The American Medical Association honored 44 health systems as recipients in the 2021 Joy in Medicine Health System Recognition Program on Oct. 7 for their efforts to address clinician burnout.
This compilation features guidance from leaders at 26 of these systems who shared insights with Becker's via email.
Question: What's the most important change you've made or initiative you've implemented in the past year to address clinician burnout?
Responses were lightly edited for clarity and length.
Griffin Myers, MD. Chief Medical Officer at Oak Street Health (Chicago):
"We have spent a lot of time understanding what causes burnout and what helps prevent and reverse it, and if we've learned anything it's that there's no single answer. An organization must start with a strong commitment to its values, values that clinicians share and have spent their life pursuing, and then complement those values with the tools and resources to support clinicians in that mission. Only then do the incremental burnout-specific interventions like gifts, educational and affiliation events such as Grand Rounds, emotional resilience training, and social events make a difference. If you're not credible as an organization that cares about patients and providers, then the extra things don't matter."
Heather Farley, MD. Chief Wellness Officer and Head of ChristianaCare’s Center for WorkLife Wellbeing (Newark, Del.):
"ChristianaCare has had a robust peer support program, known as Care for the Caregiver, in place since 2015, providing support after adverse events to over 500 caregivers per year. To respond to the changing needs of our caregivers, we have on-boarded additional peer supporters from a variety of roles and clinical areas. We have also evolved and expanded our training so that peer supporters can respond effectively to a broader array of clinician stressors, including racial trauma and litigation stress. In addition, we collaborate with our behavioral health clinicians to provide timely appointments for caregivers who would benefit from more intensive support."
Angela Myers, MD. Division Director of Infectious Diseases and Interim Medical Director for Center for Professional Wellbeing at Children’s Mercy Kansas City (Mo.):
"I think the most important change that came from the COVID-19 pandemic was that healthcare worker mental health became a normalized topic of discussion. Once burnout, anxiety and depression are recognized and called out, we can then utilize strategies to improve these issues. You must first recognize the problem exists and acknowledge it before you can make it better. Our Center for Wellbeing team has continued current programming such as mindfulness-based stress reduction, virtual support groups, and 1:1 sessions with clinical licensed social workers, while also building new programming like the Love Supports program, in which a team adopts another team from across the organization to provide support and encouragement through cards, notes, candy and other goodies. This has been wonderful in that it has increased gratitude shown by one team to another, but has an added benefit of meeting new people from across the organization who are all working toward the same mission and vision."
Jonathan A. Ripp, MD. Dean for Well-Being and Resilience and Professor of Medicine, Geriatrics and Palliative Medicine, and Medical Education at the Icahn School of Medicine at Mount Sinai (New York City):
"Our ability to provide support to a workforce in the midst of crisis while continuing our signature initiatives during the last year has, in my view, been the most important approach to maintaining clinician well-being and addressing clinician burnout. By launching a robust research platform to study the impact of COVID-19 on our clinicians, we were able to demonstrate and publish our findings, which helped inform and lead to the development of our Center for Stress, Resilience and Personal Growth, a center that provides free mental health screening, treatment and referral services, as well as resilience skills-building offerings, to all employees. We were able to do this all while our Office of Well-Being and Resilience maintained its well-being champions program, dedicated to identifying and developing department-focused action plans to unload drivers of burnout that can erode well-being."
Aurelio Duran, MD. Physician Co-Director Wellness & Resilience Program Orlando (Fla.) Health Medical Group:
"Orlando Health’s Wellness and Resilience Program was created in the backdrop of an understanding of the great stresses faced by physicians and unique personal traits which place them at risk for burnout and less-than-optimal well-being. The key highlights of our program include providing physicians and other team members an awareness of stress in their personal and professional lives, unique personal traits that allow them to be successful, but also placed at risk for problems and provide resources to address these. Most importantly, we underscore to physicians and all of our healthcare family we deeply care, understand their situations, and have resources to continuously help them. It has enhanced an already existing culture of collaboration and appreciation we derive as medical professionals in helping other human beings and their families."
