The University of Texas Medical Branch: Wellness Initiative Cara Geary, MD, PhD - Chief Wellness Officer Tammy Cupit, PhD, RN-BC - Associate Chief Wellness Officer July 27, 2022
Evolution of U.S. Health System Priorities
ReduceTripleCostAim 2 From the Institute for Healthcare Improvement (IHI)
U.S. Health
PopulationHealthImproveExperienceImproveQUINTUPLEAIMPatientAdvanceHealthEquityReduceCostsImproveProviderWorkLifeof
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Evolution of System Priorities
ProfessionalEngagement?Wellness?Vitality?Fulfillment?Well-Being?JoyinMedicine?
Urgency of Caring for Health Care Providers • Expected 130K physician shortage in next 5 years • Aging patients & providers (Silver Tsunami) • COVID-19 residual impacts and recovery • ‘The Great Resignation’ (Staffing Shortages) • Ongoing financial challenges • Increasing regulatory burdens 5
Some InitiativeWellnessDriversUTMBfora • Great departmental variability (0-20%) • Appears burnout related: • Departures to local institutions (not promotion, retirement, family issues) • Departures in groups • Cost estimate per loss $500K-1 millionTurnoverClinicalFacultyat7.2% • Significant increase recently • Currently with over 100 staff vacanciesTurnoverNursingat>13%
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Vision UTMB’s work culture fosters and prioritizes care for our employees.
UTMB Wellness Initiative
Mission Help health care providers rediscover calling and purpose by supporting professional fulfillment for UTMB faculty and staff through a multi-faceted model enhancing leadership skills, interpersonal communication, professional resilience, and community building.
Foundation: Stanford Professional Fulfillment Model Culture of Wellness • Leadership • Values Alignment • Community • Appreciation • Voice/Input • Culture of Trust Efficiency of Practice • Scheduling • Triage • Unit Flow • Team-Based Care • EHR Usability • Regulatory Work Personal Resilience • Self-Care • Self-Compassion • Meaning-In-Work • Work-Life Integration • Emotional Flexibility • Cognitive Flexibility 8
PeerProgramMentor ProgramSupportPeerProfessionalMeaning&PurposeGroups ExpansionSustainedforImpact PilotWellnessUTMB’sProgram
10 Scholars in Leadership: Culture of Wellness and Efficiency of Practice • Professional Fulfillment in Healthcare – Culture of Wellness – Efficiency of Practice • Leading/Managing Yourself • Leading Change • Leading and Aligning Vision & Strategy • Wellness Centered Leadership • Leader as Healer • Scholarly Projects
11 Scholars in Healing: Culture of Wellness andResiliencePersonal • Well-being in Health Care • Mindfulness • Communication • Meaning and Purpose • Compassion Training • Boundaries and Shame Resilience • Self-Awareness and Self-Reflection • Scholarly Project
• 10-month program involving monthly dinners for 150 individuals • Facilitated by participants in Scholars in Healing and Scholars in Leadership • Sessions focus on community-building and collegiality • 10 carefully chosen topics disseminated to 150 participants and done as pre-dinner assignments focused on improving work life at UTMB Professional Meaning & Purpose Training: Extending the Message 12
Peer Programs: Reaching Colleagues before ‘Issues’ become ‘Problems’ • Staffed by volunteers in Scholars in Leadership and Scholars in Healing • Scheduling mentoring/peer-support sessions for interested colleagues • Evidenced-based offering • Develop safe venue for professionals to identify options for career mentoring, coaching, and professional and/or personal challenges 13
Wellness Initiative: Expansion and Sustained Impact • Culture of Wellness Committee • Efficiency of Practice Committee • Meaning & Purpose Communities • Integration into Culture and Curricula • Workshops & Short Courses • Peer support and mentoring • Ongoing assessments/metrics 14
Institutional Metrics • Turnover • Patient Satisfaction • Institutional priorities Program Metrics • Program & ParticipationCommittee • Course Feedback UTS Task Force • Professional Fulfillment Index • Mini-Z o Leadership Metric o Others Rapid Iterative Experimentation • Models such as “Plan-Do-See-Act” • Example: Meaning & Purpose Dinners as pilot for improving collegiality and community Metrics for Sustained Impact: Strategic Approach to Measuring Progress 15
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APPLICATION IN PROCESS…….
