Thank you for completing two surveys over the past 18 months from the WellDOM group, which were distributed to all sites, including UCH, Denver Health, VA, and National Jewish. 

• The 2019 Thriving Culture Survey asked questions regarding workplace culture and wellbeing domains including burnout, emotional-thriving and emotional-recovery. 
  
• The AMA COVID-19 Wellbeing Survey was first distributed in August 2020 and repeated specifically for staff and researchers in November 2020, and asked questions regarding individual wellbeing in light of the pandemic. 
• Data from the surveys was presented at town halls, division head meetings, and division meetings and we met independently with division heads. 

---

Survey Summaries and Actions Taken

2019 Thriving Culture Survey: 34% Response Rate

Qualitative Analysis (Major Themes): Workload and expectations; tangible resources; work culture; and salary and benefits affect emotional-thriving, recovery and burnout (all influenced by leadership). Responses pointed towards the importance of clear and reasonable workload and expectations, coupled with fair compensation and appropriate resources, existing within a supportive work culture. Leadership was seen as key to balancing resources and wellbeing. 

Quantitative analysis: 54% Burnout rate 
Workplace culture questions showed that feeling “We are in this together” and “People I work with care about me” were most correlated with increased emotional-thriving, emotional recovery and decreased burnout. Regardless of the metrics on emotional-thriving, emotional-recovery, or burnout, less than half of respondents agreed that we have adequate staff to handle workload. 

Thriving Culture Survey - Actions Taken

Culture: Given the importance of community and wellbeing culture seen in the survey, the following programs were launched: 

• Division WellDOM Champions group formed, now with 50 members representing wellness within all Department of Medicine divisions. 
• Department of Medicine WellDOM webpage
• WellDOM @ the Table Groups 
• Balint Leader Training and Initiation of Balint Groups 
• WellDOM Champions Curriculum on Human-Centered Design Thinking 
• Building a Culture of Wellbeing lecture 

Efficiency of Practice

• Epic Sprint Outcomes lecture 
• Measurement of Pajama Time

Personal Resilience 

• HeartMath/Muse training 
• Growth Mindset lecture 
• Resilience for Staff lecture 
  

---

AMA COVID-19 Wellbeing Survey 2020 

• Response: 425 responses from all surveys ( ~22% response rate)
• Physicians: 174 responses (~12% response rate) 
• APPs: 66 responses (~34% response rate) 
• Research: 14 responses (~4% response rate, August, 2020). 105 responses (~35% response rate, survey repeated November, 2020) 
• Staff: 80 responses (~52% response rate) 
  

Summary:  

• All Respondents: Significant mental health symptoms noted, including anxiety and depression, sleep issues, and feelings of isolation.  
  
  
• APPs: APPs had some of the most worrisome scores with 79% endorsing burnout.   
  • Scored much higher than physicians and researchers on mental health measures, including anxiety, depression, and sleep concerns.
  • High fear of clinical exposure to COVID-19, and financial concerns 
  • Higher intention to reduce hours or leave clinical practice  
  • Did not feel as valued as their physician colleagues
    
    
• Physicians: CU DOM physician metrics were generally worse than the national benchmark. Physicians endorsed:
  • Higher concerns over childcare 
  • Higher burnout than national benchmark
  • Higher sense of meaning during the pandemic 
  • Higher sense of feeling valued than APP colleagues 
    
    
• Researchers:  
  • High worries about funding and decreased productivity 
  • High mental health issues (including sleep and suicidal ideation) 
  • Higher rate of isolation and considering leaving in the next two years 
  • Lower sense of meaning in their jobs compared to clinical colleagues 
    
    
• Staff:   
  • Very high rates of mental health concerns
  • Highest rate of feeling valued 
  
  

AMA COVID-19 Wellbeing Survey Response – Actions Taken

Mental Health Measures 

• Resources provided in collaboration with Department of Psychiatry 
  • Team debriefs with mental health provider 
  • Individual virtual mental health support 
  • Clinician support groups
  • Staff and faculty mental health clinic 
  • One link form for to make appointments and obtain outreach call for the staff and faculty mental health clinic
  • Three town halls devoted to mental health 
  • Writing exposure therapy/COVID narratives 
  • Mindfulness sessions 
    
    
• Other mental health-related developments
  • Adoption of Stress Continuum common language and badge cards 
  • Leadership rounding at University Colorado Hospital and in clinics with “tips and treats” 
  • Wellness Wednesdays weekly resource e-mail
  • DOM COVID-19 and WellDOM webpages - added mental health resources sections 
  • Mental health resource materials developed for each division
  • HeartMath/MUSE mindfulness and biofeedback training 
  
  
• Organizational Changes 
  • Caregiver resources including collaboration on Care@Work
  • FTE allocation for WellDOM leadership staff and APP positions 
  • DOM Gratitude Program to recognize work of colleagues 
  • APP focus groups: changes initiated as a result of high APP distress on survey (analysis is ongoing)
    • Increased signage in clinic rooms about mask-wearing for patients
    • Increased transparency about promotions during COVID-19 
  • Researcher focus groups (in progress)
  • Division wellbeing strategy planning
  • Ongoing annual surveys in collaboration with UCHealth to assess progress with our institutional efforts
  • Active collaboration with UCH/SOM and Department of Psychiatry 
    
    
• Community and Social Support
  • WellDOM Champions with division leadership created over 30 social programs at the start of pandemic including buddy systems, cocktail hours, evening salons, joy in medicine emails, TEAMS channels, virtual mindfulness, gratitude practices, check-ins, book clubs, trivia nights, buddy systems 
  • WellDOM Champions continue to monitor divisions and create programs with leadership 
    
• Upcoming Programs
  • Suicide prevention in the workplace
  • Peer support program
  • Sleep program
    

---

If you have questions or concerns regarding the survey data or the WellDOM initiative, please reach out to our team: 

Katherine Morrison, MD, Assistant Professor, General Internal Medicine KATHERINE.2.MORRISON@CUANSCHUTZ.EDU 

CT Lin, MD, Professor, General Internal Medicine CT.LIN@CUANSCHUTZ.EDU 

Roxana Naderi, MD, Assistant Professor, Hospital Medicine ROXANA.NADERI@CUANSCHUTZ.EDU