The plan is guided by three key strategic objectives, adopted from Stanford’s Model,16 which are applied to the unique challenges we are facing at Baystate.
- Foster a Culture of Wellness: Promote a supportive organizational work environment, values and behaviors that promote self-care, personal and professional growth, and compassion for ourselves, our colleagues and our patients
- Ensure Efficiency of Practice: Through workplace systems, processes, and practices that promote safety, quality, effectiveness, positive patient and colleague interactions, and worklife balance.
- Support Personal Resilience: Gain and sustain individual skills, behaviors, and attitudes that contribute to physical, emotional, and professional well-being.
Provider Well-being Advisory Council
The Council is committed to the shared responsibility of enhancing and supporting provider well-being including a supportive and efficient work environment. This includes the adoption of continuous quality improvement methodology including the administration of baseline and follow-up measures of provider well-being, the application of evidence-based improvement strategies, the use of PDSA methods for developing innovative improvement strategies, and continuous review and monitoring of impact.
The Provider Well-being Council is charged with:
- Identifying Baystate provider needs and areas of focus
- Collaborating with local work units to determine and implement pilot interventions
- Making recommendations to the BMP Board to disseminate change across the organization
Subcommittee Areas of Focus
Electronic Medical Record Optimization
Members serve as liaisons from our group to the upcoming CIS optimization initiative to ensure that our perspectives are considered in the process.
Efficiency of Practice & Team-Based Care
Members develop initiatives to make clinical practice more efficient and to reduce administrative burden. They identify and extract “pebbles in the shoe”. Members develop local demonstration projects to enhance team functioning towards physicians/APs working at the “top of their license” with the goal of reducing the sense of isolation and to increase ownership of responsibility for patient care at the team level.
Humanism in Medicine
Members develop pilot programs to help people rediscover meaning in their work and re-connect to the values which led them to go into the medical field.
Members work on initiatives to ensure that people use their PTO and protect time for their personal lives and family.
Communications & Publicity
Ongoing awareness and education about Provider Wellness Council progress.
April 20, 2021: Psychiatry Ground Rounds- Physician Wellness
View the recording "Physician Well-being: Psychological PPE in the Age of Covid and Beyond" Presented by Carol Bernstein, MD, Vice Chair, Montefiore Medical Center/Albert Einstein College of Medicine Professor of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology and Women’s Health Montefiore Medical Center/Albert Einstein College of Medicine
February 4, 2021 Surgical Grand Rounds- Physician Wellness
View the recording "The Doctor is Sick - The Decline in Physician Wellness." Presented by John Romanelli, MD, Professor of Surgery, UMMS- Baystate General SurgeryDivision Chief, Baystate Medical Center.
September 26, 2019: Progress Update
Read The BMP Voice interview with the co-chairs of the Provider Wellness Council, Dr. Beth Brady and Dr. Barry Sarvet.
June 1, 2019: Subcommittee Progress Updates
1. Modification of Post-Call Day
Pilot #1: The Pediatric Surgery Group is trialing a “No Scheduled Clinical Activity after 12:00 Noon” on the post-call day. The team shifted the clinical hours from 8:30-12:30 to 8:00-12:00, maintaining the 4 hour block so patient care was not affected. One medical assistant and one clerical staff come into work 15 minutes early to accommodate. It was decided that there was some flexibility built in so the post-call surgeon would be able to see an urgent patient if needed, staying after 12:00. The office administrator helped facilitate this and will monitor the call schedule, making every effort to adjust the post call days.
Pilot #2: The Cardiology group decided to trial modifying the post-call day by “Starting Clinical Activity at 11:00 am.” This is contingent upon the fact that patient care is not negatively impacted, so if need be, the post-call cardiologist would start earlier. The practice scheduler makes every effort to modify the post-call day, if possible. Results to date: 50% of the time, the post-call physician is involved with patient care before 11:00 am, but the group feels it is still worth doing and reports it has improved moral.
Humanism in Medicine
1. Finding Meaning in Medicine Dinners As a pilot, this subcommittee held two Finding Meaning in Medicine dinners with Council members. The benefits felt by the group were a sense of community not found elsewhere and a venue to be heard by colleagues who had similar life experiences. However, the group has also learned that finding time in the evening for fellowship is challenging and occasionally family issues prevented attendance even when originally the evening was free.
2. October 14 Wellness Committee Panel at Schwartz Rounds Council members will present progress to date and open up for discussion and feedback from audience members. We invite others to join us for this generative conversation, Monday, October 14, Noon-1pm, BMC Chestnut 1 a/b. (please note that this is Columbus Day).
3. Seeking New Committee Members The Humanism in Medicine subcommittee is seeking to broaden the membership with non-Council members who are clinicians at Baystate.
