Essential hospitals have long led the way in building a resilient and robust workforce through wellness, mental health, and career development and use innovative solutions to overcome burnout, labor shortages, and other workforce challenges.
Prioritizing Staff Resiliency
NYC Health + Hospitals Helps Healers Heal
Association member NYC Health + Hospitals, in New York, launched the Helping Healers Heal (H3) program in 2018 to mitigate staff emotional and psychological needs using a three-tier system: unit or department support, trained peer support, and expedited referral network.
Peer support champions work with mental health experts throughout the health system to facilitate wellness rounds, host debrief sessions after adverse patient encounters, staff an employee-only behavioral health hotline, and establish respite rooms for employees.
The health system integrates H3 information into its education and resources, such as quarterly wellness events, yearly trainings and refreshers, and standardized promotional material.
Program leaders synthesize feedback gathered from wellness engagement exercises, activities, retreats, and debriefs to analyze system trends and respond to staff needs accordingly.
Jeremy Segall, MA, RDT, LCAT, assistant vice president and system chief wellness officer, urges other institutions to integrate and prioritize wellness in their strategic goals to establish true organizational cultural change.
“The more people felt cared for, seen, respected, supported, and appreciated, the more they felt safer to use their voice,” says Segall. “Psychological safety equals culture change.”
He adds that it is critical that health systems prioritize regular staff assessments, whether individual or on a team or department level, to best target necessary change or improvement.
“Understand where your staff are at, in terms of burnout, compassion fatigue, stress, anxiety, feelings of sadness or depression, and just general burnout. Measure it. Understand your baseline. If you have a baseline, then you know where you need to strategically prioritize where to go with importance,” says Segall.
Eric Wei, MD, MBA, senior vice president and system chief quality officer, says hospital and health system leaders should themselves be more open to discussing personal and work-related struggles to create a more comfortable environment for staff.
“We’re consistently trying to stop stigma to start healing,” says Wei. “Modeling the ability to be more vulnerable at work doesn’t mean that you are not able to fulfill your work duties.”
He notes that a string of turbulent national and global events in recent years has led to an even greater need for staff support.
“Who we are as a person and a human being is affected by things that are happening at home, things that are happening around our local state, national, international environments,” says Wei. “[It’s important that staff] heal as a whole person, not just their professional person. Well-supported, happier, fulfilled staff lead to higher-quality, safer patient care for [a] better experience.”
Grady Health System Launches Employee Resiliency Services
Similarly, at association member Grady Health System, in Atlanta, employees expressed frustrations over COVID-19 exacerbation, high-stress environments, and turnover rates. Hospital leadership and the behavioral health team recognized that something had to change.
Gregory Scott, program manager of integrated behavioral health and employee resiliency services, helped establish Employee Resiliency Services, where staff can meet privately with licensed therapists at no cost. The health system prioritizes confidentiality by waiting until staff have made an appointment to disclose its location and urging them not to share the location with others. Scott says the biggest challenge was creating an online system to make appointments confidentially without integrating with the health system’s main records system. “It’s totally confidential and you have no cost. There’s no documentation anyone will see,” explains Scott.
He says staff often remain hesitant to voice that they’re struggling out of fear that their challenges will affect their employment. Wei shared that NYC Health + Hospitals staff have expressed similar concerns, but both Scott and Wei say they actively work to reassure staff that what they share will always remain confidential.
Scott prioritized creating a warm and welcoming environment for these appointments. He didn’t want staff to feel like they were at work when meeting with the therapist or counselor.
“We wanted it to feel different from a hospital, [as if] they were going to a private practice office. That’s why we changed the name from [Employee Resiliency Clinic]. Employees thought it might feel too much like one of our other clinics where patients go, so that’s why we switched it to Employee Resiliency Services,” says Scott. “We didn’t want to medicalize them or pathologize them.”
Noting that visible support from Grady leadership was critical in allowing staff to feel more comfortable seeking help, Scott encourages administrators at hospitals with similar programs to publicize and promote these resources. He also says working collaboratively with Grady’s marketing team has proved a critical component in promoting the services.
