MHealthyAdvisoryCommitteeNovember 18, 2021Beyond Burned Outto Beyond BurnoutSandy Goel, PharmDSenior Administrative Manager, Wellness OfficeAdjunct Clinical Assistant Professor, College of PharmacyKaren Schmidt, MPHSenior Director, MHealthyHealth & Well-Being Services

Burnout BackgroundAgenda Local Data and Drivers Beyond Burnout Well-being Strategies, Resources, Tactics Discussion Questions

Everyone isTalking AboutBurnout

Everyone isTalking AboutBurnout

Characterized byBurnoutDefined Emotional exhaustion feeling depleted Depersonalization detachment, cynicism, irritability Low sense of personal accomplishment feeling unproductive

Burnout is anOccupationalPhenomenon

Burnout included ICD-11 as an occupational phenomenon not classified as a medical conditionWHOClassification Burnout is defined as: a syndrome conceptualized as resulting from chronicworkplace stress that has not been successfully managed It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings ofnegativism or cynicism related to one's job; and reduced professional efficacy. Burnout refers specifically to phenomena in the occupationalcontext and should not be applied to describe experiences inother areas of life.

Burnout vs.DepressionBurnoutDepressionOccupational syndromeClinical mental health diagnosisJob demands/resources, workenvironmentGenetics, biochemistry,hormones, environmentalfactorsChanges in the workenvironment, coaching,breaks/time awayPharmacologic andpsychotherapyMedical errorsSuicidal ideationAdapted from Tait Shanafelt, American Conference on Physician Health and Stanford Medicine WellMD WellPhD presentations, October 2021

NationalAcademy ofMedicine

Organizational-levelLeadership behaviors, decision-making,work expectations, cultureContributorsof BurnoutWork-levelWorkload overload, inefficiencies, long hours,administrative burden/EHR; lack of autonomy, controlor flexibility, lack of respect among colleaguesIndividual-levelSelf-criticism, over-commitment, coping strategies,work-home imbalance, no sleep or support

Consequencesof BurnoutOrganizational-levelTurnover, quality of care, patient satisfaction, safety; 500K-1 million for physicians, 1-2x salary of nursesWork-levelInterpersonal conflict, decreased productivity, detachmentfrom patients, loss of joy in work, professionaldissatisfactionIndividual-levelMorale; physical, emotional and mental health; strainedrelationships, alcohol and substance abuse, isolation,suicidal ideation, neglecting personal needs

Workplace Well-BeingWorkplaceWell-BeingOptimal quality of life and experience at work Having energy for work, or feeling energized by it Feeling connected to people and purpose Having flexibility between work-home Experiencing psychological safetyAble to speak up with your ideas, questions and concerns,or make mistakes, without fear; be full self at work

1. Prioritize well-being as a core value & dailypracticeBeyondBurnout2. Measure to improve our quality of life at work3. Seek to understand root causes and systemlevel solutions4. Invest in people, programs, and initiatives forwell-being

“ promoting thewell-being of self andothers”PrioritizeWell-Being as aCore Value &Daily PracticeWellness Office

PrioritizeWell-Being as aCore Value &Daily PracticeMHealthy

Model ofWell-Being:Michigan Medicineand MHealthyWorkplace Well-BeingOverall Well-Being

What effect will my actions and decisions todayhave on staff, faculty & learner well-being?Prioritizing –Ask OurselvesEach Day What can I do (or stop doing) to facilitate thewell-being of our staff, faculty, and learners? How can I take care of myself and each othereach day?