1. Teams that Deliver BOTH High Quality Care and Team Member Well-being
The first teams we will bring forward are: A BMC emergency room team, a primary care practice site (Baystate Medical Practices Quabbin Adult Medicine, Ware) and the 140 High Street geriatrics multidisciplinary outpatient team. They will be interviewed to share their strategy and operational tactics that have made their teams successful- both in terms of high quality patient care and team member well-being. Their stories will be videotaped and available for others to glean ideas from in order to generate practice-specific approaches.
2. Identification of Additional High Functioning Engaged Teams
As we move forward, ultimately, we envision featured teams to act as consultants and mentors to other teams. As such, we are seeking teams across the organization, from different disciplines, specialties and levels of care (outpatient, ED, inpatient…etc.) that demonstrate concepts and ideas that make their teams successful—professionally and personally. In the near future, we will be eliciting input from teams across the organization. Stay tuned.
Additionally, our committee will be utilizing the Press-Ganey Engagement data coupled with the Provider Resilience results to further identify areas of BMP practices that demonstrate strength in team-based care.
1. EMR Assessment
This subcommittee has made significant headway in identifying the stakeholders and establishing dialogue to identify aspects of the Baystate Healths’ EMR that contribute to provider engagement and burnout. In particular, we have partnered with the Informatics Department to closely evaluate the EMR and our members are represented on Informatics departmental committees. Our subcommittee members also participated in the Patient Keeper and Provider Collaboration meeting that included Patient Keeper senior leadership, where we provided robust feedback on the current system and suggested valuable solutions for upcoming upgrades.
2. New Survey – During Informatics System Upgrades
Currently, we are in the process of formulating a survey to evaluate the experience of practice sites and hospitals that are undergoing different informatics upgrades and transformation. The survey will be provided during or immediately after an implementation to gather real time feedback as to what is/is not working well and to collect recommendations/solutions for real-time and post-implementation improvements. Finalization of the survey is planned for early June.
April 3, 2019: Subcommittee Progress Updates
Efficiency of Practice
This subcommittee is currently working on the following projects:
- Flexibility of scheduling options
- Efficiency of billing practices
- A pilot of hiring an assistant to take on administrative duties to help with efficiency of practice in the hospitalist program.
This subcommittee is currently working on the following project:
Developing a tool to evaluate the practices undergoing EMR changes with regard to their experiences related to adequacy of upgrades, IT support, leadership and identify the constituents that were either implemented efficiently or agonizing to execute.
Humanism in Medicine
This subcommittee has held one evening dinner and discussion session.
This subcommittee is currently working on:
A variety of best practice team-based care practices and strategies in various departments and levels of care. Examples include:
This subcommittee has accomplished and continues to work on:
- Increasing awareness. Dr. Albert has presented at staff meetings, Grand Rounds, the Patient Experience Seminar, BayCare Board of Directors, PLT and the BH Board of Trustees.
- Surveying the providers for feedback and suggestions to assess the prevalence of distress at Baystate.
- Establishment of a Provider Wellness Fund within the BH Foundation.
- Opportunities to build in more flexibility to the schedule particularly; Flexibility in clinic start and end time (i.e. come in later or leave early) and Modifications to post call day rules (i.e. if on call night before, leave clinic by noon).
As a result of these conversations Schedule Flexibility Guidelines have been drafted and will be reviewed at PLT/Directors Meeting on May 2nd.
Draft Guidelines for Schedule Flexibility for Providers
The process for approving provider requests for schedule changes is as follows:
- Discuss with local practice leadership (MD and PM) to understand how the change may affect the entire team (staff, other providers) and, mostly importantly, access for patients. This will include a notice to Directors/Chiefs where appropriate.
- Financial/RVU targets must be met.
- The care and access for patients may not be compromised - the needs of patients come first.
April 1, 2019: Why Provider Wellness?
By Mike Albert, MD, Medical Director, Operating Rooms & Surgical Floors
Why focus on provider wellness? A healthy workforce is essential to our success as a health system. Despite the increasing complexity of health care, Baystate Health excels in safety, quality and value. However, this has come at the expense of our workforce, evidenced by the 2017 survey of Baystate providers that indicated the stress level of our providers is higher than their national peers.
Provider wellness impacts our ability to deliver on our strategic goals and recruit and retain the best talent. Even more importantly, our providers need to feel that they can give our best effort to our teams and patients. To do this we providers to be energized and engaged.
A Provider Wellness Advisory Council was formed, co-chaired by Barry Sarvet MD and Beth Brady MD, to review literature and national best practices, and develop a comprehensive, evidence-based plan to address burnout and enhance provider wellness.
