Caring Greatly

In this episode of Caring Greatly, Mr. Forti shares the science of autonomic downregulation as a focal point for individual wellbeing. While he is an advocate for system change, he believes that those in the healing profession also have a moral obligation to care for their personal wellbeing, given the critical nature of the work they do and the proven links between wellbeing and patient care outcomes. At Hospital for Special Surgery, Mr. Forti created a program that teaches the science behind autonomic downregulation as well as simple practices such as sleep, breathwork, alcohol-abstention, gratitude and nutrition that support heart-rate variability (HRV), a key measure of wellbeing. To date, more than 700 clinicians have completed the training.

The views and opinions expressed in this podcast are those of the speakers and do not necessarily reflect the views or positions of Vocera, now part of Stryker.

In this episode of Caring Greatly, Dr. Sexton talks about his team’s focus on providing accessible, evidence-based wellbeing practice to healthcare team members across the country. His five-part training covers gratitude, work-life balance, self-compassion, awe and wonder, and group-level wellbeing. The approach mixes didactic learning on the science behind wellbeing practices as well as time to put the concepts into practice. Dr. Sexton believes that evidence-based, individually-focused wellbeing practices are an essential complement to broader efforts to transform system factors that cause burnout and distress.

In this episode, Dr. Harry and I talk about the principles of cognitive load theory and how they apply to the practice of medicine. We discuss individual, team, and systems approaches to managing and minimizing cognitive load by removing extraneous load from system processes and technologies. We talk about the need to bring human factors engineering science and principles into healthcare so that leaders can work with the cognitive capacities of team members, and free up their finite resources for the most human-centered tasks and relationships. Finally, Dr. Harry shares insights into how leaders at every level can contribute to team member and patient safety by prioritizing an understanding of cognitive capacity and designing accordingly.

Dr. Liz Harry is a leader who cares greatly.

In this episode, Dr. Ofri and I talk about an article she recently published in the New Yorker titled, “The Curious Side Effects of Medical Transparency.” We delve into how the act of exposing medical notes to patients necessarily changes their purpose and their content, and how that, in turn, changes the thinking processes of clinicians. We talk about how art and expression are both integral to and separate from the art and science of medicine. Finally, Dr. Ofri offers advice to rising clinicians about how to separate their responsibilities from their identities to support sustainable practice.

Dr. Danielle Ofri is a leader who cares greatly.

In this episode, Dr. Fisher and I talk about how he came to medicine and his experience of burnout, depression, and disillusionment in his early career. That experience led him to take a deep dive into ancient wisdom traditions, but with a scientist’s mind. We look at the seven traits of the heart (steadiness, wisdom, openness, wholeness, courage, lightness and warmth) and how bringing these into healthcare practice creates presence, connection, and, ultimately, healing.

Dr. Jonathan Fisher is a leader who cares greatly.

In this episode, Dr. Rushton and I talk about the concept of values discordance, and what happens when a person perceives their personal or professional values to be out of alignment with their organization’s values. We look at the ways values play out in an organization – through leadership, decision making, and budgeting. We dig into the link between values and moral injury, and how ethics considerations need to be a central component of leaders’ wellbeing and leadership strategies. And Dr. Rushton lays out a structure for how leaders can safeguard ethics and values through leadership and safety infrastructure to support expectations and accountability, practice integration, continuous improvement, and competency building.

In this episode, Dr. DeChant and Liz Boehm talk about what’s different about workplace transformation in the trailing edge of the COVID-19 pandemic. We look at the need to rethink workload as an antidote to burnout, digging deeper than the concept of exhaustion into the causes of cynicism and inefficacy. This means delving into concepts such as respect, values, and community connection. Dr. DeChant talks about management concepts such as LEAN and what it takes to apply these in ways that solve for burnout rather than contributing to it. We touch on leadership burnout and how leaders can care for their own resilience and wellbeing and then lead others on a path toward joy and wellbeing at work.

In this episode, Mr. Feist and I talk about the factors that led to Dr. Breen’s death by suicide in 2020. Chief among these was a fear of losing her medical license if it became known that she had needed mental health support. This legacy is what has led the Foundation to launch a campaign to eliminate intrusive mental health questions from healthcare professional licensure and credentialing processes, a change that will help reduce the stigma that currently exists in healthcare around seeking mental health support. This change is beginning to happen at healthcare institutions and in state licensing boards across the country and represents a simple yet meaningful change to creating safer healthcare workplaces for team members and patients alike.

