Unlike traditional programs that focus on clinicians primarily, the initiative has a more inclusive approach to help recognize the contributions from all of URMC’s more than 26,000 employees.
The 13 fellows in the program’s inaugural class will learn and implement improvement science to help develop innovative projects. The fellows will work to improve well-being, listen to expert speakers and meet for regular education and coaching sessions. A nurse education, physician assistant, clinical coordinator from URMC’s hospital pharmacy, a hospital chaplain, physician faculty members and a public researcher will be included in the class.
Becker’s connected with Craig Rooney, PhD, URMC’s chief well-being officer and Jessica Shand, MD, associate chief well-being officer at URMC, to discuss the program’s goals and what sets it apart from other similar programs.
Editor’s note: Responses were lightly edited for length and clarity.
Q: Why was including staff in the fellowship program important, and how does it set URMC apart?
Dr. Craig Rooney: Well-being is a team sport — it’s impossible to enhance the well-being of only one group when our work is so interdependent. By including clinical and research faculty with a pharmacist, an APP, a nurse educator and psychologists, the potential for interprofessional collaboration and operational synergy has a multiplier effect that will inform higher yield interventions.
Dr. Jessica Shand: Academic well-being programs tend to focus on physicians. We designed our program to include representation from advanced practice, clinical psychology, nursing education, pharmacy and public health research to better reflect the interprofessional reality of healthcare, and to receive continuous feedback about how to best deliver our curriculum to different learner groups.
Q: What are some innovative projects the fellows are working on, and how will they impact employee well-being?
CR: Our fellows are in the early stages of project planning but we’re seeing a wide range of ideas: spanning building infrastructure for interprofessional efforts in a complex service environment, addressing a workflow issue that currently results in more work for an overburdened department, and challenging cognitive distortions that create a barrier to adopting technology that has been shown to help enhance well-being.
JS: Our projects include interventions to reduce moral distress in the emergency department, tools to improve cognitive adaptation to workflow changes in the electronic health record, and strategies to reinforce total worker health for our nutrition and environmental services staff. Our fellows will be studying the impact of their interventions on workforce vitality, sense of community and purpose, and quality of care using validated tools from quality improvement and design theory.
Q: How might this program drive broader workplace well-being changes at URMC and beyond?
CR: Mature well-being initiatives are now focused on addressing system and operational drivers of occupational distress. We were inspired by Gaurava Agarwal’s Scholars of Wellness AMA Steps Forward program and hope our program adaptations continue local and national dialogue for how to nurture, develop and implement pilot projects that can advance well-being in health care ecosystems.
JS: Our program is intentionally designed to create a “multiplier effect” across our organization. Each participant has the capacity to mentor others locally, influence strategic decision-making within their department leadership and participate in larger institutional conversations about how and where to invest in larger collaborative initiatives.
Q: What challenges have you faced in expanding well-being efforts, and how do you measure success?
CR: We have broad institutional support which is a necessary ingredient for success because the challenges are manifold: in a complex environment like academic medicine there are many different microenvironments with multifaceted and different drivers of occupational distress. Measuring success is the holy grail everyone is grappling with; in brief, success is measured through a combination of global and targeted well-being surveys paired with existing downstream data that are already being collected by partners and stakeholders.
JS: Well-being is an example of “mortar work” in healthcare institutions- integral to the structure of clinical, research, quality, and education bricks but with corners more difficult to define. Our biggest challenge is how to define and measure success in a way that makes the value-add clear to everyone. Our solution is to embed well-being measures in all places where core institutional missions are being assessed. This program is [a] key part of that solution!