Heather Spies, MD. Physician Director of Clinician Experience and Well-Being, Sanford Health (Sioux Falls, S.D.):
Sanford Health has built a culture of well-being through small peer groups, trainings, mentorship, a clinician assistance program that provides confidential counseling, a clinician wellness council and other programs that provide support at the organizational level and encourage self-care, wellness and a healthy work-family-life balance. We also have a comprehensive strategy to support the well-being of our caregivers and promote awareness and prevention of mental health issues. We want our clinicians to know that it’s OK to not be OK sometimes. We are intent on ensuring that our people are treated as human beings first and as clinicians second. The recognition from the AMA is a testament to being deliberate and purposeful in how we invest in and support our clinicians."
Robert Lam, MD. Emergency Medicine Physician and Director of Physician Wellness, UCHealth South Region, Colorado Springs Memorial Hospital:
"We redesigned our physician lounge as a hub for social connection for clinicians, who were often siloed in their work environments. We saw immediate returns on this investment including increased use of the space for social connection and mentoring, along with clinical collaboration among specialties. We also launched a peer support program for all of our clinicians that is both reactive to critical incidents but also proactive for clinicians who are showing early signs of distress."
Scott Rissmiller, MD. Executive Vice President and Chief Physician Executive at Atrium Health (Charlotte, N.C.):
"We have a saying within Atrium Health, 'self-care leads to best care.' We utilize an effective Code Lavender program, where we focus on creating a culture of compassion for self and mutual care among teammates to enhance resilience and prevent compassion fatigue and burnout. We also support our teams through our 'Best Place to Care' initiative, which includes executing a workforce manager system in ambulatory practices to ensure clinicians have adequate staffing support; providing a well-being helpline, available 24/7, to facilitate peer-to-peer, EAP, mental health and chaplain services; and establishing PeerNet, a system staffed by faculty members to help clinicians dealing with adverse clinical events, as well as processes to reduce administrative burdens."
Thomas Vaughan, MD. Chief Wellness Officer and Radiologist, Bayhealth (Dover, Del.):
"As we build the foundation for our Medical Staff Wellness program, the most important thing we've done is foster relationships and collaborate with leadership across all aspects of the organization in order to advocate for, develop and promote initiatives to enhance professional fulfillment for our clinicians."
Genevieve N. Parsons, MD. Director of Clinician Wellness Children’s Primary Care Medical Group (Chula Vista, Calif.):
"Over the past year, we have initiated a comprehensive Care Team Redesign effort. This initiative includes physician leaders in partnership with our leaders from our management company. Together, we are approaching aspects of patient care, communication, and IT innovations as we migrate from a traditional to a team-based care model."
Kristin Jacob, MD. Medical Director of Spectrum Health Office of Physician and APP Fulfillment:
"Since the onset of the pandemic, Spectrum Health has been committed to consistent, clear, transparent communication. This has been a foundational practice throughout the pandemic in order to build trust, share key information about rapid changes, and to promote the many resources of support. It has also been imperative to address the emotional health of our team members by holding virtual support groups, group meetings with our Employee Assistance program, and debriefings with our Critical Incident Stress Management team. Spectrum Health has also recently launched a pilot program for Caregiver Peer Support which offers 1:1 peer support for clinical colleagues. Spectrum Health also has been committed to meeting the basic needs of our team members by offering a new benefit for childcare through a partnership with Care.com, offering meals, snacks and coffee to our busy clinicians and implementing competitive wage increases."
Marc Moss, MD. Head of the Division of Pulmonary Sciences and Critical Care Medicine at the University of Colorado School of Medicine (Aurora, Colo.):
"Burnout is an occupational health issue, and addressing our wellness has become a priority. We discuss burnout at our faculty meetings in order to normalize and destigmatize it. We have worked on maintaining and building a sense of community, and providing methods to make sure we take care of ourselves so we can more effectively care for our patients."