In this episode, Dr. Bukovac and I talk about the factors in obstetrics that lead to physician burnout – especially the way that clinical practice is structured in a way that creates conflicts of time, attention and clinical expertise. Dr. Bukovac advocates for a fundamental restructuring of obstetrics training and operations that encourages physicians to specialize in office care, hospital care, or surgery. She believes this will not only lead to better clinical outcomes, but also a more manageable and sustainable practice model for clinicians. Dr. Bukovac shares her own journey from burnout to a practice that sustains her passion for medicine and allows her to balance work with her other life pursuits.

The views and opinions expressed in this podcast are those of the speakers and do not necessarily reflect the views or positions of Vocera, now part of Stryker.

In this episode, Dr. Rushton and I talk about the current divide between advocates of system change to improve clinician well-being, and those promoting personal resilience and well-being training. We look at the challenges of managing polarities as leaders embrace a both/and approach to team member well-being. Dr. Rushton shares the specifics of a personal resilience training that equips nurses at Hopkins to stand firm in their ethics and values, and to act as advocates for system improvement without sacrificing their personal well-being. Finally, Dr. Rushton paints a picture of leadership in which clinicians gain empowerment to manage their own well-being while acting as advocates for both their patients and their profession.

The views and opinions expressed in this podcast are those of the speakers and do not necessarily reflect the views or positions of Vocera, now part of Stryker.

In this episode, Dr. Raso and I talk about her latest research looking at authentic leadership, healthy work environment, team-member well-being, and nurse retention. In it, she uncovered a remarkable resilience of nurse leaders to continue leading with authenticity and humanity, even as the work environment for nurses has diminished. We talk about the need to support nurse leaders with the same process and practice improvement, as well as well-being support that frontline nurses need and deserve. Dr. Raso lays out a hope-filled vision for a future in which the structures of support for nurses and nurse leaders emerge from the challenges of the pandemic stronger and more human-centered than ever.

The views and opinions expressed in this podcast are those of the speakers and do not necessarily reflect the views or positions of Vocera, now part of Stryker.

In this episode, Dr. Woodruff and I talk about the central role that trust plays in supporting team member safety and well-being. While trust is not an unusual concept in leadership, Dr. Woodruff takes an expansive view, connecting it to every process that an individual interacts with within a system. He believes that any process that isn’t explicitly designed to build trust – by showing respect and integrity – has the potential to erode trust, and that those small, daily interactions carry more collective weight than a single, positive, in-person encounter. He and his team use two questions to filter the trust factor on organizational processes: Does it support the mission? And, is it kind?

The views and opinions expressed in this podcast are those of the speakers and do not necessarily reflect the views or positions of Vocera, now part of Stryker.

In this episode, Dr. Sherman and I discuss the transformative changes that are happening in the healthcare workforce, led by three critical trends: COVID-related turnover and travel; mental health challenges, and PTSD, and the shifting demographics of the workplace. We discuss how these trends are causing dramatic shifts in the structure of healthcare work and challenging leaders to find the flexibility and creativity to rethink how healthcare is delivered. Finally, we look ahead to a future in which team member well-being is the center of a vibrant healthcare workforce.

In this episode of the Caring Greatly™ podcast, Dr. DeRienzo and I discuss his new orientation to the “why” behind care transformation. Like most quality improvement leaders, Dr. DeRienzo’s focus has long been on the triple aim of improved care quality, reduced cost, and improved experience. But the work he’s focusing on now is creating energy and opportunity for a greater focus on health equity, necessary variability, and humanity. Care transformation, then, becomes less about productivity and standardization as a primary aim, and more about allowing clinicians to practice at the top of their humanity and their license in a way that is fulfilling and meaningful – which is also very likely to boost productivity and practice resilience over the long run.

In this episode, Dr. Mate and I talk about research the IHI recently completed into a broadened definition of team member safety and well-being put forth by the CEO Coalition, a group of US-based healthcare CEOs who see team member safety and well-being as an essential component of healthcare efficacy and sustainability. The CEO Coalition’s Heart of Safety Declaration of Principles expands the definition of safety to include protecting psychological and emotional well-being, promoting health justice by declaring equity and anti-racism core components of safety, and ensuring physical safety, which includes a zero-harm program to eliminate workplace violence, both physical and verbal. Dr. Mate shares what he and his team learned through the research process and how improvement science is critical to advancing safety and well-being. He also shares a long-term vision for healthcare in which the traditional locations and relationships of care expand, requiring a renewed focus on adaptive leadership competencies.

