How to create clinician resilience: 3 experts weigh in

The pandemic has caused an increased need to address employee stress, fatigue and exhaustion among clinicians battling COVID-19. However, there are steps health systems can take to address this need.

A panel of health experts discussed key tips for promoting clinician resilience and well-being during a session at the Becker's Healthcare Clinical Leadership Virtual Event on Sept. 10. The panelists were Jason Mitchell, MD, senior vice president and CMO of Presbyterian Healthcare Services in Albuquerque, N.M.; Kristine Keefer Wolff, DNP, RN, vice president of patient care services and chief nursing officer for UPMC Somerset (Pa.); and Amy Compton-Phillips, MD, executive vice president and chief clinical officer for Renton, Wash.-based Providence St. Joseph Health. Kelly Gooch, senior writer/reporter at Becker's Healthcare, moderated the panel.

Here is an excerpt from the conversation, slightly edited for clarity. To view the full session on-demand, click here.

Question: How can hospitals and health systems increase efforts to create resilience among clinicians?

Dr. Jason Mitchell: I think one of the most important things is for everyone to recognize that it's important. Clinician experience is absolutely critical. Their well-being is critical. Because you can't deliver high-quality care with people that are unable to care for themselves.

I think it's really a look into the organization. Have you told the stories? Do they understand what your clinicians go through? Do they understand why it's important for your clinicians to be resilient? Because if they don't, it's easy to look at it as, "Well, they're professionals, they should suck it up." But they may not know that before that meeting, you lost a patient, or you lost three patients this week, or any of a number of things.

I think until you create some reality for all the leadership staff and all the staff as to what it really is like to be a clinician and care for patients, it's hard for everyone to get on board, say, wait a second, they do need help. Let's help them. They see us as the caregivers and the helpers and may not recognize that we're the ones that need help. I think it's that enterprise recognition and, depending on the culture, that may not come fast. It may take years to really help people understand.

I think for us, it took a couple of years. I look back to 2014, 2013, and that's not the way we were as an organization, but through sharing stories, through bounding, through sharing experiences, I can tell you at this point that the entire organization values our clinicians. They value them as humans. They really treat them differently. They think about them differently. Down to our revenue cycle has changed how they word messages to us in our EMR. The health plan has changed how they message all the doctors in their entire network because they realize what trigger words we have.

I think it's that deep change in culture, and then it's removing friction, but if you don't have everyone bought in, it's going to be really hard to then go back to remove all the friction of clinical practice.

Dr. Amy Compton-Phillips: What I think COVID did is operations stepped back and clinicians leaned in and led the response to COVID, because it was a clinical problem, so that was the dichotomy. Clinicians, from the very start, when a patient has a problem, you try something and you say, "If it doesn't work, let me know." You actually have this ability to fail. That ability to fall down seven times, get up eight, creates a learning culture. We approached COVID with a learning culture, and I think the long run that is exactly what builds resilience, having the ability to fall down, get up, try again, fall down, get up, try again.

What I think the long-term change coming into healthcare systems to build resilience is allowing operations to fail. Operations historically comes with an accountability model versus a learning model, so adapting the accountability model to embed the learning model within it and allowing us to try things and have them not work and then tweak them and try them again, is, I think, the way that, as we move forward, we're going to have a more resilient, more adaptable, faster evolving healthcare system.

Dr. Kristine Keefer Wolff: I think as leaders, we have such great responsibility and to be able to care for our staff to really be at their most optimum state that they can care for people.

One of the things that I'm really excited about is that we have, through the leadership of our chief nurse executive for the system, during this time, she actually implemented a mindfulness program and it was really targeted to clinicians to be able to make sure that they were caring for themselves and to learn true techniques on how to do this. It started back in March. It was about an eight-week program that she developed working with our Employee Assistance Program representatives to really be able to bring this to front-line caregivers.

The results so far are very promising. Of course, she wanted to do some surveying of the participants. We're seeing that the levels of stress, similar to what Amy had described, have really changed in those eight weeks that she has implemented this program in a pilot form. We are very excited about what the future is on that, and that will be something that we'll be spreading out systemwide, but it's having that confidence of what we're doing in our organizations and being able to spread that and to share those best practices. I think that's really the part of helping us build that resilience.

The other piece I just want to touch on for the final comment is that I think it's about celebrating these people. It is about telling the story and to be able to recognize and thank. It's all of the caregivers, all of the essential workers, not one group in particular or another, because we couldn't really do our work and we couldn't serve our patients if it weren't for all of the members of the team.

I think it's really important as the leaders also to sometimes hit that pause button, step back, and really recognize and celebrate what our folks are doing. It's not easy work. Jason talked about you never know when someone has lost a patient or lost three patients. I think that that is so true. But the work continues on, so we really have to make sure that our folks are caring for themselves and that they feel that they are valued by their leadership to be able to continue to face this day in and day out. Because this is really for the long haul.


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