Making clinician well-being a priority
By: Heather Farley, MD, MHCDS, FACEP
Heather Farley, MD, MHCDS, FACEP, shares successful measures implemented at Christiana Care Health System in Newark, Del. She is chief wellness officer at Christiana.
Clinician well-being is finally starting to get the attention it has long deserved. Emerging evidence suggests that we are seeing early signs of improvement. As stated in a recent NEJM Catalyst article, titled, “Defending the Term ‘Burnout’: A Useful Tool in the Quest to Ease Clinician Suffering”:
“To build on these early gains and successfully transform the health care industry, we need new financial and operational models that prioritize clinician well-being. All stakeholders — individually and collectively, on an organizational and a national level — must be accountable for addressing the root causes of burnout.”
Like other vanguard organizations leading the charge to improve the clinician experience, at Christiana Care Health System, we approach the well-being of our clinicians following a three-pronged model, focusing on:
- culture of well-being
- efficiency of practice, and
- personal well-being
The Center for Provider Well-being’s mission is to “foster joy and meaning in work for providers and their teams.” The Center provides a host of resources in service of this mission, which can be found at https://christianacare.org/ forhealthprofessionals/providerwell-being/resources-forproviders/. A handful of these resources are highlighted below:
Care for the Caregiver – The Care for the Caregiver peer support program is designed to support clinicians who feel traumatized by an adverse event while at work. The goal of Care for the Caregiver is to help our clinicians understand what is known about the second victim phenomenon, to normalize what they are experiencing and to provide the support they need to return to caring for their patients with a healthy state of mind. We provide peer support to approximately 350 clinicians annually.
COMPASS – The goal of the COMPASS (Clinician-Organized Meetings to Promote and Sustain Satisfaction) initiative is to encourage physician collegiality, shared experience, mutual support and meaning in work to decrease burnout and promote well-being. Each COMPASS group consists of six to eight physicians who meet over a six-month period to share a meal while a facilitator leads discussion on topics, such as medical mistakes and the wounded healer, personal and professional balance, and finding sources of meaning.
OASIS Project – The OASIS Project is a multifaceted approach to build resilience within care teams. The OASIS model emphasizes the process of mentoring embedded staff members over the course of six to 12 months to become on-site experts who bring content directly to their colleagues during the course of the work day. Dedicated “reset” space with soft lighting, massage chairs and other well-being resources is also provided within each OASIS unit.
EHR User Experience – We employ a robust collaborative strategy including EHR design, customization, one-to-one training, at the elbow support and post go-live optimization to maximize the EHR clinician user experience. Early successes include significant decreases in pop-up alerts, team ownership of the “inbox” and a virtual scribe pilot.
Thank You Project – The Thank You Project is designed to enable patients and their families to express their thanks and appreciation to the caregivers who touched their lives, and reminds clinicians of the remarkable impact they have on the world. You can view a video about the project at www.youtube.com/watch?v=hgdflRHJYH0.
Ice Cream Rounds – Ice Cream Rounds (ICR) are quarterly residents-only supportive and reflective sessions that occur during protected lecture time. During ICR, residents are encouraged to think deeply about the challenges and opportunities encountered during this capstone training experience, and to share their experiences and developing wisdom with each other.
This is just a taste of some of the efforts that are integral to fostering joy and meaning in medicine, and we still have much work to do. We are continually working to promote an organizational culture of well-being, to bolster personal well-being resources and to improve the efficiency of practice for our clinicians. We look forward to continuing to innovate along with others dedicated to achieving the Quadruple Aim!
RESOURCES
To learn more about how you and your organization can improve clinician well-being, check out these resources:
The Center for Provider Wellbeing
https://christianacare.org/forhealthprofessionals providerwellbeing/
AMA’s STEPS Forward
https://edhub.ama-assn.org/steps-forward/pages/About
IHI Framework for Improving Joy in Work
http://www.ihi.org/resources/Pages/IHIWhitePapers/Framework-Improving-Joy-in-Work.aspx
NAM Clinician Well-Being Knowledge Hub
https://nam.edu/clinicianwellbeing/about/
Dr. Farley is chief wellness officer at Christiana Care Health System in Newark, Del. She is also an associate professor of emergency medicine at Sidney Kimmel Medical College at Thomas Jefferson University. She teaches and practices emergency medicine in one of the busiest emergency medicine departments in the country.