In this episode, Dr. Rizzo and I talk about the impetus behind creating the Encore Physicians Program, and the benefit it brings to retired physicians, community health centers, and the patients they serve. We look at the synergy and learning opportunities provided by linking both primary care and specialty physicians to the patients who seek care at community health centers, as well as the role of an intermediary such as Encore Physicians in creating connections between clinics and retired physicians. Finally, Dr. Rizzo shares his perspective on things to consider for leaders looking to set up similar programs in other parts of the country.

In this episode, Dr. Cziraky and I talk about her personal and practice transformation through a shift from transactional to relationship-based care, both with her team members and her patients. We talk about how a drive toward efficiency had left her feeling depleted and disconnected from her work. In early 2020, Dr. Cziraky was introduced to the work of the Institute for Healthcare Excellence through the National Taskforce for Humanity in Healthcare, which helped her embrace positive emotions and a more relational model of work and care, which complemented and completed her drive for sustainable and effective care practice. Dr. Cziraky shares the impact of this transition on her work, her life, and her team’s ability to weather the challenges of COVID-19.

In this episode, Dr. Solomon and I discuss the impact of poor practice design on the mental health and well-being of nurses. We delve into the specific trauma of the pandemic, and the need for system-level support and changes to overcome the “tyranny of individual responsibility” that is too often attached to mental well-being. We look at the need to include nurses in system decision processes and for leaders to listen with an open mind to nurses’ demands for system change – including the need to mark loss and make space for grieving. Finally, Dr. Solomon paints a future vision in which nurses are treated as full partners in a system that prioritizes prevention and well-being for patients and team members alike.

In this episode, Dr. Pettit and I talk about how advances in cancer treatment have increased survivorship, but also resulted in patients living long enough to experience the long-term side effects of both primary and adjuvant therapies. Often these impact survivors’ physical, emotional, and even financial and social well-being. Dr. Pettit and her team conduct and support research and innovation that bridge the interests and inputs of patients, life sciences firms, academic medicine, clinicians, and public health toward a future of survivorship that supports all aspects of patients’ health, well-being, and thriving.

In this episode, Dr. Ideker and I dig deep into her team’s work on EHR optimization to ensure that the EHR works for clinicians and not the other way around. In 2020, after rapidly standing up telehealth infrastructure in response to the COVID-19 pandemic, Dr. Ideker and her team identified four key areas of focus for EHR improvement: orders redesign, documentation, best practice and medication alerts, and Epic proficiency. In each of these areas, she and her team designed solutions using a data-driven approach, in partnership with clinicians, and always with the aim of making the technology effective, efficient, and even delightful.

In this episode, Dr. Heineberg and I look at how the default tendencies of the brain can undermine compassion and resilience, especially in times of extraordinary stress such as the COVID-19 pandemic. We delve into the ways that technology can help extend access to mental health resources, while reinforcing social connections that support well-being. Finally, Dr. Heineberg outlines the importance of integrating well-being practices into collective daily work so that they help change culture.

In this episode, Mr. Segall and I talk about the interconnectedness of wellness and process improvement, particularly at this time when team members have experienced such intense stress and trauma and when staffing shortages are rampant. We delve into the need to integrate well-being into the daily work and operations of the health system so that team members have a chance to debrief and begin healing from stressful events without needing to carve out additional time. Finally, Mr. Segall lays out a vision for the future that rethinks the role of wellness and resilience as a core leadership responsibility.

In this episode, Dr. Collins and I talk about how responses to the COVID-19 crisis put stress on nurses in a way that will have long-term implications for individuals and the profession. We delve into the challenges that arise when seasoned professionals must shift from situations in which they can draw on ingrained expertise to ones in which they are relatively inexperienced – in other words, moving from novice to expert and back. We look at the ways nurse leaders can apply technologies and process improvements to minimize the cognitive burden on nurses, allowing them to limit stress and achieve professional well-being. Finally, Dr. Collins outlines a new study she is launching that uses the NASA Task Load Index to gauge the burden of clinical communication on nurses in high-stress environments with the aim of driving improvements across the industry.

In this episode, Ms. Smith-Hill and I discuss the challenges of providing support to loved ones receiving care during the pandemic. We talk about the importance of strong communication, and the emotional impact of feeling disconnected. Finally, we look ahead to how family support will evolve as the pandemic subsides.