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July 2022 Jan. 2023 Identify First PilotGroupCohort Identify 2024 Target Group LaunchSoft Programof IndividualsSelect for 2023 Cohorts Refine CurriculaDevelop& 2023 StrategyMetricLaunchMetrics First Six Months 19
2023Jan 2023July 2024Jan 2024July 2025Jan 2025July Scholars in Leading Cohort 1 (N=25) Scholars in Healing Cohort 1 Scholars(N=25)in Healing Cohort 2 (N=25) Scholars in Leading Cohort 2 (N=25) 2026Jan 2026July 2027Jan Scholars in Leading Cohort 3 (N=25) Scholars in Healing Cohort 3 (N=25) Meaning & Purpose 1 (N=150) Meaning & Purpose 2 (N=150) Meaning & Purpose 3 (N=150) Peer Mentoring or Efficiency of Practice Committee Peer Support or Culture of Wellness Committee Peer Mentoring /Efficiency of Practice Peer Support /Culture of Wellness 4-Year Timeline
2023 Pilot Cohort: Scholars in Healing, Leading & Meaning & Purpose Training 21 Eligibility for Pilot Cohort • Full time, active status • Assistant, Associate or full Professor • Doctoral degree • Not a contract employee (UTMB, CBC Clinics) • Not MD Anderson as they have programs eligibleTotalfaculty % of FacultytotalacrossSON,SHPandSOM # faculty for ScholarsLeadingin # faculty for ScholarsHealingin SOM 649 81% 20.5 20.5 SON 80 10% 2.5 2.5 SHP 67 8.4% 2 2 OTHER SELECTION CRITERIA under consideration: • 6 years out from training for Scholars in Leading • 4 years out from training for Scholar in Healing • At UTMB for at least 3 years • Recognized by Chair/Dean as an advocate/leader for Well-Being/Professional Fulfillment • Support from their Chair/Dean for completely protected time • no clinical, administrative or phone service during session time
• Adapting curriculum for researchers, educators, allied professionals, APNs & PAs • CMC has recruited a Wellness Program Manager that will work with us • Nursing and Clinical Support Service offerings being developed for 2023 – “Leaders in Healing" o Program combining Scholars in Leadership/Scholars in Healing curriculum o Similar format anticipated; continuing education credit o Pilot program to be developed after initial pilot is fully developed – Path for professional development o Precipio and related materials • Develop approach for residents and fellows starting January 2023 (Drs. Blackwell and Pine) • Identify best approaches for researchers Phase II: Focus on All Educators, Researchers, Care Providers 22
AdvancedDegree? OpportunitiesDevelopmentProfessionalOnline Meaning & Purpose Dinners Scholars ScholarsLeadingininHealing OpportunitiesDevelopmentProfessionalOnline CommitmentCommitmentPost-SiHPost-SiL OpportunitiesDevelopmentProfessionalIn-Person LeadersProgramHealingin Post CommitmentLiH Peer Mentoring MyPath Career Development: All Employees, All Roles Model based on MDA Leadership Institute and the potential of Precipio program YESNO
JoyAMAin Medicine Health RecognitionSystemProgram 24
annually • Facilitate monthly dinner session with
faculty for 10 months • Complete scholarly project – Culture of Wellness, or – Efficiency of Practice • Commit to continued engagement for two years after completion – Peer Mentoring or Peer Support Volunteer – Efficiency of Practice Committee – Culture of Wellness Committee 25
months – Scholars in Leadership:
Scholars in Healing: two-day retreats every 6 potential two-day retreats other
Scholars in Healing/Scholars in Leadership Format • Meet for ½ day every two weeks for two years (5% time & effort) –
Anticipated Format for Scholars Sessions • Pre-assignment • Lunch and community building • Presentation of content • Reflective activity for individual work area • Experiential activities within teams • Large group debriefing 26
