Health Sciences Education Symposium
Presentation Format
Poster
Type of Activity
Innovation
Original Presentation Date
2023
Date of Submission
March 2023
Abstract/Short Description
Background. The impact of COVID-19 on the physical and mental health of individual providers and entire health care systems has had a devastating blow to already fragile networks.[1] It is imperative to identify strategies that heal, repair, and build capacity in health care providers and fix the system in which they practice. Building resilience through self-care is only a part of the solution.[2,3] Health care organizations are striving for solutions that target issues such as psychological safety, interprofessional teamwork, and wellness-centered leadership, which are more likely to reduce burnout than individualized self-care programs.[4,5] The purpose of the Strength in Caring Project (SCP) is to build engagement and promote departmental resilience and psychological safety among physicians and advanced practice providers (APPs) in the VCU Department of Surgery. The interprofessional project team includes 3 physicians, 3 nurse practitioners, 2 educational researchers, and a project coordinator with expertise in medical anthropology. This 3-year project began by collecting and analyzing data from the providers for customizing and implementing sustainable wellness initiatives.
Innovative Practice. Funded by the Health Services Research Administration (HRSA), this project includes three interventions: (a) providing inclusive strengths-based leadership (ISBL) training to providers, (b) developing wellness ambassadors within the divisions, and (c) facilitating rapid cycle quality improvement (RCQI) projects focused on organizational wellness, with assistance from DNP students. A survey that includes measures assessing psychological safety [6], resilience [7], work environment [8], engagement, and intent to leave is being administered every six months to evaluate outcomes. Data were collected in early fall 2022 to measure baseline characteristics of the department before the first ISBL training. Follow-up meetings are being conducted with individual divisions within the department to share those results and discuss frustrations to address through RCQI projects, and wellness ambassadors are beginning their work.
Results. After two months and multiple emails, 74 physicians and APPs (48%) completed the baseline survey. There were response similarities among providers across the department, but also nuances between divisions. 3 of the 11 divisions scored above the national benchmark for psychological safety, and 7 divisions scored above the benchmark on resilience. 61% of respondents expressed overall satisfaction with their job, but more than half (55%) describe themselves as burned out or having symptoms of burnout. A further 32% see themselves as under stress. The strongest drivers of burnout included frustration with the EMR (58%), chaotic work environment (53%), lack of control over their work (49%), frustration with the amount of work completed at home (48%), and not enough time to complete their work (42%).
Conclusion. While many providers report high scores on the psychological characteristics that typically mitigate burnout, the number experiencing burnout is still substantial. The stressors most frequently cited indicate that poor systemic processes are the primary cause in most divisions, rather than team dynamics among caregivers. The project team is mindful of the need to develop strategies that can be tailored to each division. The baseline survey was intended to inform initial activities for the three interventions, but the project team struggled to engage effectively with busy clinicians across multiple divisions in a large department. The low response rate may reflect the multifaceted workplace demands on these providers and the organizational frustrations that impact their wellbeing. With multiple teams (the grant team, wellness ambassadors, DNP students, RCQI project teams, and an analysis team) working in tandem, meeting the project’s goals will require a commitment to honest communication, reflection, and quality improvement. This project provides an opportunity to learn how to work differently, which may be part of what it takes to strengthen our complex multi-team systems in healthcare.
Rights
© The Author(s)
Is Part Of
VCU Medical Education Symposium
First Author Information
Kelly Lockeman, PhD, VCU