Heat-related challenges and interventions in hospitals: A future-oriented, qualitative approach to improve nurses' working conditions

Objective: This study explores organizational interventions aimed at mitigating heat-related challenges and stress for nurses in acute care settings, with a focus on adapting to the intensifying climate crisis. Method: Six trans- and interdisciplinary participants participated in the workshop. The one-day workshop was based on the methodology of 'Zukunftswerkstatt' (Futures Workshop) and 'design thinking' principles. Participants analyzed challenges related to heat waves and developed actionable, future-oriented interventions based on scenarios and tools. Data collection involved photographs of handwritten workshop activities and researchers' notes. Data analysis followed three main steps to abstract and synthesize results: discussing results using the collected data, participants' feedback on the workshop documentation, and final synthesis. Results: The study identified several key interventions to manage heat-related stress, including the development of a comprehensive Heat Health Action Plan (HHAP), modular training programs, and a mobile staff app for real-time communication. Interventions were categorized into four phases: prevention, preparation, response, and recovery, with organizational strategies outweighing individual-level interventions. Participants highlighted the need for leadership commitment, adequate resource allocation, cross-sector collaboration, and clear communication. Successful implementation of HHAP was viewed as dependent on engagement from middle management and its integration into hospital governance and strategic planning. Conclusion: This study highlights the complexity of heat adaptation in hospitals. Findings underscore the importance of successful heat adaptation for hospital employees. Strengthening institutional commitment and integrating staff-driven approaches are essential for developing robust, future-ready heat preparedness in hospitals.