Health Care Homes Sustainability Roadmap 
Workforce

The world we live in can be challenging on most any day, but on those days that we are not feeling at our best or strong enough to face it, it can be overwhelming. No matter where we live, what we do for a living, or how we like to spend our time, we all face the same prices at the gas station and grocery store, share supply chain issues, and wake up to similar news reported.

How are we supposed to stay strong during these challenging times? A local grassroots initiative, Bounce Back Project™, reminds you to go back to the basics. Instead of looking for expensive remedies, perhaps using simple tools to increase your resilience will work just as well. We all have the ability to utilize these simple reminders to increase our overall resilience and well-being. These reminders can be used by all ages and do not have a price tag.

One of the easiest ways to increase our happiness is to do a random act of kindness for someone else. Not only does this make their day better and increase their happiness for the next 24 hours, but you benefit by increasing your own happiness for up to two weeks. It’s a win-win for sure and it makes our communities better places to live. Think smiling at others and saying hello, sharing flowers from your garden, kind sidewalk chalk messages, or volunteering locally. Involve your whole family.

Another easy tool is to start writing down three good things every day. It can be hard at times, but there is always something to be thankful for. Sunshine, the smell of freshly cut grass, kids playing and laughing, grilling hamburgers – writing down three good things for two weeks can help increase your happiness for up to six months. You basically retrain your brain to look for the positives that are right in front of you every day.

How about writing a letter of gratitude to someone who has made a difference in your life? Sharing a small message (250 words or so) of how and why they impacted you, allows your happiness to increase and depression to lessen. How wonderful to be able to tell them why you appreciate them.

Lastly, maintain social connections with family and friends! These are the people who will help us through life’s toughest moments, listen when we need them most, and allow us to be our authentic self. When we surround ourselves with people who matter to us, we can live a longer, healthier and happier life.

The HCH program thanks Melissa Pribyl MSN RN, CentraCare Community Health & Wellness Specialist, for her work on this article.

Let’s face it, humans are designed for sprints, not marathons. We likely would have made it through a 2-week sprint relatively unscathed. However, we’ve found ourselves in what seems like a never-ending marathon of increased workload, staff shortages, changing guidelines, and sicker than average patients. This has left many of us regularly feeling exhausted.

This can lead to feeling cynical about health care and the work we do. We might even ask ourselves if this is the best career path to stay on because it is hard to find fulfillment in our work like we once did.
The relentless demands, uncertainty, and lack of control when working in health care during a pandemic is a recipe for burnout. And the latest health care workforce numbers indicate that many have chosen to pursue options like a different career or early retirement. It is a testament to the commitment and resilience of all involved that the system hasn’t collapsed.

Resilience is defined by Dr. Ann Masten in her wonderful book Ordinary Magic (Masten, 2015) as “the capacity of a dynamic system to adapt successfully to disturbances that threaten system function, viability, or development.” The threats of the past two and a half years might be obvious. However, feelings of burnout within health care predate the pandemic and were on the rise well before any of us had heard of COVID-19. The pandemic sped up a process that was well underway.

Historically, a lot of the work on burnout and resilience focused on the individual. What can we as individuals do to increase our resilience? Certainly, there are things each of us can do to improve our immunity to burnout, thus enhancing our well-being and our work performance. For example, research has shown that individuals confronted with serious and life-threatening situations fare better emotionally if they rely on positive social support, exhibit optimism and positive affect, maintain a positive view of self, focus on a sense mastery, and foster mindfulness [Manigault, et al, Psychological Science 2022, 33(8) 1328-1339]. Also, it is well known that intentional efforts at stress management, exercise, healthy nutrition, and adequate sleep are vital for us all.

However, only focusing on what each of us as individuals working in health care can do for ourselves has led to resilience becoming a 4-letter word of sorts. We take offense to such a singular focus because it feels that we are being blamed for our discomfort. Such an individual focus misses significant opportunities that the systems in which we work can take to create and foster a culture of wellness by promoting appreciation, fairness, safety, and shared responsibility. For example, some healthcare organizations are hiring Wellness Officers. Others are forming interdisciplinary work groups such as Resilience Committees. Such officers and work groups study burnout in their systems and work to implement strategies and create opportunities that reduce burnout by promoting engagement and wellness throughout their systems.