Alexa B. Kimball, MD. President and Chief Executive Officer of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center (Boston):
"We constantly work at improving both the work environment and benefits we provide our physicians. One of our most successful projects has had two parts: a survey given to our group about what they want us to work on and an opportunity to allow them to choose from a benefit program to help them experiment with services that might help them juggle it all. The latter program has included meal plan services, fitness programs, laundry services, child activities, engagement opportunities and meditation apps. Physicians not only report a high level of satisfaction with the program, but also have noted that it makes them feel valued, especially our female physicians. We continue to make fighting burnout a top priority, bringing options to our physicians so they can match them to their needs."
Karim Awad, MD. Medical Director for Clinician Wellness, Chief of Sleep Medicine, and member of the Board of Trustees at Atrius Health (Newton, Mass.):
"Out of all the initiatives Atrius Health has implemented to address clinician well-being and burnout, one of the most significant is our 24/7 clinician helpline. Clinicians can call, email, or page this helpline at any time to be connected to executive coaching or behavioral health support – addressing both the professional and personal challenges they may be facing during this stressful time. We’ve seen meaningful success through this helpline, with individuals reporting timely, comprehensive, and sensitive responses. We’ve also begun to roll out peer support programs in several specialties, training clinicians on how to spot burnout among colleagues and giving them the tools to provide immediate, basic intervention techniques."
Kate Regan, MD. Chair of MidMichigan Health’s Provider Wellbeing Council (Midland):
"Realizing the contribution of physician leadership training to clinician burnout, MidMichigan Health designed and welcomed its first cohort of physicians and APPs to its inaugural nine month Provider Leadership Institute program. Continued growth of our Peer Support Network and Connecting with Colleagues programs have been important in sustaining burnout efforts, as well."
Amy Case, MD. Chair of the Department of Palliative and Supportive Care at Roswell Park (Buffalo, N.Y.):
Roswell Park Comprehensive Cancer Center has grown its staff resiliency committee of all disciplines to 58 members with several active subcommittees. The program includes initiatives such as an interactive online platform and inpatient nursing support groups on the floors. In addition, we obtained a grant for an electrotherapy device to benefit staff mental health and obtained funding for a resiliency coordinator with a social work background as well as a program leader with a psychology background."
Jay Kaplan, MD. Medical Director of Care Transformation at LCMC Health (New Orleans): "To address clinician burnout at LCMC Health, the most important change we've implemented this year is to create our Be Well Center and hire a full-time Program Coordinator to focus on the three key components of clinician well-being:
- Align organizational culture to understand that the way to create a culture of wellness for our community is to start by doing so for our staff and medical staff.
- Concentrate on improving the efficiency of practice by doing the 'Pebble in the Shoe' exercise and asking our staff: 'What's the best part of your day? What gets in the way of the best part of your day? What's the worst part of your workday? What's one thing we could do to increase your sense of fulfillment and give you more of that best part?'
- Improve the personal resilience and wellness capability of our staff by creating a well-being website with robust resources, performing well-being and emotional debriefing rounds on more than 150 units and service lines, and initiating a peer ally support program that will be spread to all our hospitals after the initial pilot at Children's Hospital."
Melissa Wolf, MD, OB/GYN, and Melissa Reily, MD, Rheumatologist. Physician Wellness Directors, Bozeman (Mont.) Health:
"The most important initiative we have implemented in the past year to address clinician burnout at Bozeman Health is to establish the concept of care team wellness as a priority for our health system. This has brought awareness and attention to everything that may be helpful in alleviating burnout such as improved call room spaces, availability of food overnight, access to confidential counseling, peer support, community support, optimization of the electronic health record, and clinical efficiency projects. Now, the concept of care team wellness is included in how we design and implement projects at all levels of the health system."
