Today, 65 percent of US employees cite work as a significant source of stress. More than a third experience chronic stress. Physicians are at an even higher risk, with roughly half experiencing some sign of burnout.
“Some believe that burnout is the price of success when in fact a growing body of research shows just the opposite is true,” said David Entwistle, President & CEO of Stanford Health Care. “When we prioritize our well-being, our decision-making, creativity and production improve dramatically.”
Resilience is the ultimate burnout buster
Resilience is defined as the ability to confront adversity or challenges and bounce back from them, said Bryan Bohman, MD, Chief Medical Officer for University HealthCare Alliance. “Resilient people tackle problems from the perspective of: What part of this do I own? What can I contribute to the solution? Rather than: Why is this happening to me? They don’t see themselves as victims; they function at a high level regardless of their circumstances.”
Although personal resilience is essential to combatting burnout, there is a growing understanding that organizations have a role to play. “Wellness is not only about personal resilience or just taking care of ourselves with sleep, exercise and nutrition,” said Tait Shanafelt, MD, Chief Wellness Officer for Stanford Medicine. “We now recognize how the system, the work environment in which we function, is a critical driver and the next frontier to make progress.”
To combat the high rate of burnout among physicians, Stanford Medicine developed the Professional Fulfillment Model, which acknowledges three factors necessary for professional fulfillment—personal resilience, an organizational culture of wellness and an efficient practice or work environment.
“We believe that this approach of looking at professional fulfillment (as opposed to burnout alone) is applicable to everybody in any job across Stanford Health Care,” said Bohman. “Many of the same stressors that affect physicians are occurring in every level of the health care organization.”
Stanford Health Care is working on re-engineering its organizational processes to allow staff to complete their work more efficiently, without having to put in a super human, super stressful amount of effort. Ongoing quality improvement initiatives are part of this effort. Standardized, reliable processes and workflows help create a consistent, reliable workplace, a key factor in reducing stress among employees.
Human Resources has a role to play in shaping the culture of wellness at SHC, said David Jones, its Chief of Human Resources. “We are helping to impact the employee experience, everything from the work environment that we create, to trying to have a workplace of high trust and high integrity to helping leaders be sensitive, highly skilled and effective,” said Jones. SHC has introduced the Stand Out model to create a workplace that nurtures professional fulfillment. “The more time a person can spend in the areas of their strengths, the higher their resilience, and the higher their productivity, engagement and effectiveness,” said Jones.
Resilience takes practice
SHC’s comprehensive employee wellness program, HealthySteps to Wellness, supports employees in building their own personal resilience. Just as building muscle strength requires exercise, resilience requires practice to develop the skills, behaviors and attitudes that contribute to physical, emotional and professional well-being. Asking self-reflecting questions, meditating, mindful breathing, physical exercise, building community, finding meaning and connections at work; all these micro practices can impact general resilience.
At Stanford Health Care, employees are building resilience practices into their daily work. A team of OR nurses ends every huddle with the question, “What’s your resilience level today?” A group of contract administrators bikes to lunch together, getting physical exercise while also building the social connections that are critical to emotional health. Nurses on B2 practice mindful breathing as they gel in and out of a patient’s room, re-centering themselves for the next patient encounter. A group of Advanced Practice Providers meets for lunchtime walks to combat the isolation of their jobs.
“We can’t eliminate all stress from our work; that’s not even realistic,” said Entwistle, who unwinds on regular bicycle rides. “But we can incorporate practices that make us all more resilient.”