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As leaders at the Hennepin Healthcare Institute for Professional Worklife, we have focused on health care provider satisfaction and burnout prevention for many years. (Readers may be familiar with the widely used Mini Z survey tool to measure physician burnout Dr. Linzer and the Hennepin team developed.) We are often asked how health system leaders can improve joy in work during the COVID-19 pandemic. Our answer is the same as it would have been before the current public health crisis:
Health system leaders don’t create joy; we create the space where joy can exist by cultivating workplaces where people can connect with their meaning and purpose.
During a recent Institute for Healthcare Improvement (IHI) Joy in Work Results-Oriented Learning Network call that brought together health systems and community health centers from around the world, we shared keys to creating space for joy during times of crisis and change:
- Redefine joy. What does joy mean to us during the pandemic? It means knowing what matters most to all. Hennepin Healthcare has found, amid COVID-19 stress, that feeling valued has been most important when dealing with work overload and anxiety. What this means has evolved in the last year. During the early surge, for example, having sufficient, high-quality PPE and easy access to food and beverage helped people feel valued. Throughout the pandemic, people have welcomed open lines of communication and sincere expressions of appreciation.
- Rightsize the work. In times of crisis or change, we may not have the mental capacity or resources to take on all the challenges we see. Sometimes it’s essential to pivot to work that is cost-neutral or less ambitious. If we can’t change the whole system, what part can we change? Conversations about what matters most to staff can help determine the projects with the best potential for creating space where joy can exist while work gets done. Using PDSAs to test changes provides the opportunity to set small and specific goals, and allows for action and learning even when pressed for time or low on energy.
- Plan for times of change. Health care systems do and will change as leadership and other personnel change. How do we create the space for joy during leadership changes, job losses, pay reductions, furloughs, mergers, and other disruptions? Sustaining the culture of joy in work requires planning. For example, when onboarding new leaders, we must make sure we familiarize them with the joy work, what it’s trying to accomplish, and the language we use to talk about it. Leveraging a core group of frontline staff who are interested in this work can ensure the work is maintained and stays on leadership agendas during changes. Nurturing and tending to the well-being of your leaders (who may also be stressed), can be a meaningful investment in time and energy. (There is also a Mini Z workplace satisfaction survey for administrators and other leaders.)
- Engage your Chief Financial Officer (CFO). We all do better when we all do better. In other words, improving wellness, increasing joy, and decreasing burnout raises productivity, frees up bandwidth for high quality care and innovation, and decreases turnover. All these improvements are good for finances. While we should pursue joy in work for its inherent benefits, rather than its benefits for the bottom line, it is nevertheless important to know how to make this link to sustain the work. Use metrics to measure progress, and demonstrate a willingness to be realistic and flexible. Linking worklife findings to quality, safety, productivity, and turnover can be helpful for leaders seeking data on the impact of burnout, and the benefits of burnout reduction. Leaders are often asked to create a culture of joy in work while balancing budgetary needs. Being sensitive to their challenges will help establish long-term relationships and a collaborative spirit.
Addressing well-being and supporting what brings meaning and purpose to health care professionals creates the space for joy to exist. The first year of the COVID-19 pandemic was indescribably challenging for health care workers, many of whom were suffering from burnout long before COVID-19. As we start another year of the COVID-19 pandemic and face challenges with vaccine rollout, making room for this work is essential to our health care workforce and the patients we serve.
Mark Linzer, MD, MACP, is a primary care physician and the Director of the Hennepin Healthcare Institute for Professional Worklife (IPW). Elizabeth Goelz, MD, is an internal medicine physician and the IPW’s Associate Director.
You may also be interested in:
Annals of Internal Medicine - Supporting Clinicians During the COVID-19 Pandemic
Conversation and Action Guide to Support Staff Well-Being and Joy in Work During and After the COVID-19 Pandemic
IHI’s Joy in Work Results-Oriented Learning Network (begins August 2021)