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Extraordinary People |joy in practice
Center for Provider Wellbeing
One of them was nurse practitioner Judith G. White, FNP, who “When we focus on people, when we focus on that fourth aim of im- received Care for the Caregiver peer support while working in the proving the experience of providing care, when we appreciate the Emergency Department. power of cultivating joy and meaning and we tap into that innate
“The support was priceless,” said White. “The continued check-ins that the program provided were also beneficial. They remained available, but at the same time they were non-intrusive and re- spected my privacy. I think this program has so many benefits and can help employees with a variety of needs.”
In a 2015 study published in Mayo Clinic Proceedings, more than half of all surveyed doctors reported feeling professional burnout and nearly half expressed dissatisfaction with work-life balance, a significant increase in both markers since a 2011 study. Research also shows that burnout is nearly twice as prevalent among physi- cAians as other U.S. workers.
National Academy of Medicine discussion paper sug- gests that the rise in burnout correlates to rapid changes in the U.S. health care system, including changes in clin- ical practice to meet the needs of an aging population
with increasingly complex health needs, new payment and care models, the movement to an electronic health record and public- ly reported quality metrics. The paper concludes that emotional distress and burnout among health care providers can negatively affect quality, safety and health care system performance.
“Achieving professional fulfillment isn’t just about the absence of burnout,” said Vanessa Downing, Ph.D., director of content and development training for the Center for Provider Wellbeing. “It re- quires being very honest about what works and what doesn’t work in our system, and accepting that individual change is not enough. What’s needed is systemwide change.”
With the leadership of Dr. Farley and her team, Christiana Care has expanded its focus beyond individual support to interventions to increase the resilience and well-being of teams, as well as program- ming that reaches across departments and service lines to identify the most effective ways to infuse joy and meaning into caregivers’ work. Toward this goal, the health system established the Cen-
ter for Provider Wellbeing in 2016. The center is a member of the National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience and the Physician Wellness Academic Consortium.
“The health and well-being of our own extraordinary people are essential to delivering on our mission,” said Christiana Care President and CEO Janice E. Nevin, M.D., MPH. She emphasizes that provider well-being is key to Christiana Care’s commitment to be exceptional today and even better tomorrow in providing high-quality, safe care in ways that our neighbors value.
The mission of the Center for Provider Wellbeing builds on the Triple Aim, a guiding principle to improve health, provide a better patient experience and reduce costs. The mission expands to the Quadruple Aim, which includes a vital fourth element — a positive clinician experience.
desire within each of us to really make a difference, the results are transformational,” said Dr. Farley.
From burnout to joy in practice
“In order to care for patients the way we would like to, we need to bring our best selves as providers,” said Patricia M. Moore, M.D., director of provider development and experience for perioperative services at the Center for Provider Wellbeing.
Even in the midst of the pace and pressure that can create increas- ing stress for health care professionals, it’s possible to nourish the joy and sense of purpose that led so many providers to the field.
Research shows that individual clinicians in partnership with health care teams and senior hospital leadership can alleviate workplace stress, said Stephen Swensen, M.D., MMM, FACR, medi- cal director for Professionalism and Peer Support at Intermountain Healthcare, and senior fellow of the Institute for Healthcare Im- provement, where he co-leads the Joy in Work Initiative. “We need to move more of us away from looking at our work as just a job and toward looking at it as a calling full of rewarding purpose. With time and attention, we can change the course of provider burnout.”
Dr. Swensen was keynote speaker at “Esprit de Corps: From Burnout to Joy in Practice,” the spring symposium of the Center for Provider Wellbeing, at the John H. Ammon Medical Education Cen- ter. Panel discussions on ways to support esprit de corps featured Christiana Care clinicians from inpatient and outpatient settings.
Fortunately, there are methods for establishing a satisfying work environment that fosters the ability to deliver high-quality care to patients, said Dr. Swensen. Among them is establishing a positive environment with a focus on compassion for patients and the
Thealth professionals who care for them.
he most joyful and engaged staff feel both physically
and psychologically safe, appreciate the meaning and purpose of their work, have some choice and control over their time, experience camaraderie with others at work,
take care of themselves emotionally and physically and perceive their work life to be fair and equitable, said Dr. Swensen. He empha- sized that this supports both clinicians and their patients.
Christiana Care is making a significant commitment to nurturing positive work settings, including establishing the Center for Provider Wellbeing, said Dr. Farley.
“We don’t just want to minimize burnout. We want our providers to flourish,” she said. “Christiana Care is an incredible place to work already, and we are committed to making it even better, while also equipping our providers with the knowledge and skills they need to thrive.” 

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