“It sends a really strong message that administration is supporting,” explains Scott. “That feels good to employees as well as…the quality of the therapy they’re getting.”
Workforce Development Efforts
UVA Health System: Community Responsibility
As economic engines, essential hospitals have a responsibility to create a healthy and sound working environment for the benefit of their broader communities, as well as their patients and staff.
“Not only do we take care of patients, but often we’re the largest employers in our community,” says Wendy Horton, PharmD, MBA, CEO of association member University of Virginia (UVA) Health System, in Charlottesville, Va. “Of course, our patients need us, but our community needs us.”
Strengthening the pipeline of new employees is critical as staff shortages have further burdened an already struggling health care workforce.
UVA Health System developed the Earn While You Learn Program, which allows hospital employees to work toward a variety of medical certificates and degrees while receiving a full-time wage and benefits. Participants who complete the program are guaranteed employment at the health system.
“For the first time, many people in our community were able to figure out how to make this work because they could learn at work,” explains Horton.
The program partners with a local community college, as well as a trade college, where students can get certified, shadow professionals, and gain mentorship.
Horton says the program has been tremendously beneficial in easing workloads for staff who have been forced to take on additional responsibilities.
“Now, you have a fresh pipeline of people, and all these [previously empty] roles are filled, you have help and support,” Horton notes. “That means a lot when people can help you while the bells are going off.”
Charlottesville and UVA Health have a profound connection to the heavy toll COVID-19 took on health care workers. It was in Charlottesville, on April 26, 2020, that a visiting New York emergency medicine physician, Lorna Breen, died by suicide — an outcome her family attributes to the pressures of the pandemic.
Breen was transported to UVA University Hospital but succumbed to her injuries. Her death inspired action by mental health advocates and a new law, the Dr. Lorna Breen Health Care Provider Protection Act. The act, endorsed by America’s Essential Hospitals and signed into law March 18, 2022, created grants and requires the U.S. Department of Health and Human Services to conduct activities to improve mental and behavioral health among health care providers.
UMC El Paso: Investing in Staff
Association member University Medical Center (UMC) of El Paso, in El Paso, Texas, has a similar program, called the UMC CARES PULL-OPP (Pursuing Upward Learning Legacy Opportunity) Program. The PULL-OPP Program allows hospital employees to further their education while working part-time for full-time pay.
In exchange, existing or new employees commit four years to serving at the hospital. This benefits the hospital greatly, Mielke says, at a time when talent recruitment has become greatly competitive.
“We’re not going to have to spend X amount of dollars on recruiting a new person if we can take a fraction of that and spend it on educating one of our own,” says Mielke. “It is a large amount of money that all hospitals expend when they go through their recruiting process that they could offset by simply growing their own, demonstrating great commitment to their associates, and helping them grow.”
UMC El Paso, like many essential hospitals, offers Level 1 trauma care and disaster response, which often can take a heavy and lingering toll on providers. Such was the case after a mass shooting in 2019 at an El Paso Walmart. The incident left many UMC El Paso staff with lasting trauma from caring for patients who sustained assault rifle wounds.
Soon after the shooting response, the hospital designated an onsite psychologist as a no-cost resource for staff struggling with the aftermath as well as ongoing confidential counseling.
“The wounds are just something that I think have lasted on the psyche of our associates,” Mielke explains. “On that day, I think in that aftermath, we realized the great need to have that on-staff psychologist who could be there in times of crisis, who could be there at times of anxiety, of whatever our staff is going through.”
Mielke urges all hospitals to be proactive and have resources, such as a psychologist, available.
“I think you have a responsibility to your staff to have those resources. You may get lucky and never use them,” says Mielke.
It is critical essential hospitals continue their efforts providing staff support and cultivating the future workforce to ensure high-quality care and staff resiliency.
This blog is a part of a series focused on health care staff resilience. How is your hospital combating staff burnout and developing its workforce? Share your best practices with us at dept-comms@essentialhospitals.org.