Nigel Girgrah, MD, Chief Wellness Officer at Ochsner Health (New Orleans):
"Fortunately, we had already formed the Ochsner’s Office of Professional Well-Being in 2019 and had interventions in place as part of leadership development to improve the well-being of our physicians and advanced practice providers. In response to COVID-19, and in collaboration with colleagues in Behavioral Health and others, we expanded on those by spearheading a rapid response unit rounding program, which let leaders frequently debrief with staff and proved crucial to providing on-demand mental health and emotional support to over 1,000 Ochsner front-line staff. Mental health became a valued ongoing conversation, as opposed to a stigma, as we talked through fatigue, depression and burnout. We also set up 'decompression zones' where staff could unwind before or after shifts; we opened COVID-19 crisis support lines 24/7 and we offered virtual mindfulness sessions and other webinars on wellness."
Lotte Dyrbye, MD. Associate Director of the Department of Medicine Program on Physician Well-Being at Mayo Clinic (Rochester, Minn.):
"In the last year, we have facilitated grass-roots well-being innovation and design efforts in 15 work units across the Mayo Clinic enterprise, piloted tested virtual scribes, informed the design of telemedicine, leveraged data analytics and technology to drive progress, and supported a culture of well-being by building collegiality and community through COMPASS group, expanded peer support, enhanced leadership capabilities through focused training, and instituted organizational policy that approves reimbursement of fees charged for professional development coaching."
Amy Locke, MD. Chief Wellness Officer at University of Utah Health (Salt Lake City):
"Over the last year, we have honed our ability to work as a complex and interdisciplinary team of teams to address the well-being of our healthcare workers. By leveraging the strengths of many individuals of different backgrounds and skill sets we are beginning to change the culture of medicine at our institution. This impact goes far beyond any one program or intervention."
Marschall Runge, MD, PhD. Chief Executive Officer of Michigan Medicine, Dean of the U-M Medical School and Executive Vice President for Medical Affairs at the University of Michigan (Ann Arbor):
"We added new domains of well-being to our annual faculty and staff surveys, including feeling valued, psychological safety, connection with leaders, work-home balance, and professional fulfillment. We also implemented a new program this year to fund the dedicated effort of six faculty members. Their six areas of focus are decreasing time spent in the EHR, improving psychological safety, reducing the burden of email, balancing job demands and resources, overcoming the obstacles many faculty members have taking time off from work, and developing a culture for parental well-being."
Susannah Rowe, MD. Associate Chief Medical Officer for Wellness and Professional Vitality, Boston Medical Center:
"Our work at BMC seeks to acknowledge that the experiences of both our patients and our clinicians differ by social identities (including race/ethnicity, gender and sexual orientation), and that these differences can have profound impacts on our professional quality of life. Approaching clinician well-being through the lens of equity is essential to improving professional fulfillment and preventing burnout."
Tait Shanafelt, MD. Chief Wellness Officer at Stanford (Calif.) Medicine:
"Over the past 18 months, the most important thing for us to be doing has been implementing regular and deliberate 'listening' strategies to identify clinician needs. We’ve created multiple robust channels to do so, which has enabled us to address the dynamic needs as they have evolved during the different phases of the pandemic. For example, childcare support, meals, and lodging near the hospital in early days; concierge services and remote-work equipment to help with work-life integration six to 12 months into the pandemic; a new focus on addressing increased EHR inbox message volumes in current phase; and holistic support for those who develop COVID-19 as well as access to mental health support throughout. Given that the needs have been great, diverse, and dynamic, creating regular channels to seek continued input on what support is needed, using it to inform leaders and guide the organizational response has been critical."
Herbert A. Schumm, MD, Vice President, Medical Director Education and Physician Engagement at Mercy Health (Cincinnati, Ohio):
"We instituted a variety of programs, but one especially stands out. Early in the pandemic, eight Bon Secours Mercy Health psychiatrists and psychologists volunteered to be available for their colleagues 24/7. They have not only personally assisted more than 200 colleagues and enhanced the use of our Employee Assistance Program, but also founded a peer support program which now includes nurses, chaplains and therapists."