Awareness and feedback are key
To increase awareness about provider wellness, we’ve presented at many leadership and staff meetings. (If you are interested in hosting a presentation, let me know.) We continue to reach out to providers for feedback/suggestions (and welcome yours) and have established a Wellness Fund through the Baystate Health Foundation to support related initiatives.
The council has devised a plan guided by several strategic objectives include:
- Foster a culture of wellness: Promote self-care, personal and professional growth, and compassion for ourselves, our colleagues and our patients.
- Ensure efficiency of practice through systems, processes, and practices that promote safety, quality, effectiveness, positive patient and colleague interactions, and work/life balance
- Support personal resiliency that impacts physical, emotional and professional well-being.
There has been a great deal of interest in this topic and I am hoping that many of you will choose to participate in developing approaches and solutions to improve provider wellness. Our goal is that this process is broad-based, transparent, focused, deliberate and, most importantly, successful.
Baystate Health is committed to advancing care and enhancing lives. This applies to our patients, our medical staff and our teams as we fulfill our mission to improve the health of the people in our communities every day with quality and compassion. I look forward to your participation and feedback.
Pilot Changes in Your Department
Several Council members have begun piloting changes in their individual practices by Getting Rid of Stupid Stuff (GROSS) and making changes to enhance the work environment for all practice members.
If you have thoughts about potential pilot projects in your area that address any of the below, send your ideas to ProviderWellbeing@bhs.org:
- Electronic Medical Record
- Efficiency of Practice &Team-Based Care
- Humanism in Medicine
- Worklife Balance
Recharge Your Batteries
A deep passion and purpose to serve humanity in a career that provides the opportunity for continued growth and advancement, has it rewards and its challenges. This drive often comes with a heightened sense of personal responsibility and this level of dedication to others makes it very easy to become consumed by the work. Self-care is a critical part of maintaining and regaining health and well-being in order to be an effective and fulfilled healthcare provider. Even a saw needs sharpening.
Reconnect with Who You Are (and those around you)
Continually, find opportunities to reconnect with who you are and what it is that brings you joy.
Lean more about Finding Meaning in Medicine.
Regularly start your day recalling why you went into the field.
Recall your passion, desire and ambition that led you here. Reflect on the people whose quality of life has been improved as a result of your passion, training and expertise. Learn more about mindfulness, meditation, guided imagery, positive psychology and access to mobile tools.
Consider how things might change if you responded to yourself in the same way you typically respond to others when they are suffering. Test how self-compassionate you are.
Explore complimentary aspects of healing.
Learn more about the Integrative Medicine and Alternative Therapies at BH. (need hyperlink or additional information)
Attend Schwartz Rounds
Attend and gain greater insight into your feelings and responses.
Make someone else feel amazing
Take a moment to recognize a colleague. Not only will you contribute to enhancing another's well-being, you'll strengthen your social connectedness and your own well-being. Seek out opportunities to recognize your peers using Baystate Celebrates online recognition system--it's easy! And even easier when you use the app. In the app store, select Globoforce Mobile and enter your Baystate Health email address and login credentials.
Know When to Ask for Help
We all know that healthcare and caring for patients is difficult and demanding work and can leave us feeling irritable, frustrated, overwhelmed and very sad and lonely at times. Part of the challenge is that we are so immersed in our work that it becomes difficult to recognize and respond to our own, very human, mental and emotional health needs.
Another part of the challenge is our physician nature or are “personality”.
• We are committed and thorough and often find ourselves considering what else could be done or whether or not we have missed something in caring for our patients.
• As a group we tend to have an exaggerated sense of personal responsibility that makes it difficult for us to not be consumed by our work.
• We have a survival mentality and believe things will get better.
• We tend to opt to fix our own problems, which are difficult to fix when we are exhausted or have concerns about confidentiality.
In part, what makes us good at what we do, can be a double-edged sword. Unattended distress has ramifications on our quality of life and well-being. But, we do not need to just accept that feeling distress is part of the role of being a physician. We encourage you to think about attending to your own needs and to utilize the resources needed to help you stay well or begin your own healing process.
Prioritize YOUR Well-being and Worklife Needs
Visit the Baystate Healthy home page for a host of resources that support your physical, mental & emotional, and financial well-being along with resources to help you integrate your personal and work life.
