Well-being programs for emergency department teams
The Dr. Lorna Breen Act and the ED connection
Dr. Lorna Breen was the medical director of the emergency department at NewYork-Presbyterian Allen Hospital. She died by suicide in April 2020, overwhelmed by the COVID surge in New York City and the cumulative burden of caring for patients in crisis without adequate support for herself. Her family channeled grief into action, and the legislation bearing her name — the Dr. Lorna Breen Health Care Provider Protection Act — is now the most significant federal investment in healthcare worker mental health in U.S. history.
Dr. Breen's story is an ED story. It is a story about what happens when the clinicians who staff the front door of the healthcare system — absorbing the highest volume, the highest acuity, and the greatest unpredictability — are not given the infrastructure to sustain themselves. Emergency medicine's burnout rates are among the highest in any specialty, and they were elevated long before the pandemic made the crisis visible.
ED-specific stressors and their cumulative toll
Emergency departments concentrate stressors that other clinical environments experience intermittently. ED teams manage death — including the death of children — with a frequency and without the relationship continuity that makes loss in other settings more bearable. They manage moral injury from undertriage decisions made under resource constraint. They absorb workplace violence at rates second only to behavioral health settings. And they manage the patient boarding crisis that has made EDs the default overflow capacity for a system that is structurally full.
Second victim syndrome — the psychological impact on clinicians involved in adverse patient events — is particularly prevalent in emergency medicine, where adverse events occur more frequently and the workload structure leaves little time for processing before the next patient arrives. ED nurses and physicians who experience a patient death or a serious adverse event are often back at the bedside within minutes, with no organizational space to process what just happened.
The case for real-time well-being monitoring in the ED
Annual well-being surveys are structurally inadequate for emergency departments. The ED experience is highly variable by shift, by season, and by the specific events that occur — a trauma code, a pediatric resuscitation, a patient assault — in ways that an annual snapshot cannot capture. What ED leadership needs is a rolling view of well-being trends that reflects the actual texture of the work: which units, which shifts, which periods are producing the highest distress signals.
Real-time or near-real-time pulse-check tools allow ED leadership to see the signal from a particularly difficult stretch of shifts while intervention is still possible. If a night shift team's well-being scores have been declining for three weeks following a period of high pediatric mortality, that is a signal for targeted support — peer debriefing, additional leadership check-ins, access to mental health resources — not an outcome to be captured in next year's annual survey.
Building well-being infrastructure that matches ED culture
ED culture is pragmatic and skeptical of administrative processes that do not demonstrably improve patient care or working conditions. Well-being programs that feel like HR initiatives imposed from outside the department will not gain meaningful engagement. The programs that work in ED environments are those integrated into clinical operations — well-being check-ins embedded in huddles, safety reporting that captures staff distress alongside patient events, and visible leadership response that demonstrates the data is actually being used.
ImprovementFlow integrates well-being pulse checks with the safety reporting and huddle infrastructure that ED teams already use — which means well-being data reaches ED medical directors and nurse managers through channels that are part of the existing management cadence. Aggregate trends surface early enough to act. And the connection between well-being concerns and improvement projects ensures that ED staff who report distress see a response — which is the essential condition for sustaining engagement in a department that has seen too many initiatives arrive and disappear without impact.
See how ImprovementFlow supports well-being in your organization
Most customers begin with safety reporting or huddle boards and expand from there. No enterprise commitment required.