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Provider Well-being

Baystate Health's Commitment to Optimize Professional Fulfillment

Baystate Health recognizes that provider wellness needs to be a significant focus given feedback from providers and the important role they play in ensuring the safety, quality and value of care to our patients.  Baystate is committed to improving the professional fulfillment and personal well-being of physicians and advanced practitioners, through a comprehensive and long-term strategic plan that aligns with individual, team and organizational priorities at Baystate.  As such, the Provider Well-being Advisory Council was founded in 2018 to address the challenges and implement solutions.

 

Strategic Objectives 

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.

1. 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

2. Ensure Efficiency of Practice: Through workplace systems, processes, and practices that promote safety, quality, effectiveness, positive patient and colleague interactions, and worklife balance.

3. Support Personal Resilience: Gain and sustain individual skills, behaviors, and attitudes that contribute to physical, emotional, and professional well-being. 

Key Areas of Focus

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:
1.Identifying Baystate provider needs and areas of focus
2.Collaborating with local work units to determine and implement pilot interventions
3. Making recommendations to the BMP Board to disseminate change across the organization

Subcommittee Areas of Focus

Electronic Medical Record Optimization
Subcommittee members serve as liaisons from our group to the upcoming CIS optimization initiative to ensure that our perspectives are considered in the process. 
Chair: Saad Usmani
Members: Sarah Workman MD, Tenielle Langevin NNP, Meghan Hickey MD, Ryan Quarles MD, Elizabeth Brady MD

Efficiency of Practice
Subcommittee members develop initiatives to make clinical practice more efficient and to reduce administrative burden. They identify and extract “pebbles in the shoe”.  
Chair: Linda Polonsky MD
Members:  Rushika Conroy MD, Adam Kellogg MD, Alena Kreychman MD, Stephanie Silverman MD, Joseph Schmidt MD, Aseesh Sreedharala MD, Njogu Njuguna MD

Team-Based Care
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. 
Chair: Shadi Zaghloul MD
Members: Maura Brennan MD, Kristin Dardano MD, Hilary Hayden-Moryl AP, Jonathan Moss, Marcia VanVleet MD

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.
Chair: Mary Kraft, MD
Members: Barry Sarvet MD, Christina Fitch DO, Ellen Miller-Mack NP

Work-Life Balance
Members work on initiatives to ensure that people use their PTO and protect time for their personal lives and family.
Chair: Mike Albert, MD
Members: Wayne Duke MD, David Tashjian MD, Lisa Bowler, James Gebhardt MD, Danielle Lipoff MD, Zachary Testo MD, Amir Lofti MD, Njogu Njuguna

________________________________________________________

Publicity: Barry Sarvet MD, Elizabeth Brady MD, Lisa Bowler, Adam Kellogg MD, Zachary Testo MD

News

April 3, 2019: Subcommitte 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.

EMR Optimization

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.

Team-Based Care
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:

Worklife Balance
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 suggesions 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:
1.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.
2. Financial/RVU targets must be met.
3. The care and access for patients may not be compromised - the needs of patients come first.

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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 [hyperlink to email address]) and have established a Wellness Fund through the Baystate Health Foundation to support related initiatives.

Strategic objectives 

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.

Take Action: Practice Transformation

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. 

 

Get Inspired

Learn more (hyperlink) about what various areas are doing and draw from their finding and success to find ways to improve your team’s everyday experience.  We will be sharing these pilot successes with you in the near future.

 

Take Action

Share your work with the subcommittee Council Chair listed below and your ideas will be shared to maximize the impact across the organization.  Send your enhancements to X email.
Efficiency of Practice – Chair; Linda Polonsky, MD
Electronic Medical Record – Chair, Saad Usmani, MD
Team-Based Care - Chair; Shadi Zaghloul, MD
Humanism in Medicine- Chair; Beth Brady, MD
Worklife Balance- Chair;  Mike Albert, MD

 

 

Take Action: Recharge-Refresh-Renew

Recharge Your Batteries

A deep passion and purpose to serve humanity in a career that provides the opportunity for continued growth, 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 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.
    o History of Finding Meaning in Medicine Groups
    o Finding Meaning in Medicine Resource Guide

•  Regularly start your day with recalling why you went into the field.  Recall your passion, desire and ambition that led you here.  Reflect on the people’s 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.

•  Practice self-compassion. 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.
•  Attend Schwartz Rounds 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 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

You can’t do it all, nobody can.  It's not uncommon for providers to feel, at one time or another, unable to cope with life's stressor's. But it can be difficult to reach out for help when providers are the ones that provide help to others. Persistent stress, major life changes and poor sleep are among the many of the factors that can be aided by seeking help for yourself.
1. Talk it through. Our brain is a conflicted and busy organ and deserving of the time and attention necessary to nurture it.  Find a licensed counselor or therapist in the community or across the nation.  Available in-person, by web-chat or by phone.
2. Access assistance from a Worklife Specialist: The ongoing "to-do" list, raising a family or caring for an aging family member are just some of the areas where a worklife expert at Life GuidanceResources & EAP can help lighten your load a bit.