MyWellness TASK FORCES # ADVISORY BOARD METRICS SCHOLARS in Leading SCHOLARS in HEALING 1 President Raimer Cara Geary Don Prough Cara Geary 2 Dean Mouton Dylan Lancaster Cara Geary Era Buck 3 CEO, Tim Harlin Susan Weller Josette Armendariz Natalie Williams Bouyer 4 PEC members Mary Havard Ken Adcox Laurie Farroni 5 Majka Woods John/ Chris McKee Beth Fingado Tammy Cupit 6 Gulshan Sharma Vivian Kardow Deborah Jones Julie McKee 7 Era Buck Joseph /Jody Thomas (HR) Kendall Campbell Marce Navarro 8 Roberto Garofalo Gwyn Richardson Cindy Wigg 9 Deborah Jones Majka Woods Becky Risinger 10 Carlos Clark Shannon Guillot Wright 11 Rafael Fonseca Charlena Melnyk 12 Amber Armstead Monique Ferguson 13 Anish Bhardwaj Janet Enderle 14 Future Planning (Resident/Fellows) Gulshan Sharma Angela Raimer 15 Tom Blackwell Jeff Farroni Miles Farr 16 Harold Pine (sabbatical) Philesha Evans Cody Dodd
• Meeting plans and approach for your group • 40 total half-day sessions for each Scholars groups over 2 years – Approximately 8 sessions reserved for Scholarly Projects – 32 sessions being divided across the 4 teams • By September 15, 2022: – Determine optimum number of sessions needed for your team – Determine content to be delivered – Task force leaders will then determine order of sessions across the 18 months • By November 1, 2022 – Determine team activities and use of threads across curriculum – Determine instructors for each topic (task force member or other?) – Determine individual (niche) reflections/activities • Early December 2022 – Large group task force meeting Charge to Each Task Force Team & Timeline 28
Resources #1Resources #1 ~100 articles related to Wellness on Share Point drive for this task force Try to relate every session improvingtowardsWellness
Resources #2 &ReviewHarvardBooksBusinessSeriesselectotherbooks HBR Emotional Intelligence Series HBR 20-minute Manager Series HBR Leadership Series Leader as Healer by Nicholas Janni Lean Leadership in Healthcare The Coaching Habit by Michael Bungay Stanier Humble Inquiry & Humble Leadership by Schein Building Resilience with Appreciative Inquiry
⇒ Human Resources ⇒ Leaders ⇒ Leadership Development ⇒ Sign-in
Resources #3 LibraryLearningVirtual Precipio Video Library Human Resources website Array of topics from book reviews, channels, webinars to
https://intranet.utmb.edu/iutmbcourses
• Integration over entire curriculum for seamless learning – Goals and Objectives, should drive the contents o Content should not be driving the school bus – Create reinforcement without duplications – Identify block topics vs. one’s to integrate over time – Provide threads across curriculum for reinforcement o Topic progression over time o Cases to work and build upon over time o Skill development, such as communication o Scholarly projects – Unify resources for participants • Ability to identify potential needs for retreat learning
Tenets
DevelopmentCurriculumof
UpcomingDetailstoConsider • Participant Resources? – Books required vs. recommended vs. choice from list – Virtual home: Black Board? Other? – Syllabus for 6 months vs. Handouts at each session – CME potential for session • Topics for participants to disseminate easily – ‘Canned’ Power Point presentations on basics that scholars can give to their division/ department to avoid re-inventing topic presentations • Scholarly Projects Guidelines to develop – Timeline for project progression – Project options chosen in partnership with mentors, Chairs, other? – Identifying Project mentors
Possibilities for Task Force Participants& • Well-Being Director Certification – Every Scholar in Healing and Leading will be certified • Appreciative Inquiry Certification – Training available for Task Force Member interested in using and teaching appreciative inquiry • Other short trainings that Scholars can fit into the program goals & objectives is worth considering
• Most institutions are still taking small steps toward wellness • UTMB is positioned to lead • Academic Opportunity – Institutional wellness metrics will be available for pre- and post-program rollout – Scholarly projects can be designed for QI/QA publications • Publication/Presentation Potential – Research meetings related to wellness o Physician Wellness Academic Consortium Annual Meeting o AMA Annual Meeting o Wellness Sections now being added to many academic meetings and journals – Larger study of UTMB’s approach could result in a landmark article on the subject UTMB Wellness Initiative: Academic Potential 35
Thank you!
