Organizational Solutions

Robust organizational efforts to advance professional fulfillment and well-being must take a holistic approach that tends to all dimensions of the model. The Stanford Model of Professional Fulfillment is a simple framework that many organizations have found to be helpful for their efforts to develop a holistic strategy to promote professional fulfillment for their physicians and other healthcare professionals. Other organizational interventions that have proven effective are leadership coaching and trainings, hiring a Chief Wellness Officer (CWO), and other measures described in the research below.

a. The Stanford Model for Professional Fulfillment

1. Physician Well-Being: The Reciprocity of Practice Efficiency, Culture of Wellness, and Personal Resilience.
Bohman B, Dyrbye L, Sinsky C, Linzer M, Olson K, Babbott S, Murphy ML, deVries P, Hamidi M, Trockel M. NEJM Catalyst. Aug 7 2017. (article)

2. Menon NK, Trockel MT, Hamidi MS, Shanafelt TD. Developing a Portfolio to Support Physicians' Efforts to Promote Well-being: One Piece of the Puzzle. Mayo Clin Proc. 2019;94(11):2171-2177. doi:10.1016/j.mayocp.2019.09.010

3. Trockel MT, Hamidi MS, Menon NK, et al. Self-valuation: Attending to the Most Important Instrument in the Practice of Medicine. Mayo Clin Proc. 2019;94(10):2022-2031. doi:10.1016/j.mayocp.2019.04.040

4. Sinsky C, Colligan L, Li L, et al. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Intern Med. 2016;165(11):753-760. doi:10.7326/M16-0961

5. Shanafelt TD, Schein E, Minor LB, Trockel M, Schein P, Kirch D. Healing the Professional Culture of Medicine. Mayo Clin Proc. 2019;94(8):1556-1566. doi:10.1016/j.mayocp.2019.03.026
 

b. Developing the Organizational Infrastructure

c. The Healthcare Chief Wellness Officer

D. Examples of Specific Interventions to Promote Physician Well-being

1. Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clin Proc. 2017;92(1):129-146. doi:10.1016/j.mayocp.2016.10.004

2.West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174(4):527-533. doi:10.1001/jamainternmed.2013.14387

3. Dyrbye LN, Shanafelt TD, Gill PR, Satele DV, West CP. Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Intern Med.2019;179(10):1406–1414. doi:10.1001/jamainternmed.2019.2425

4. Swensen S, Kabcenell A, Shanafelt T. Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. J Healthc Manag. 2016;61(2):105-127. https://pubmed.ncbi.nlm.nih.gov/27111930/

5. Linzer M, Poplau S, Grossman E, et al. A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study. J Gen Intern Med. 2015;30(8):1105-1111. doi:10.1007/s11606-015-3235-4

6. Mizumoto R, Cristaudo AT, Hendahewa R. A surgeon-led model to improve operating theatre change-over time and overall efficiency: A randomised controlled trial. Int J Surg. 2016;30:83-89. doi:10.1016/j.ijsu.2016.04.033

7. Shipman SA, Sinsky CA. Expanding primary care capacity by reducing waste and improving the efficiency of care. Health Aff (Millwood). 2013;32(11):1990-1997. doi:10.1377/hlthaff.2013.0539

8. Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T. In search of joy in practice: a report of 23 high-functioning primary care practices. Ann Fam Med. 2013;11(3):272-278. doi:10.1370/afm.1531

9. Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015;90(4):432-440. doi:10.1016/j.mayocp.2015.01.012

10.  West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388(10057):2272-2281. doi:10.1016/S0140-6736(16)31279-X

 

e. Leadership Behavior

1. Shanafelt TD, Gorringe G, Menaker R, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015;90(4):432-440. doi:10.1016/j.mayocp.2015.01.012

2.Seppälä, E. "Good Bosses Create More Wellness than Wellness Plans Do." Harvard Business Review. April 11, 2016. Retrieved September 17, 2020. https://hbr.org/2016/04/good-bosses-create-more-wellness-than-wellness-plans-do.

3. Stoller JK. Developing Physician Leaders: A Perspective on Rationale, Current Experience, and Needs. Chest. 2018;154(1):16-20. doi:10.1016/j.chest.2017.12.014

4. Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clin Proc. 2017;92(1):129-146. doi:10.1016/j.mayocp.2016.10.004

5. Lobas JG. American J Med 116:617

6. Souba WW. New ways of understanding and accomplishing leadership in academic medicine. J Surg Res. 2004;117(2):177-186. doi:10.1016/j.jss.2004.01.020

7. Dyrbye LN, Major-Elechi B, Hays JT, Fraser CH, Buskirk SJ, West CP. Relationship Between Organizational Leadership and Health Care Employee Burnout and Satisfaction. Mayo Clin Proc. 2020;95(4):698-708. doi:10.1016/j.mayocp.2019.10.041

8. Shanafelt TD, Makowski MS, Wang H, et al. Association of Burnout, Professional Fulfillment, and Self-care Practices of Physician Leaders With Their Independently Rated Leadership Effectiveness. JAMA Netw Open. 2020;3(6):e207961. Published 2020 Jun 1. doi:10.1001/jamanetworkopen.2020.7961

 

f. Organizational Culture

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g. Reducing Stigma

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h. Organizational Strategy Blueprint


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