Why It Matters
“It has been validating to know that across the world, we’re all dealing with very similar issues. Getting energy from the passion and dedication of all of these other health care systems across the globe has helped to feed the energy of our team."
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Learning Together to Promote Joy and Well-Being

By IHI Team | Monday, November 21, 2022
Learning Together to Promote Joy and Well-Being Photo by Joseph Redfield Nino | Pixabay

Working to improve joy and well-being in work can be challenging, so doing it with others can have multiple benefits. Participating teams in the Institute for Healthcare Improvement (IHI) Joy & Well-Being in Work Results-Oriented Learning Network have reported learning new methods, making valuable connections, and getting results by connecting with other organizations.

Launched in March 2020, the Network follows the IHI Breakthrough Series Collaborative model and partners with forward-thinking organizations committed to system-wide joy in work, increased staff engagement and productivity, and improved overall quality of care and experience for staff and patients. The Network used the IHI Framework for Improving Joy in Work as its foundation. The framework consists of four steps (forming the “how” of the work) and nine elements (forming the “what”). These elements include physical and psychological safety, meaning and purpose, choice and autonomy, and teamwork and camaraderie. Together these elements contribute to a happier, healthier, more productive workforce.

Joy in Work Framework

IHI Framework for Improving Joy in Work


In addition to providing the Network’s foundation, some participants saw the Framework as giving credibility to joy and well-being work. As Jennifer Molano, MD, Associate Professor at the University of Cincinnati (UC) Health put it, IHI’s imprimatur indicates the methods are “considered best practice, which helps with organizational leadership buy-in.”

The Framework also provided a strategically planned sequence for the learning. “We noticed that each session seemed to be right on time,” said Lisa Melink, MA, Manager of Wellness and EAP Service at UC Health. “If we were feeling discouraged about something, it was energizing at the next session to hear that others were in a similar situation.”

This kind of invaluable validation came from teams based around the world, from the UK to Cameroon. “It has been validating to know that across the world, we’re all dealing with very similar issues,” said Jill Cordes, Senior Workforce Development Officer at Newcastle upon Tyne NHS Trust. “Getting energy from the passion and dedication of all of these other health care systems across the globe has helped to feed the energy of our team.” She expressed gratitude for “the support, knowledge, expertise, and camaraderie” received from her Network peers.

Changing Mindsets and Being Adaptable

Ebenezah Otoo, Continuous Quality Improvement Specialist at Dartford and Gravesham NHS Trust, recalled one Network faculty member who told the parable of the elephant, the rider, and the road. In this allegory, the elephant represents the emotional mind, the rider represents the rational mind, and the road represents the environment. This framing helped the team focus on changing one of the three elements rather than trying to change everything all at once. “We might not be able to fix the pressure, but we might be able to do something about the stress,” Otoo said. This new perspective “changed how we approached projects.”

Other changes in mindset the teams learned included flexibility and taking the long view. “You have to meet the people you’re working with where they are,” said Molano of UC Health. “If there’s high acuity and low staffing rates, you may have to take a pause, but go back to it.” She adds, “You have to celebrate the small wins because there is a mountain to climb.”

At the University of Mississippi Medical Center School of Dentistry, Harold Mark Livingston, DDS, MS, Chairman of Hospital Dentistry and Advanced General Dentistry, said the team realized through this work that some of the staff felt taken for granted. Livingston and others have begun to make a point of expressing appreciation for one another. After a stressful procedure, he now makes sure to say, “‘I could not have gotten this done without you. Thank you so much. If you weren’t here, what would we do without you?”

To assess how their organization was coping with change, the team from Dartford and Gravesham NHS Trust used the Change Curve framework developed by Elisabeth Kübler-Ross. Also known as the 5 Stages of Grief, the framework includes the following phases: denial, anger, bargaining, depression, and acceptance. Originally developed to describe the grieving process, the framework is now often used to represent how people deal with change. When Dartford and Gravesham NHS Trust leaders asked one team to identify where they were on the curve, most said they were in the depression stage. After about two months of work, however, everyone identified as being in the acceptance phase, which indicated remarkable progress.

Additional affirmation came from one staff member who acknowledged that they had been actively looking for a new job. After a staff retreat focused on joy and well-being in work, though, “they realized there were a lot more changes they could make where they were. They felt more empowered,” Otoo recounted.

Otoo marvels at the progress Dartford and Gravesham has made since joining the Network, including forming a Continuous Quality Improvement team and a Joy in Work team. Asked for his advice to others, “Just get started,” Otoo recommended. “Otherwise, you may wait forever for the perfect time to begin, and there never is one.”

You may also be interested in:

IHI Leadership for Workforce Well-being Professional Development Program (In-Person and Online starting March 27, 2023)

Tips for Measuring Joy in Work

Equity Work is Joy Work

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