The leaders told her how hard they had worked to build best practices over the years. They explained how proud they were of all they’d accomplished and that they were afraid the changes would limit their personal power. When they shared Natalie’s messages, they found their own fear and uncertainty mirrored back to them through the eyes and words of their direct reports.
Several months earlier, the company had launched an organization-wide initiative to address evolving customer needs and improve the quality of their products. Although changes were progressing well in other locations, morale was extremely low at the Buffalo plant. My job was to find out why.
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Internal studies found measurable benefits from participation in the COMPASS group meetings, including reduced burnout, increased well-being, improved meaning from work, reduced social isolation and improved job satisfaction. Due to the success of these early studies, Mayo Clinic leadership continues to support this program with funding derived from clinical sources within each hosting department. As of July 2017, nearly 1,500 physicians and scientists have signed up to participate in a COMPASS group, representing 40 percent of eligible individuals across all Mayo Clinic sites. At the end of the first six-month period, more than 95 percent of group leaders reported that the groups were valuable and that they planned to continue meeting. Although this program is successful, lessons were learned during implementation that may prove helpful for other institutions and practices considering a similar effort.
Anticipated reduction in burnout
In 2007, the Mayo Clinic Department of Medicine created the Program on Physician Well-Being (PPWB) to better understand the entire spectrum of personal, professional and organizational factors that influence physician well-being. This effort was led by Drs. Tait Shanafelt, Lotte Dyrbye and Colin West. The program spanned across disciplines, including medicine, psychology and health science research. In the first few years, the focus of the PPWB was on establishing the epidemiology of burnout and distress. Based on institutional and national survey studies, it became evident that burnout is highly prevalent among physicians across all specialties. The drivers vary from practice to practice, but include excessive workload, inadequate support at work, work-home conflicts, loss of control and diminished meaning and purpose from work.
Relative reduction in burnout anticipated from intervention
The PPWB’s research on the epidemiology of stress and burnout made it clear that they had to address these problems, but they weren’t sure what would work best. Therefore, they decided to conduct randomized trials of interventions designed to reduce distress and promote well-being. One of the ideas tested was to hold small, organizationally supported physician group meetings oriented around topics reflecting common stressful physician experiences. This initiative was called COMPASS — COlleagues Meeting to Promote And Sustain Satisfaction.
Relative reduction in burnout common estimate 20%
Results: Since the creation of the Resident Wellness Committee in 2013, residents have participated in community garden projects, The Over the Mountain Miracle League to help children with disabilities play baseball and Habitat for Humanity. The committee, comprised of residents from all levels of training, meets quarterly to plan future projects. The Memorable Patient Lecture series has had seven speakers from 2013-2015, including the Department Chair of Medicine and the Residency Program Director. Feedback from these presentations has been highly positive with attendees expressing “very heartfelt” and “great realistic discussion.” The problem solving committee addressed scheduling stressors by creating a new cross-cover system on General Medicine wards. The Resident Wellness Committee has enjoyed time together away from the hospital and has led to the creation of a standing social gathering and sports clubs. Early feedback suggests that combatting the individual components of resident burnout can be an effective way to preserve the hearts of residents.
“Breathe, Sher. Take a big, deep breath and just breathe.”
According to Nance McClure, Chief Operating Officer of HealthPartners care group, “It would be great if decreasing time spent working only required a single work plan or initiative; however, we learned our approach must include multiple initiatives working towards the same goal.” Some of the most impactful strategies include: