Section 1 | Supporting the Team
Addressing Well-Being
Burnout is not new. However, COVID-19 has highlighted the challenges faced when administrative burden, sub-optimal communications systems, and unbalanced teams collide with an extended crisis.
In addition, the traumatic impact of COVID-19 has amplified the need for support and efforts to improve well-being, destigmatize mental health and address overall wellness.
Well before the pandemic, health care professionals were challenged by imbalances between job demands and resources. While organizations have long sought to address the system-level drivers of workplace stress and burnout, these drivers became more pronounced as COVID-19 added extended periods of stress to all parts of the health care workforce. When physicians, nurses and health care professionals experience extended periods of stress and burnout, they often feel as though they are letting down their patients, their families, and their colleagues. Moreover, they feel more challenged to care not just for their patients, but also themselves.
The impact of these extended stressors makes it critical for hospitals and health systems to address burnout from a system-wide level to better care for the health care workers who care for our communities.
In addition, efforts should reinforce that our health care workforce are humans who need access to safe and effective resources to address the mental health impact.
As noted by the recent Nursing Think Tank recommendations, assessing and responding to the continuum of stress injuries from burnout to impacts on mental health are imperative in retaining a strong and healthy workforce.
For more information on the need for behavioral health and the importance of reducing stigma, please see chapter 2.
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Top Takeaways for CEOs
1 Identify an accountable leader within the executive team to lead and measure well-being efforts.
2 Set aside resources, including executive time and energy, to address well-being among your employees and staff.
3 Walk the walk. As the top leader, model actions your team is implementing and talk about the challenges and importance of well-being.
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As you work to identify the best approaches to develop or expand current well-being efforts, taking the time at the senior leadership team level to review what exists, how successful you have been, and where the continued needs are will help direct next steps.
It’s important to include perspectives from human resources, clinical, operational, facilities, quality, technology and patient experience teams, to review current activities and outline an approach for the organization to engage in well-being.
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- Inventory the well-being efforts available. Identify what offerings are available at the individual level, such as employee assistance programs, the unit or department level, and those at the organizational level.
- Quantify current program use, value and success, where possible.
- Identify any data sources for understanding the current state of the workforce, whether well-being or employee engagement survey data, specific program evaluations, or other existing data to provide clarity on what is needed.
- Assess commitment and resources available at the executive level and assign an executive team lead to manage the ongoing work with accountability back to the leadership team.
- Resource
Well-being 5 – The AHA and a number of other national health care organizations published five evidence-based action items that hospital and health system leaders can use to support wellbeing now. The resources include examples focused on developing peer support programs, crisis documentation protocols, voluntary team redeployment, rapid improvemment processes and psychological first aid training. Watch a webinar on these examples.
- Resource
- As further detailed in Chapter 2, assess the availability and access to behavioral health resources to support the workforce.
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- Keep in mind that addressing burnout is not a checklist of tasks to complete, but a cultural shift that should involve all stakeholders. As an organization, work within the existing culture of your organization to shift it in the right direction.
- Develop a plan to engage key stakeholders, including front-line and core managers in addressing burnout and well-being plans. Those on the front lines likely have the best view of where changes can drive success but will need support in building the organizational structures to sustain change.
- Podcast
Leading With Empathy: Workforce Well-Being at Ochsner Health Addressing burnout and the mental health of employees is not only the right thing to do, but also improves care, quality, patient satisfaction and the financial health of the organization. In this conversation, Nigel Girgrah, M.D., chief wellness officer at Ochsner Health, discusses his evolution in workforce well-being, building a business case for organizational buy-in and the importance of combining leadership with mental health transparency.
- Podcast
- Identify gaps from current resources to desired state, and prioritize needs and opportunities to develop pilot improvement efforts.
- Include efforts to support and address self-care from education and training through onboarding and continuing education.
- PLAYBOOKS
The AHA Well-Being Playbook contains seven key steps for success and provides real-world case examples of successful interventions deployed in various health system settings.
The AHA Well-Being Playbook 2.0 contains additional resources on scaling and spreading pilot programs and activities and addressing the underlying organizational culture - RESOURCE HUB
National Academies of Medicine Clinician Well-Being Collaborative Resource Compendium. Containing resources from across the health care field, this compendium walks through advancing organizational commitment, leadership, conducting assessments in the workplace, review of existing policies, addressing workplace efficiency and cultivating a culture of connection. - GUIDELINES
The Nursing Organizations Alliance, of which AONL is a member, recommends these elements for a healthy practice environment.
- PLAYBOOKS
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- Ongoing leadership of well-being efforts and the influence of leaders on the organizational culture will greatly impact your success. Prepare your core management and senior leadership teams to support their team’s well-being and overall health as well as their own. Leader burnout can erode the health of the entire team.
- RESOURCE HUB
American Organization for Nursing Leadership’s Leading through Crisis: A Resource Compendium for Nurse Leaders – learn how nursing leaders can support their teams, and themselves, in the midst of crisis and beyond. - EDUCATION
AHA Leadership Experience Program trains leaders in leading themselves and their teams to value well-being. - PODCASTS
AHA Masterclass Podcast discusses how to build leader well-being.
Trauma-informed Leadership Podcast – understand the opportunities and challenges in leading a team impacted by trauma.
- RESOURCE HUB
- Meaningful recognition is powerful and tied to purpose. Leaders can buffer the negative effects of burnout, foster a positive work environment, and cultivate a culture of gratitude and trust by creating and sustaining a culture of recognition. Activities range from local individual efforts to national recognitions.
- RECOGNITION PROGRAM
A program like DAISY is a sustainable and evidence-backed system for providing feedback from patients and families to clinicians. - AWARDS
AONL yearly presents national awards and recognitions for nursing leaders. - TOOL
AONL Foundation created tools for nurse manager recognition during COVID-19. Learn more about Beyond Gratitude.
- RECOGNITION PROGRAM
- Ongoing leadership of well-being efforts and the influence of leaders on the organizational culture will greatly impact your success. Prepare your core management and senior leadership teams to support their team’s well-being and overall health as well as their own. Leader burnout can erode the health of the entire team.
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- Growing evidence points to the protective value of teams in supporting well-being in health care settings. Programs such as Team Training and other collaborative action frameworks can help instill a team-based culture.
- PARTNER
All In: Well-Being First for Healthcare – A collaborative community established by the Dr. Lorna Breen Foundation and many others, the group offers grants to organizations seeking to engage in well-being work. - VIDEO TOOLS
Team Training tools have been shown to increase communication and engagement — explore the full video library of trainings. View a webinar on the use of Team Training tools to address burnout.
- PARTNER
- Growing evidence points to the protective value of teams in supporting well-being in health care settings. Programs such as Team Training and other collaborative action frameworks can help instill a team-based culture.
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- Supporting the well-being of the health care workforce is an effort that requires actors from across the field as well as learning from other industries. Like the work to support patient safety and quality, this effort is a journey, where each step helps us improve. National activities supporting this work: