We're All in This Together
How teamwork restored the spirit of comraderie, increasing both clinical staff and patient satisfactionClinical Affairs | CU School of Medicine Jul 30, 2019
(August 2019) More clinicians and institutions are taking clinician burnout and resilience seriously, as they recognize the threat to both clinician wellbeing and patient care. A little over a year ago, the section of Child Neurology took notice and decided to do something about it.
“The awareness of the problem has grown,” explains Jenny Reese, MD, Section Head, Pediatric Hospital Medicine. “It’s gotten more visibility, partially because people are publishing on the topic. But it’s also the result of a collective cry from providers who are suffering, who know we need to do something. It used to be seen as touchy-feely, fluffy stuff, but now the seriousness is more visible.”
The CU School of Medicine Resilience Program offers a range of services to help individual clinicians, including individual consultation, a mindfulness program, and a lecture series. Importantly, the program also works on system-level solutions, looking at ways to solve root-cause problems that contribute to exhaustion and burnout. To do this, the program seeks support at the highest levels of the system, but focuses on doing the actual problem-solving work at the team level.
“The first step was recognizing the problem. We needed to get beyond the idea that this is an individual problem. It’s everybody’s problem,” Dr. Knupp recalls. “Then we needed to do the work ourselves as a team. It’s important to empower groups to make the changes they need to make.”
Late in 2017, the Children’s Hospital annual Faculty Medical Staff Satisfaction survey showed there were some big opportunities for improvement in satisfaction and engagement. Some members of the group reached out to Dr. Reese for her help.
Dr. Reese worked with Read Pierce, MD, Director of the Certificate Training Program in Quality Leadership at the Institute for Healthcare Quality, Safety, and Efficiency, to propose a solution. They collaborated with leaders in the section of Child Neurology to develop a more detailed survey and plan a staff retreat. The retreat would be an opportunity to focus on the team’s values and find solutions to some of the challenges driving the dissatisfaction.
There was some concern that the neurology team would be cynical about the retreat. After all, they were already feeling like no one was listening to them. So Dr. Reese and Dr. Pierce intentionally focused on both the individual and system aspects of wellbeing. They used appreciative inquiry to understand the problems and discover workable solutions, giving power back to the team and avoiding the helpless feel of a gripe session.
“Engaging the entire group to have these conversations is vital,” says Dr. Pierce. “This work cannot simply take a top-down approach. With strong support from senior leaders, every member of the section needed a chance to voice concerns and personal experiences, to help us see what ‘a great day at work’ looks like, and to propose solutions.”
In addition to reconnecting the clinicians to their values as individuals, the retreat reconnected them as a team. This approach addresses several issues at once: it fosters camaraderie, which is an important factor in clinician wellbeing, while giving the team time to pause and analyze the system factors together.
“At first, our team wanted someone to swoop in and fix everything,” says Dr. Knupp. “But the retreat helped us see the value of working together on micro-system processes – small fixes that make a big difference over time. We saw that we have to break it into small pieces and give people the ability to go forth and work on it. It’s important to have everyone involved as a community to fix it.”
This experience helped Dr. Reese learn more about the best way to lead a team through a retreat to promote wellbeing and resilience while solving problems. She now has a playbook that can be used to repeat the process with other groups.
For Dr. Reese, the recurring theme in her resilience work over the last four years is the importance of connection, community and engagement – the “we’re all in this together” spirit. She hopes to continue working to restore that spirit to care teams across the campus and the state.