26 michigan MEDICINE® | Nov / Dec 2022 REFERENCES 1. Leiter MP, Maslach C. Six areas of worklife: a model of the organizational context of burnout. J Health Hum Serv Adm. 1999;21(4):472-89. 2. Maslach C, Leiter MP. The truth about burnout: how organizations cause personal stress and what to do about it. Jossey-Bass;1997. https://psycnet.apa.org/ record/1997-36453-000 3. Schein EH. Humble Inquiry: The Gentle Art of Asking Instead of Telling. Berrett-Koehler; 2013. 4. Palamara K, Sinsky C. Four key questions leaders can ask to support clinicians during the COVID-19 pandemic recovery phase. Mayo Clinic Proceedings. January 1, 2022. https://doi.org/10.1016/j.mayocp.2021.10.015 5. Sexton JB, Adair KC, Profit J, et al. Safety culture and workforce well-being associations with Positive LeadershipWalkRounds. Jt Comm J Qual Patient Saf. July 2021. https://www.jointcommissionjournal.com/action/ showPdf?pii=S1553-7250%2821%2900094-5 6. Shanafelt TD, Makowski MS, Wang H, et al. Association of burnout, professional fulfillment, and self-care practices of physician leaders with their independently rated leadership effectiveness. JAMA Netw Open. 2020;3(6):e207961. https://jamanetwork.com/journals/ jamanetworkopen/fullarticle/2767214 7. Gamble M. Hospitals’ ivory tower problem. Becker’s Hosp Rev. February 2, 2022. https://www. beckershospitalreview.com/hospital-managementadministration/hospitals-ivory-tower-problem.html 8. National Academy of Medicine. Resource compendium for healthcare worker well-being. https:// nam.edu/compendium-of-key-resources-for-improvingclinician-well-being/ 9. ALL IN: WellBeing First for Healthcare. 2022 healthcare workforce rescue package. https://www. allinforhealthcare.org/articles/76-2022-healthcareworkforce-rescue-package For further assistance, contact the Department of Patient Safety and Risk Management at (800) 421-2368 or by email. The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered. Reprinted with permission. ©2020 The Doctors Company (thedoctors.com). be better?”5 They openly acknowledge the individuals and teams doing the good work and take respectful, supportive action to effect change. Effective people-first leaders also model pro-wellness behaviors for selfcare6 and cultivate these actions for their teams. Take a Hard Look Next, people-first leaders examine their policies and practices with an eye toward eliminating the drivers of burnout that come from lead- ership mandates. These include non- evidence-based policies, metrics over mission, dysfunctional EHR systems, unaddressed patient safety concerns, trivial administrative tasks, regulatory myths, staffing shortages, and lack of childcare or mental health support. Leaders gain knowledge by rounding during busy late shifts and observing firsthand the change opportunities that stare them in the face.7 Fix Inefficiencies While shadowing, rounding, and (most importantly) listening deeply, people-first leaders scan for opportunities to enhance workplace efficiency and facilitate improvements for streamlining functions. Implementing time-saving team-based documentation and care, Lean methods, EHR optimization, and staff training eliminates waste in workflows and allows clinicians to spend more time with patients. Cultivate a Culture of Well-Being Finally, people-first leaders work to cultivate and sustain a culture of respect, community, connection, and support. This starts with creating conditions that allow healthcare workers to feel safe and joyful at work and return home with enough time and energy reserve to enjoy their personal lives. It continues by building support and time for a culture that includes at-work buddy systems, meal sharing, and peer-to-peer and mental health programs. People-first leaders destigmatize and normalize asking for help. The evidence-based actions discussed here have been field tested by healthcare leaders in the real world, organized into a framework of six essential elements based on expert guidance, and assembled into a compendium of resources for healthcare worker well-being by the National Academy of Medicine.8 With the promulgation of these resources and others—like the 2022 Healthcare Workforce Rescue Package from ALL IN: WellBeing First for Healthcare—a movement is underway.9 While leaders may not be able to fix every problem, people-first leaders achieve quick wins on easier challenges and take collaborative action to build the capacity to address the bigger challenges. Taking people-first action is imperative. The well-being of our nation’s healthcare depends on it.
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