1. Prioritize well-being as a core value & dailypracticeBeyondBurnout2. Measure to improve our quality of life at work3. Seek to understand root causes and systemlevel solutions4. Invest in people, programs, and initiatives forwell-being

Press GaneyMichigan Medicine2021 Faculty andStaff EngagementSurveys

KeyDomainsof ntFeelingValuedBurnoutOrganizational-level metricPsychologicalSafetyBurnoutDriversFaculty onlyfor 2021LeadershipConnectionEmotional& MentalHealthOnly on WellnessOffice SurveyDiversity, Equity& Inclusion

Key Domains of Well-BeingMichigan Medicine2021 Faculty andStaff EngagementSurveys

70%59%60%BurnoutOver Time*40%35%32%30%10%53%48%50%20%*Burnout question varied slightlybetween surveys & veyN gementSurveyN 2,313N 468N 17,716N 2,466N 2,3780%20192020StaffFaculty2021

Overall, the University of Michigan actively supports a workculture and environment that promotes the health and wellbeing of its faculty and staff.31.06%Strongly agreeMHealthy Data34.79%45.73%Agree45.20%15.45%Slightly agree13.41%3.85%Slightly disagreeUMHS (N 6,304)U-M (N 14,443)3.25%2.44%Disagree2.13%1.46%Strongly disagree1.22%0%5%10%15%20%25%30%35%40%45%50%

The person I report to is supportive of workplace healthand well-being activities.31.06%Strongly agree43.87%45.73%AgreeMHealthy Data39.52%15.45%Slightly agree10.66%3.85%Slightly disagreeUMHS (N 6,304)U-M (N 13,917)2.11%2.44%Disagree2.34%1.46%Strongly disagree1.50%0%5%10%15%20%25%30%35%40%45%50%

In the past year, which of the following have been majorsources of stress for you?33.32%36.19%Job responsibilities33.30%35.32%Coping with too much to do26.76%24.76%Finances loan mortgage19.99%18.94%Family problemMHealthy Data16.53%17.49%Relationships at workOther major source of stress15.32%14.91%Illness or injury of loved one14.66%14.83%13.09%14.38%Personal illness injuryUMHS (N 6,438)11.37%11.58%Dealing with child careU-M (N 14,743)9.72%10.51%Care of elderly parentDeath of a spouse, life partner or other lovedone8.09%7.63%3.70%3.51%Divorce or separation1.93%1.93%Legal problem0%5%10%15%20%25%30%35%40%

1. Prioritize well-being as a core value & dailypracticeBeyondBurnout2. Measure to improve our quality of life at work3. Seek to understand root causes and systemlevel solutions4. Invest in people, programs, and initiatives forwell-being

“ contributes to my feelings of burnout or stress.”BurnoutDrivers: FacultyEmailClericalBurdenMiChartInsufficientTime esProductivityRequirements/ExpectationsLack ofFlexibleWorkSchedule64%55%33%

1. My work unit/department is adequately staffed. 46% of respondents agreedTop Areas ofConcern: Staff2. The environment at this organization makesemployees in my work unit/department want to goabove and beyond what's expected of them. 50% of respondents agreed3. The amount of job stress I feel is reasonable. 54% of respondents agreed

1. Prioritize well-being as a core value & dailypracticeBeyondBurnout2. Measure to improve our quality of life at work3. Seek to understand root causes and systemlevel solutions4. Invest in people, programs, and initiatives forwell-being

PromotingWell-Being Intentionally ensure well-being is factored into decisionsHelp teams prioritizeAsk for inputAllow some control (self-determination) in decision-makingIncorporate flexibility where you canModel well-being behaviorsAsk about well-being (including during annual reviews)Identify contributors of burnout, measure itShare your stories, talk about itMake it ok to seek help, make room for help, be the helpPause for acknowledgement, praise, recognitionKnow the resources that are available

Department Leadership MeetingsIdentifyingOpportunitiesMeeting individually to discuss well-being data,opportunities, and goals in more detailConnecting the DataReview SurveyResultsIdentifyStrengths andOpportunitiesConnect toOthers/ShareBest PracticesConnect toPrograms andResources

Connectingto Programsand ResourcesWellness ssOfficeWebsiteWell-BeingSurvey ToolsandDashboardToolkits &TrainingsWell-BeingHelp CenterBestPractices &PublicationsFacultyAssociateProgram