It has become impossible for a family practice physician to independently complete all required tasks within a typical workday. To meet the expectations, there must be teamwork. Similarly, I believe it is impossible to be fully resilient and to thrive on our own. We must work as teams supporting each other with respect, kindness, and professionalism. We must listen to each other and learn from others’ perspectives remembering that no one of us is as smart or capable as all of us. We must work to ensure equity and share responsibility for our patients, our outcomes, and our collective well-being.

It has been said that if you want to go fast, go alone; but if you want to go far, go together. Teamwork is required to ensure we make it through this marathon and the challenges that lie ahead in health care. So, to individuals: Be intentional about making your well-being a priority, so you can continue to support and care for others while engaging with your teams. To organizations: Make it an active and ongoing priority to create and sustain meaningful opportunities for appreciation, engagement, and wellness throughout your organizations.

Let’s go far, together.

The HCH program thanks Paul A. Davis, PhD, LP, Licensed Psychologist, Lakewood Health System, for his work on this article and for sharing his expertise.
 

Southside’s approach to building an employee wellness program

Southside Community Health Services is a Federally Qualified Health Center (FQHC) that provides high-quality primary care through integrated medical, dental, vision, and behavioral health services.  

Southside’s Quality Program addresses the management of chronic conditions through support and education around behavior modification and lifestyle changes. Chronic conditions can be difficult for anyone to manage. However, 93% of Southside’s patient population are at or below 200% of the Federal Poverty Guidelines, which adds food and housing insecurity and a lack of transportation to the list of patient challenges.  

The Quality Program is built on a continuous improvement model based on a foundation of psychological safety, trust, and compassion. The patients in the Chronic Condition Program have developed relationships with their care team who believe in meeting people where they are at. This approach allows Southside to provide individualized care and guidance to patients to support them in living healthier, happier lives.

As part of an industry where compassion fatigue and burnout can be very high, Southside also recognizes the need for care teams to better manage to care for themselves while they care for the people around them. Through regular staff surveys, Southside leadership gathers feedback on how employees feel about communication, organizational culture, and engagement activities. These surveys show how the organization is doing. But how does Southside learn how its employees are doing?  

In February 2023, Southside developed and conducted its first Staff Wellness Survey. The survey was presented as an opt-out model, meaning that all employees had the option to decline, but this option was not publicized, nor was it noted that participation was mandatory. Methods for survey completion included: online, in person or via Zoom with an individual unaffiliated with the organization. This approach allowed employees to answer sensitive questions in an anonymous and safe way.

The 31-question survey included topics such as physical and mental health; drug, tobacco and alcohol use and exposure; stress levels and coping mechanisms; and other sociopolitical risk factors. An additional survey asked employees to describe what “staff wellness” meant to them and solicited ideas for wellness in the workplace.

Through this feedback Southside learned its own team members were managing their own chronic conditions, mental illnesses, living with food insecurity, and having difficulty coping with stress. How did Southside address this? They did exactly what they do for their patients: they met them where they were at.  

Southside formed a multi-disciplinary Staff Wellness Committee which then developed employee resources to address food insecurity; implemented policies around only purchasing nutritious foods; keeping healthy snacks on-site; implementing standardized mindful moments during meetings; and partnering with an Employee Assistance Program that offers free and anonymous therapy, financial and legal advice.

More recently, Southside has begun offering the same activities to their employees that they offer to their patients: nutrition and cooking classes, grocery store tours, lessons on nutrition label reading, group physical activity, and support through safe and trusting relationships.  

Aligned with its ongoing continuous improvement philosophy, Southside plans to continue monitoring staff wellness through regular surveying efforts. While the physical wellness activities are all voluntary, participants are asked to share their individual successes. Employees are not asked to share the specific details of their health, but only whether or not they have experienced an improvement in various aspects of their lives like nutrition, physical and emotional health, lifestyle behaviors, and more.  Participants are also asked to recommend areas of improvement as they engage in various programs.

Southside honors and values the lived experiences of all individuals and takes recommendations from staff to enhance its overall programs for all people – patients and employees alike.