How to Provide a Centralized Model of Wellness

to Optimize Physician Health

S White, MSW, LCSW, OSW-C; R Wilson Zingg, DO; D Fouts, MFA; M Banner, RN, MSN, OCN; S Childress, RN, MSN, OCN; K Walker, HFI, CCET; A Budhathoki, DAOM, L.Ac; P Thielking, MD; J Howell, BS, CMF; S Sample, MFA, PhD; A Effiong, MPH;

A Horyna, MSW, LCSW, OSW-C; W Dunson, MD; D Milligan, MBA; N Robinson, MSW, LCSW, OSW-C; J Mijangos, MSW, LCSW, OSW-C; J Sweetenham, MD; A Beck, MD; P Hansen, MD

Huntsman Cancer Institute at the University of Utah

LEARNING OBJECTIVES

• Learn resources to promote well-being of staff, patients, and caregivers in an academic setting

• Provide a model of how to integrate wellness services throughout hospital and clinic settings

• Describe Compassionate Workplace initiatives to decrease burnout

ABSTRACT

The cancer hospital and outpatient clinics of Huntsman Cancer Institute (HCI) at the University of Utah take an innovative, proactive approach to create a culture of wellness supporting professional resilience. The Linda B. and Robert B. Wiggins Wellness and Integrative Health Center (Wellness Center) started offering services to staff in 2012. The Compassionate Workplace initiative was added in 2015 and continues to evolve as a multidisciplinary program that addresses the physical, mental, and emotional health of HCI staff.

TIMELINE

• The Wellness Center, founded in 2005, began as a patient-driven service. The cancer hospital executive director, an MD specializing in physical medicine and rehabilitation, and an advanced practice nurse initiated the program.

• In 2010, outpatient clinic directors and mental health providers developed a five-session training about compassion fatigue and reducing burnout. All outpatient clinic staff and faculty were required to attend. The training included these topics:

― Overview of Compassion Fatigue― Effective Communications― Mind/Body Skills

• The Wellness Center opened acupuncture, art, and group exercise classes to staff in 2012. Massage therapy was added in 2014 for patients, caregivers, and staff. More than thirty programs and services are currently available to staff. (Figure 1, Table 1)

• In 2016, HCI’s Supportive Oncology Program and Patient and Family Services began Restoring Balance Retreats. These one-day CME-accredited retreats for health care professionals (physicians, advanced practice clinicians, nurses, social workers, and chaplains) teach coping skills to manage stress, increase resiliency, and prevent burnout and empathy fatigue. Attendance to date numbers 206 (Figure 2). The retreats include a variety of elements:

― Didactic teaching― Guided stress-reduction exercises, including mindfulness and yoga― Facilitated group discussions― Time for personal reflection

• In 2016, HCI began monthly Schwartz Compassionate Care Rounds. These lunchtime forum sessions offer opportunities for health care providers to discuss social and emotional issues that arise with patient care. Providers share experiences and thoughts on topics drawn from actual patient cases. CME credits are available. About 100 providers, on average, have attended each session. Total attendance for the past 12 months of sessions is 1,013. (Figure 2) Here is a sampling of session topics:

― When Enough Is Enough: The Challenges of Futile Care― The Gifts of Patient Care― The Power of Apology― Managing Cancer Pain Amid an Opioid Crisis― The Work-Life Puzzle

• Compassionate Workplace (CW) is a comprehensive, evidence-based program created to promote employee wellness and serve as a model for other cancer institutions.

• CW crosses departmental boundaries, bringing expertise already available at HCI together in a joint effort. The CW committee consists of representatives from these areas:

― Hospital administration― Physicians― Nurses― Social workers of HCI Patient and Family Support― HCI Supportive Oncology and Survivorship Program― Wellness Center― Chaplains― Pharmacy― Other support entities including Communications, Environmental

Services, Facilities, Human Resources, and Volunteers

• Since its beginning in 2015, CW has logged these and other accomplishments:

― Began monthly Restoring Balance Retreats― Placed massage chairs in hospital staff areas― Began quarterly chair massage program― Remodeled breakrooms― Scheduled Wellness Center activities at convenient times for staff― Opened a Starbucks outlet at HCI― Began monthly Schwartz Rounds sessions― Provided certification support for all professions― Piloted a small meal cart program

Table 1. Caregiver, patient, and staff use of Wellness Center services

Figure 2. Cumulative attendance numbers for Schwartz Rounds (October 2016-September 2017) and Restoring Balance Retreats (August 2016-September 2017)

See the 5-minute video

What Has Compassionate Workplace Done for Me?

http://bit.ly/2ko2nQz

CONCLUSION

Our hospital has developed a robust, multifaceted resilience program for all staff. The program benefits individuals and also works to change institutional culture to promote these values:

• Wellness• Work-life balance

• Peer support• A sense of meaning in work life

ACKNOWLEDGMENT

Our thanks to Sarah Duricy, BS, for her help in preparing graphs and tables, and to Mara Carrasco for coordinating Wellness Center services.

Figure 1. Staff use of Wellness Center services. Figure 1A shows numbers of staff attending August 2016 to August 2017. Figure 1B shows same data broken out by percentage of use for each category.

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― Work-Life Balance― Self-Care Tips