2020-21Improving Workflow to Alleviate PhysicianBurnout (Drs. Nieves & Oral, Internal Medicine)Faculty & StaffWorkplace WellBeing GrantsProfessional Development for RadiationOncology and Medical Physician Trainees(Drs. Paradis & Laucis, Radiology Oncology)Improving Radiology Wellness ThroughInclusive Imagery (Drs. Garver & Joshi,Radiology)Three Good Things (Dr. Gold, Family Medicine)Ob-Gyn Wellness Book Club(Dr. Seewald, Ob-Gyn)Overcoming Barriers to Participation inCOMPASS a Peer-to-Peer Support Program(Dr. Marr, Internal Medicine)2021-22Timeular: A Different Approach to TimeManagement, Productivity Tracking, and theWork/Life Balance (Courtney Oliver, InternalMedicine)Improving Burnout and Wellbeing forFaculty, Staff and Learners with PositiveLeadership Training (Drs. Garver & Young,Radiology)Adapting the Providers Share WorkshopMethodology to Support COVID Caregivers(Dr. Harris, Ob-Gyn)Parenting Stories at Michigan Medicine (Drs.Paradis & Morgan, Radiation Oncology/Ob-Gyn)Compassion Awareness ProjectSustained Presence of High-Quality Nutrition (Sarah Thurston, ULAM)Leads to Improved Provider WellnessCreating a Positive Organizational Culture(Dr. Amin, Internal Medicine)with Storytelling (Drs. Garver & Young,Women in CVM Peer Mentorship PilotRadiology)(Dr. Gualano, Internal Medicine)

NameDepartmentFocusIM - Hosp MedEmail BurdenDr. Kris ChrouserUrologyJob Demands & ResourcesDr. Helen MorganOB/GYNParental Well-Being CultureDr. Laura OwensOB/GYNVacation UseDr. Gurjit SandhuSurgeryPsychological SafetyDr. Raf RizkIM - GIEHRDr. Anita AminFacultyAssociateProgram

Burnout Toolkitand ReflectionGuides

MentalHealthCounselingConnectingto Programsand ResourcesCOMPASSPeer ienceRoundsSupportGroupsDebriefingsupport afterimpactful eventsEducationalpresentationsand programsCrisis SupportResourcesStress FirstAidProgrammingResource Coach, Financial well-being, Online programs and tools, Ergonomic GrantsAlcohol Management, Tobacco Treatment, Physical Activity, Healthy EatingOCWR & FASCCOMHealthyCulture lnessGrantsFocusedPartnershipsHealth andCultureSurveys

Well-being is more than the absence of burnout Individual resilience important but not enoughSummary Well-being requires organization-level strategies and goodpartnerships Well-being needs everyone, everyone needs well-being Tailor solutions at local levels based on data Start with self-compassion, this is a lot Know some improvements will take time Our values will get us there


People want to be asked what really matters“Mattering” Know they matter You matter!

Beyond BurnoutWorkplace Well-BeingDiscussionQuestions1. From an organizational-level, how might U-M bettersupport faculty and staff in addressing burnout (i.e.,systems, policies, practices, etc.)?2. From a “work” or unit/department-level, how might U-Mbetter support faculty and staff in addressing burnout?(i.e., local/team leaders, unit level interventions, etc.)3. Based on what you heard today, from an individuallevel, how might U-M better support faculty and staffwho are experiencing burnout?

What CanWell-BeingSound Like?My direct supervisor ispresent and I feel shelistens to what I haveto say. I enjoy my job,99% is because of her.I feel that I amsupported byLeadership to askquestions and bring upissues that arise.The difference on our unitis we are a team, we helpeach other. We recognizewhen someone isoverwhelmed and step inand help.I feel thoroughly supportednot only in my current role,but also in as manypersonal facets as can beimpacted by professionalinteractions.Our management reallylistens to their employeesand is extremelysupportive in all aspects ofour lives. They genuinelycare about us and ourphysical and mental wellbeing.Very positive andengagingenvironment.Strong foundationof trust andrespect for oneanother.I really enjoy workingwith my directsupervisor. She takesgreat care inpromoting patientsafety and treatingothers with respect. Ifeel that my concernsare always heard.

Intentionally ensure well-being is factored into decisions Help teams prioritize Ask for input Allow some control (self-determination)in decision-making Incorporate flexibility where you can Model well-being behaviors Ask about well-being (including during annual reviews) Identify contributors o