To address burnout, one large academic medical center—under the guidance of the chief wellness officer—has expanded existing efforts and created new ones designed to improve the well-being of physicians, health professionals and staff.
Leaders at University of Utah Health (UUH) initiated a multifaceted assessment to help guide their efforts. They conducted the AMA’s Mini Z burnout survey with the addition of questions aimed at understanding the needs of academic faculty, according to an AMA STEPS Forward™ module. The survey looked at:
- Hours of direct patient care.
- Average number of patients seen in a four-hour shift.
- Feeling of support or appreciation by peers, patients, families and immediate supervisor.
- The three main sources of dissatisfaction with practicing medicine.
- Ratings of clinical support from medical assistants and nurses.
- Average daily census.
This data was used alongside in-house analysis of unique questions and additional surveys to yield benchmark data for UUH.
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After receiving the survey results, the chief wellness officer—Robin Marcus, PhD—and a faculty co-director of the UUH Resiliency Center met individually with leadership from each department within the medical school to identify opportunities for improvement. Here are some examples of the success of new wellness-related projects and collaboration among existing programs.
Each department selected one or more wellness champions to help develop projects aimed at physician well-being priorities. They used specific, relevant metrics, including patient satisfaction, number of patients being served, electronic health record efficiency and physician engagement.
“A range of projects focused on topics such as personal wellness and resilience, and advanced models of teamwork facilitation, clinic flow, EHR use and flexibility of hours,” Marcus said in the module. She is also a professor of physical therapy at UUH and a board-certified clinical orthopedic specialist.
Wellness champions attended quarterly meetings with Marcus and Resiliency Center Co-director Amy Locke, MD. This program expanded in 2018 to include faculty and staff from across the health system.
UUH also identified existing programs that addressed physician well-being and looked at opportunities for collaboration. For example, the winter 2017 weekly “community read” program created by the system’s Office of Health Equity and Inclusion was co-sponsored by the Office of Wellness and Integrative Health.
“The Community Read is similar to a book club or a journal club focused on a specific topic or area,” said Marcus. “The focus of the winter 2017 semester’s readings was the science of wellness and exploring the relationship between inclusion and wellness, and wellness and quality."
UUH also formed a group to discuss resilience among health professionals. Initially focused on physicians dealing with challenging situations, it now includes all faculty and staff.
One initiative this group spearheaded was the creation of the Resiliency Center, which brought the extensive wellness programs already in existence at UUH together for collaboration. The Center also aims to help physicians become more resilient by encouraging innovation, helping focus energy, maximize impact and avoid duplication of effort across organizational well-being initiatives.
Physician well-being is regarded as a permanent operational goal at UUH that will be addressed with a yearly burnout survey. UUH leaders will also keep looking for for ways to collaborate with existing programs to further develop the Resiliency Center and expand the number of wellness champions.
AMA’s STEPS Forward is an open-access platform featuring more than 50 modules that offer actionable, expert-driven strategies and insights supported by practical resources and tools. Based on best practices from the field, STEPS Forward modules empower practices to identify areas or opportunities for improvement, set meaningful and achievable goals, and implement transformative changes designed to increase operational efficiencies, elevate clinical team engagement and improve patient care.
Several modules have been developed from the generous grant funding of the federal Transforming Clinical Practices Initiative (TCPI), an effort designed to help clinicians achieve large-scale health transformation through TCPI’s Practice Transformation Networks. The AMA, in collaboration with TCPI, is providing technical assistance and peer-level support by way of STEPS Forward resources to enrolled practices. The AMA is also engaging the national physician community in health care transformation through network projects, change packages, success stories and training modules.
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