The Provider Wellbeing Council meets the first Wednesday of the month from 7:30 a.m.- 9 a.m. If you are interested in observing, contact ProviderWellbeing@bhs.org
Provider Wellness Council Chairs
Sarvet MD, Barry (Chair Dept. of Psychiatry)
Jones MD, Keisha (Chief, OBGYN)
Albert MD, Michael (MDir OR & Surgical Units)
Barnett MD, Michelle (Internist- Westfield Primary Care)
Bayer MD, Alina (Neurology)
Bowler, Lisa (Mgr Wellness &Work Life Prog)
Diaz, Arley MD (Medical Staff President)
Duke MD, Wayne (Pathology)
Faulkner, Jennifer (VP Team Member Experience)
Ferraro, Erin (NP-East Longmeadow)
Grindberg, Thomas (General OBGYN)
Hoar, Harry MD (Pediatric Hospitalist)
Kellogg MD, Adam (Physicians, Emergency Services)
Kostura, Laura NP (OB/Gyn Specialty)
Kreychman MD, Alena (Radiology)
Lipoff DO, Danielle (Surgeon – Breast)
Lotfi MD, Amir (MDir WMRHA (STEMI) Program)
Moss, Jonathan (Dir Physician Billing Opers)
Paez MD,Armando (Chief, ID)
Silverman MD, Stephanie (Family Practitioner Comm Prac)
Solomon, Ellen (Urogynecology)
Sreedharala MD, Aseesh (internist CHMP)
Tashjian, MD, David (Pediatric Surgeon)-Surgery Dept
Testo, Zachary, MD (Emergency Medicine Residency Program)
Usmani MD, Saad (Internist)
VanVleet MD, Marcia (Hospitalist – Neonatal)
Vieira, Peter MD (Interim Chair, Depart of Anesthesiology)
Workman, Sarah (Internist CHMP)
Wozniak Psy.D, Jessica (Mgr Clinical Research & Dev)
Zaghloul MD, Shadi (Psychiatrist-Staff)
- The BMP Voice: March 2017
- The BMP Voice: August 2017
- BH Provider Wellness Task Force Proposal: June 2017
- Addressing Provider Burnout and Improving Provider Well-Being: Part I: Diagnosis: April 2018
- Physician Burnout Is A Public Health Crisis: A Message To Our Fellow Health Care CEOs http://healthaffairs.org/blog/2017/03/28/physician-burnout-is-a-public-health-crisis-a-message-to-our-fellow-health-care-ceos/
- Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Shanafelt T, Noseworthy J. Mayo Clin Proc. 2017 Jan;92(1):129-146. doi: 10.1016/j.mayocp.2016.10.004. Epub 2016 Nov 18.
- StepsForward AMA. https://www.stepsforward.org
- Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Shanafelt TD, et.al. Mayo Clin Proc. 2015 Dec; 90(12):1600–1613.DOI: http://dx.doi.org/10.1016/j.mayocp.2015.08.023
- Understanding the Real Costs of Recruiting NEJM http://www.nejmcareercenter.org/minisites/rpt/understanding-the-real-costs-of-recruiting/
- The staggering costs of physician turnover, Recruitment spending is only the tip of the iceberg: the average group of 10 hospitalists loses roughly one provider every year. David A. Frenz. Today’s Hospitalist. August 2016.
- Utility of a brief screening tool to identify physicians in distress. Dyrbye LN1, Satele D, Sloan J, Shanafelt TD. J Gen Intern Med. 2013 Mar;28(3):421-7. doi: 10.1007/s11606-012-2252-9. (The Well-Being Index. https://www.mededwebs.com/well-being-index)
- 10 Bold Steps to Prevent Burnout in General Internal Medicine. Mark Linzer, Rachel Levine, David Meltzer, Sara Poplau, Carole WardeJournal of General Internal Medicine. January 2014, Volume 29, Issue 1, pp 18–20
- Maslach C. Job Burnout. Annu. Rev. Psychol. 2001. 52:397–422.
- Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis Colin P West, Liselotte N Dyrbye, Patricia J Erwin, Tait D Shanafelt. Lancet 2016; 388: 2272–81
- Intervention to Promote Physician Well-being, Job Satisfaction, and Professionalism: A Randomized Clinical Trial. West CP, MD . JAMA Intern Med. 2014;174(4):527-533. doi:10.1001/jamainternmed.2013.14387
- Can scribes boost FPs' efficiency and job satisfaction? Earls ST, Savageau JA, Begley S, Saver BG, Sullivan K, Chuman A. J Fam Pract. 2017 Apr; 66(4):206-214. PMID: 28375393.
- Stanford physician Wellness committee. http://wellmd.stanford.edu/center1/committee.html
- Kaiser Permanente physician Wellness committee
- Kaiser Permanente physician Wellness committee ToolKit
- Stanford’s domains of our WellMD Professional Fulfillment Model http://wellmd.stanford.edu/center1.html
- From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Thomas Bodenheimer, MD, Christine Sinsky, MD. Ann Fam Med November/December 2014 vol. 12 no. 6 573-576. http://www.annfammed.org/content/12/6/573.full
- A Crisis in Health Care: A Call to Action on Physician Burnout
- Report and Recommendations of the Workgroup on Physician Wellness and Burnout
- Burnout, Drop Out, Suicide: Physician Loss in Emergency Medicine, Part I