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Marcie Hopkins, U of U Health.
wellness
Five Ways Our Culture of Wellness is Working During COVID-19
Family Medicine physician and co-director of the Resiliency Center Amy Locke outlines five ways U of U Health’s strategic commitment to well-being is paying off during COVID-19.
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any things have been put on hold during the COVID-19 pandemic. Looking at ways to address burnout in health care and improve the well-being of our workforce isn’t one of them.

There are a variety of evidence-based approaches that can make a big impact. Foundational to all of them is building a Culture of Wellness—an organization’s commitment to the well-being of its workforce is essential to reduce and prevent burnout and increase professional fulfillment. 

At University of Utah Health, building a Culture of Wellness has been a strategic priority since 2014. As an organization, we promote individual and system resilience through structured well-being support programs, embrace a commitment to continuous improvement, and maintain a patient-centered focus on all aspects of care delivery. This strategic commitment shines in our system’s recent response to COVID-19.

Five Ways Our Culture of Wellness is Working

1. We connect as humans. 

Human connection is a basic need for survival. When we are able to connect with others at work, we can reduce burnout, improve job satisfaction, and provide support to others. The way we connect has changed dramatically in the last few months but is no less important. Some of us are still connecting in person at work but many are managing through video chats and phone calls. System leadership live streaming of updates has kept the organization connected as the COVID-19 situation rapidly changes. And the transition to virtual care has connected thousands of patients from the intimacy of their homes to our providers, ensuring safe, effective and efficient care during the pandemic.

Staying connected means knowing each other—connecting with each other as people. A simple check in at meetings is a great way to build connection. We purposefully look for opportunities to connect to strengthen relationships in our daily work.

2. We respect personal time. (For ourselves and others!)

Self-care is the first step in caring for others. We know that taking time to decompress and recharge is essential to maintaining the quality of our work. Hospitalist Emily Signor recently shared an essential component to her teams’ well-being in the response to COVID-19 was the schedule adjustment of 5-on/5-off, which allowed ample time to recharge during these intense shifts. 

This has also changed with the shift to working from home. The boundaries between work and home are fluid for many, creating new challenges in having dedicated time away from news updates and work. Leaders of teams working from home have incorporated flexibility in work schedules to accommodate those with children home due to school closures.

It can be helpful to think about addressing self-care as if you are an elite athlete: What does it take to keep you at the top of your game? Taking breaks to disconnect and get outside can help. Other ways to manage self-care include spending time with family and focusing on getting enough sleep. These approaches can all help us be more successful, productive, and fulfilled by our work. 

3. We recognize the bright spots.  

There are two essential parts here: One is appreciating the work of colleagues and sharing that appreciation. The other is recognizing what is going well and finding ways to spread the success. 

We have appreciated the deep bench of expertise shared during each Clinical Update lead by Chief Medical Officer Tom Miller. In addition to keeping us up to date, they shine a brilliant light on burgeoning thought leaders from throughout the institution, whose insights support an evidence-informed response to COVID-19. 

The sharing of recognition stories in Employee Forums, countless kudos in Pulse’s HR-lead Recognize Great Work, grassroots team-based efforts, and #UtahCares reflects a community outpouring of gratitude and appreciation for the work of health care teams.

Feeling valued at work is an important part of creating a Culture of Wellness. It increases engagement and decreases burnout. In health care, in particular, we are experts in recognizing problems. It can take effort to notice the positives and even more effort to point it out, but the benefits to doing so are substantial. 

4. We promote a safe culture. 

Health care has a history of “hero” culture—giving everything of oneself at all costs. You’ve probably witnessed someone bragging about how sick or sleep deprived they were and still came to work, or how many hours they’ve worked in a row, or how long they went without going to the bathroom, eating, etc. COVID-19 has put a dent in this approach, at least the coming to work sick part. Our new heightened appreciation for spreading infection is making us reconsider risks to patients and colleagues. We don’t need to prove ourselves through deprivation. It isn’t good for us, and it certainly isn’t good for colleagues and patients. 

5. We’re learning when to say no. 

As a system, our leadership responded with tremendous focus and fortitude in the face of uncertainty. From the abrupt shift from elective visits and procedures in March to the detailed planning a return through the stages of risk, we’ve had to say no a lot lately. These decisions have major implications for our finances and the medical care of patients. 

This response has required saying no to many things that stand in the face of traditional health care operations. The ability to know when to say no is perhaps the most important ingredient of building a Culture of Wellness—it drives our success in the other four. 

As individuals, saying no can be a struggle. As a physician, I know that many of us went into medicine as driven, success-oriented individuals. We don’t like to disappoint. We care deeply about our work. Yet, the more we say yes, the harder it is to keep our commitments and to maintain the quality of our work. For many of us in health care disciplines, the same mission driven spirit that brings us to work every day often leads us to sacrifice our own self-care in service of others. 

As we are spread thinner and thinner, burnout settles in. This is critical to address as we consider work hours and tasks that don’t directly improve patient care, our educational and research efforts. Saying no can span personally not taking on a new project to collectively not agreeing to a new workflow or task. 

A Culture of Wellness doesn’t happen by accident

We have to measure

A strategic approach that includes a process for measurement is essential. Starting with a measure of well-being allows an organization to track progress and identify target areas. At U of U Health, the well-being of our workforce is measured regularly. We began evaluating professional well-being annually in 2016. Over time, we have expanded to include all faculty and staff who work at U of U Health. This data allows us to understand what is driving well-being and burnout. During the COVID-19 pandemic, we have measured mental health specifically. 

We have to improve

System-wide well-being efforts are led by a multidisciplinary team at the U of U Health Resiliency Center, which is a part of Wellness and Integrative Health. The Resiliency Center partners with groups across the organization to build a Culture of Wellness, as well as consider other approaches to reducing burnout and improving well-being. The COVID Resiliency WorkgroupConvened in mid-March in response to COVID-19, this is a group of interprofessional experts from throughout the system coordinating efforts to address workforce needs, support services, recognition, and well-being communication. brings many experts together to consider the unique needs related to COVID-19.

The Wellness Champions program is one option to help faculty and staff tackle problems impacting the well-being of their local teams using a quality improvement model. These groups have been active addressing COVID related stressors. The Community Physicians Group has put together a psychological first aid plan for providers. The Pediatrics group has a weekly wellness outreach with resources. Internal Medicine has been working on professionalism. Anesthesia has been reaching out regularly to providers. 

A number of groups are doing regular check-in sessions to touch base and support one another.

We have to support

With current upheaval in all that we do, there is no better time than now to consider how we support a strong Culture of Wellness. Together, we are helping to turn the tide in medicine, towards considering the health of those who work in health care in addition to the patients we serve. 

If you or someone you know needs help, resources are available.

We are building a culture that maximizes our successes in patient care, research, education and community outreach while making University of Utah Health a great place to work. 

Contributor

Amy Locke

Co-Director, Resiliency Center, Family Medicine, University of Utah Health