 

Prioritize YOUR well-being

Physical Well-being: Personal Health Coaching, Fitness, Nutrition, Weight Management,  Sleep, Tobacco Cessation,
Mental and Emotional Well-being:  Counseling & Therapy, Personal Health Coaching,Resiliency programs, Stress management Apps, Tools and Guided meditations, Mindfulness programs
Financial well-being:  Retirement, Income Protection benefits, Employee discounts, Money-back Programs and Resources, Banking, etc 

Provider Well-Being Council Membership

The Council meets the first Wednesday of the month from 7:30 a.m.- 9 a.m.  If you are interested in participating, contact XXX

1. Albert MD, Michael (MDir OR & Surgical Units)
2. Bowler, Lisa (Mgr Wellness &Work Life Prog)
3. Brady MD, Elizabeth (Surgeon – Oncology)
4. Brennan MD, Maura (Chief Geriatrics/Palliative)
5. Cassells MD, Lucinda (Hem/Onc Pall. Care Phys)
6. Conroy, MD, Rushika (Pediatric Endocrinologist)
7. Dardano MD, Kristin (MDir Northampton OB/GYN)
8. Duke MD, Wayne (Vice Chair Pathology)
9. Fitch DO, Christina (Palliative Care Physician)
10. Gebhardt MD, James (MDir WWG OB/GYN)
11. Hayden-Moryl NP, Hilary (NP medical Services)
12. Hickey MD, Meghan (Neurologist)
13. Kellogg MD, Adam (Physicians, Emergency Services)
14. Kraft, Mary, MD (Program Director, Residency, Anesthesiology)
15. Kreychman MD, Alena (Radiology)
16. Langevin NNP, Tenielle (Lead AP NICU)
17. Leibowitz MD, Morris (Physicians, Emergency Services)
18. Lipoff DO, Danielle (Surgeon – Breast)
19. Lotfi MD, Amir (MDir WMRHA (STEMI) Program)
20. Mason, Holly  (Surgeon)
21. Moss, Jonathan (Dir Physician Billing Opers)
22. Njuguna, Njogu (Radiologist)
23. Polonsky MD, Linda (OB/GYN Comm Prac)
24. Quarles MD, Ryan (Internist CHMP)
25. Sarvet MD, Barry (Chair Dept. of Psychiatry)
26. Schmidt, Joseph MD (Vice Chair Emergency Medicine)
27. Silverman MD, Stephanie (Family Practitioner Comm Prac)
28. Sreedharala MD, Aseesh (internist CHMP)
29. Tashjian, MD, David (Pediatric Surgeon)-Surgery Dept
30. Testo, Zachary, MD (Emergency Medicine Residency Program)
31. Usmani MD, Saad (Internist)
32. VanVleet MD, Marcia (Hospitalist – Neonatal)
33. Workman, Sarah (Internist CHMP)
34. Zaghloul MD, Shadi (Medical Director, Baystate Wing Psychiatry)

 

 

References

Internal References

  1. The BMP Voice: March 2017
  2. The BMP Voice: August 2017
  3. BH Provider Wellness Task Force Proposal:  June 2017
  4. Addressing Provider Burnout and Improving Provider Well-Being: Part I: Diagnosis: April 2018

External References

1. 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/

2. 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.

3. StepsForward AMA. https://www.stepsforward.org

4. 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

5. Understanding the Real Costs of Recruiting NEJM http://www.nejmcareercenter.org/minisites/rpt/understanding-the-real-costs-of-recruiting/

6. 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.

7. 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)

8. 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           

9. Maslach C. Job Burnout. Annu. Rev. Psychol. 2001. 52:397–422.

10. 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

11. 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

12. 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.

13 Stanford physician Wellness committee. http://wellmd.stanford.edu/center1/committee.html

14. Kaiser Permanente physician Wellness committee  https://share.kaiserpermanente.org/article/kaiser-permanente-launches-new-tool-to-encourage-employers-to-form-wellness-committees-in-the-workplace/

15. Kaiser Permanente physician Wellness committee ToolKit https://business.kaiserpermanente.org/thrive/resource-center/wellness-committee-toolkit

16. Stanford’s domains of our WellMD Professional Fulfillment Modelhttp://wellmd.stanford.edu/center1.html

17. 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

 

Burnout Studies

1.  A Crisis in Health Care: A Call to Action on Physician Burnout
2.  Report and Recommendations of the Workgroup on Physician Wellness and Burnout