefs to facilitate after action review after particular difficult shifts (e.g., with high mortality) and to document clinical procedures and lessons learned.
	Integration of designated personnel for specialty taks (e.g., patient-family liasion) to reduce the burden on frontline HCWs of particular distressing incidents.
	Optimisation of designated communal staff rooms and rest areas to ensure co-location of staff – even during social distancing – as a basis for maintaining information exchange, team cohesion, and familiarity with colleages from all backgrounds.
Team and ward manager support	Emphasize visibility and presence on the ward to facilitate leader legitimacy and be present, and approachable, to all members of the team.
	Utilize brief team introductions during handovers, to ascertain skill-sets of deployed staff and assign responsibilities and tasks based on skill-sets.
	Enhance familiarity between personnel, by de-emphasizing professional categories, but highlighting skill-sets and value to the team and increase personal familiarity.
	Establishment of role clarity and vision across the team, to develop a common understanding of goals and responsibilities and ensure buy-in of all team-members irrespective of prof. Background.
	Clearly defined leadership structures, which empower junior leaders and those with particular professional skill-sets (e.g., family liasion), utilize shared leadership where possible to ensure both managerial and psycho-social support.
Mental health support	Re-instate in-person social events, meetings and professional development courses as quickly as Infection Control guidelines allow, to ensure personnel can benefit from the social interactions with coleagues outside of direct patient contact.
	Team-leader support for well-being, which emphasizes well-being and allows to exhibit mental health awareness, model healthy behaviors and open space to discuss mental health, by regularly checking up on staff to ensure staff well-being and “have their back” vis-à-vis organizational support.
	Integration of psychological personnel into frontline teams was highlighted by many participants as “having been there” was perceived as pivotal for an ability to open up, and allowed the alleviation of immediate concerns and team-wide discussion.
	Decompression spaces (e.g., Wobble Rooms), allowing staff – either in isolation or with a colleague/ leader – to temporarily retreat, recharge and recuperate after particularly difficult moments.
	Mutual support sessions, with deployed and permanent personnel supported by leaders or psychologists to discuss emotional aspects of their experience, aid in sense-making, find closure, reassure colleagues, and find similarity of experiences (e.g., Schwartz rounds).	Pandemic/crisis Follow up
	Occupational health support services (e.g., Psychologists, mental health courses) for personnel to find 1-on-1 support if needed.