Gabriel Perna | May 12, 2021
Heather Farley, MD, was inspired to establish ChristianaCare’s Center for WorkLife Wellbeing after experiencing an adverse event as an emergency physician.
“I was taking care of one of our own employees, I discharged her, and she died on the way home from the emergency department. That was a really difficult personal and professional experience. At that time, it was a culture of secrecy of shame and blame around these adverse events. There were no models of support out there,” says Farley, Chief Wellness Officer, ChristinaCare.
Knowing firsthand how these issues could fester, Farley wanted to create a supportive infrastructure at ChristianaCare. What started as a peer-to-peer support program with modest financial backing blossomed into the Center for WorkLife Wellbeing, a fully operational consulting and education arm of the health system.
The center, which started in 2016 with the mission to foster work-life meaning, connection and joy, has focused its efforts on efficiency of work and culture of work. While it does also offer services to help caregivers improve personal wellbeing, she says that the other two domains are perhaps more important but often overlooked.
“I always use the analogy, you can’t take the canary out of the coal mine and teach it to be more resilient and then put it back in the same coal mine and expect it to survive,” Farley says. “You actually have to change the coal mine—the environment surrounding our caregivers and clinicians.”
For the Center for WorkLife Wellbeing, this means offering direct wellbeing services that can help organizations improve the culture and efficiency of their workplace. It could be something comprehensive like starting a peer support program or something simpler like providing ice cream rounds for clinicians. After implementing these services, the center fosters and develops workplace champions for specific organizations and then advocates for systematic and national-level changes that can improve the wellbeing of caregivers.
The COVID impact
Before COVID hit, the issue of clinician burnout had been gaining traction in health care. For years, there was definitive proof building up that clinician burnout was taking hold in the industry thanks to a number of factors and ultimately having a negative impact on outcomes. Some studies have been released in recent years showing the financial side of the issue—costing health care providers as much as $11,000 per doctor and more than $4.6 billion across the industry.
Naturally, the pandemic has only put the issue further into the spotlight. A recent study from Kaiser Family Foundation and The Washington Post revealed that nearly 3-in-10 health care workers are considering leaving the profession and more than half are burned out.
“We’re having to witness more suffering and deaths. It’s obviously had a profound impact on everyone, but on our caregivers in particular. And it’s not an easy time to be a leader either. It’s really an incredibly difficult time to navigate,” says Farley. “During the acute phase of a crisis, people are putting their heads down and powering through on pure adrenaline. They don’t have the time, space or energy to absorb and process what they are experiencing and what they are being exposed to.”
Heather Farley, MD, ChristianaCare
At the Center for Worklife Wellbeing, employees underwent intensive rounding on all shifts to support caregivers, particularly those treating COVID patients. They provided support through food and drink carts, but more importantly, conversations and in-the-moment support. Farley expects that as the pandemic stabilizes, with more people getting vaccinated, utilization of mental health services among caregivers will increase.
“This is the time where it’s so important for us to keep the foot on the gas pedal for the support we are providing because what we do now will impact the likelihood that we will be able to help caregivers heal in a healthy way vs. them experiencing more longtime stress and potentially PTSD,” Farley says. “It’s important for us to resist the urge to fast forward to happier, more optimistic times. That’s our instinct, particularly as leaders, and it’s really important for us to pause, reflect and process this together.”
Measuring success: Value of Investment rather than ROI
Another thing the Center did during COVID was provide “psychological first aid” training to health care leaders. Farley says it’s not about expecting leaders to be therapists but equipping them with the skills needed to recognize warning signs in their caregivers so they can connect them with the proper resources and support. She recommends other organizations adopt similar training.
Moreover, with more people working behind computer screens, Farley says leaders have to make a purposeful effort to get in the trenches with employees and caregivers to show support. It’s not enough to just send out an email. She also suggests leaders try to create an environment where “it’s OK to not be OK” and set examples for everyone by attending to their own needs. In terms of long-term solutions, clinician wellbeing should be considered a quality metric that every organization holds itself accountable to.
“Health systems around the world have been dismayed at the low utilization of existing support resources, especially during the pandemic. There are a lot of reasons why struggling clinicians are not taking advantage of mental health services that are out there. Building a truly effective wellbeing program that caregivers actually use requires a much more comprehensive multimodal approach,” Farley says.
For measuring success in this area, Farley recommends organizations use leading indicators rather than lagging ones. While turnover and fulfillment rates are important, it often takes years to move the needle on those indicators. Instead, she says organizations should look at the things driving those indicators, such as equity, employee autonomy and sense of purpose.
“Sometimes the simplest measures are the most meaningful and it really speaks to rather than an ROI, but a VOI (value of investment) in the work that we’re doing. Simply looking at increases in utilization of our peer support program and mental health service speaks volumes to the work that we’re doing behind the scenes to normalize distress and to decrease the barriers to help-seeking behavior. A threefold increase in use of our peer support program is a meaningful metric of success for that program,” Farley says.
Homepage photo credit: ChristianaCare