Novant Health's Wellness Program Keeps Physician Burnout at Bay

Added on Jul 22, 2016

Novant Health's Wellness Program Keeps Physician Burnout at Bay
By Diana Mahoney
From Industry Edge July 2016

“The best defense is a good offense.”

Dr. Tom Jenike, chief human experience officer of Novant Health, uses this familiar sports analogy to explain his motivation for spearheading a wellness program designed to prevent physician burnout before it has a chance to take hold.

Called the Novant Health Leadership Development Program, the “voluntary but encouraged” self-awareness intervention is designed to help physicians achieve a better work-life balance; develop their leadership skills; boost their engagement, resiliency and wellness; and find more fulfillment in their professional and personal lives, Dr. Jenike explained.

Born out of Dr. Jenike’s own experience with an executive coach who helped him “recapture the joy” from his career, the program was launched in 2013, with the dual goals of ensuring staff’s ability to fulfill the Novant mission (“To deliver the most remarkable patient experience, in every dimension, every time”) and genuinely caring for and investing in the lives of the people providing that care, Dr. Jenike said.

Since that time, more than 500 physicians have participated in the intensive three-day intervention, and the results have exceeded expectations. “In 2015, engagement and alignment scores among clinic physicians who participated in the program were in the 89th percentile and 92nd percentile, respectively, compared to the 54th percentile and 55th percentile among those who had not yet participated,” according to Dr. Jenike. Further, the 2016 results to date show that engagement and alignment scores among program participants have reached the 97th percentile ranking for both measures.

Just as important, said Dr. Jenike, “participants, and sometimes their spouses or family members, have told us that the program has saved their careers and, in some cases, their marriages.”

In this month’s Q&A column, Dr. Jenike answers questions about the design and implementation of the Leadership Development Program and explains why he chooses not to describe it as a “burnout intervention.”

Q: The idea for the Novant Health Leadership Development Program came to you as a result of your own experience with an executive coach. Can you describe the journey that brought you to that point?

A: About five or six years ago, when I was about 10 years into my practice as a family physician and was taking on a number of administrative and leadership positions within the organization, I was becoming so overloaded with responsibilities that I wasn’t getting the joy from my career that I thought I should be. I was working at a high level, and from the outside, everything looked good—my patients loved me, the administration was pleased with my performance, my colleagues thought I was doing a good job—but I felt like I was on a treadmill, trying to keep up with the demands of patient care, administrative leadership commitments and being an engaged parent to my kids. In retrospect I think I was exhibiting some early signs of burnout—decreased fulfillment and fatigue—and I knew I wasn’t giving 100% of myself to any one thing or area of my life, and it wasn’t a good feeling.

I knew something had to change, so I began working with the executive coach to gain more clarity about what was important to me as a physician, an administrator, a parent and a friend. Through this process, I became much more aware of my own patterns and why I had overcommitted. It also became clear that, although I often felt like a victim of my overbooked days, I wasn’t the victim. It was my inability to say no and my attempt to please people that were much larger factors. I realized I had to start letting go of things.

When I started to let go of some of the obligations that were siphoning the joy from my work life, I was able to recommit to being a physician and an effective leader at our organization, and I began enjoying my work more. It was a dramatic shift. I’m a better physician and leader because of it, and I’m more satisfied and productive.

Q: How did this experience lead to the development of the physician wellness program?

A: I walked away from the experience knowing that my friends and colleagues who were facing similar challenges could benefit from the same type of intensive coaching that I received. The pressures and expectations weighing on physicians today can be overwhelming. In addition to delivering excellent care, our time and attention is being divided by economic, technological, regulatory and operational considerations. If we can’t properly manage the burden, everyone suffers: ourselves, our families, our patients and our health care system.

But even though there had been a lot of nationwide publicity about how much of a problem burnout is in health care, there appeared to be a lack of solutions, so I committed to trying to find a way to solve it in our organization. I talked to [Novant Health president and CEO] Carl Amato about my own experience and we began talking about ways to spread it across the organization. He was immediately on board and suggested developing a pilot program. I worked with my executive coach and leadership team to create a comprehensive program to help physicians look inside themselves and really connect with the things they value.

Q: Can you describe the intervention?

A: It is a three-day program focusing on self-awareness, and it’s driven by the concept of leadership. The goal is to help clinicians live more purposefully, rather than just “doing,” both at work and at home. Participants are guided through conversations that help them better understand the patterns, feelings and behaviors behind their actions. The program is completely focused on the individual, not on Novant Health. We believe that if we take care of our employees without expecting anything in return, our employees will care about the organization and their work. The program helps physicians achieve clarity about the things they value most in their lives, and reconnect to the reasons they initially chose this profession, while completely acknowledging the pressures of today’s health care environment. This guides them to either deny or affirm that they still choose and want to be a caregiver. The redemptive power of “I choose” vs. “I have to” helps participants to become reenergized and refocused.

Q: How was the program rolled out?

A: I approached the most senior physician leaders in our organization and had to enroll each of them on the idea that this program would benefit them and the physicians they work with. If they were going to devote three days of their already busy lives, they had to see the value in it. It was important to start with the physicians who had the most influence. I was sure they’d find it as valuable as I did, and they would then be able to communicate that to our physician partners. The first class included 32 physicians, and the response we got from them was amazing. Many of them said it was the most impactful thing they’ve done. Some said it was life changing, and others said it saved their relationships with their spouses and kids. Many of them sent letters to our CEO thanking him for supporting the program.

The early success and positive feedback made it easier each time to get the physicians at the next level of the organization to commit to the program. We saw the same results with the second cohort, and then again with subsequent cohorts. This is meaningful. We are asking them to invest in themselves and to trust that the return on that investment will be worth the effort.

In addition to offering the program to physicians, we have begun integrating nurse practitioners, physician assistants and nurse leaders. The next big job family we will be introducing it to is our front-line nurses, who are very vulnerable to the effects of burnout—particularly nurses in acute care facilities.

Q: How has the program influenced the engagement culture across the organization?

A: The physicians have become more engaged with organizational initiatives and take stronger leadership stances, either in a formal leadership role or within their direct care teams, and many have a renewed relationship with the organization. The engagement scores among those who have been through the program have improved dramatically, and the improvements appear to be very sustainable. Based on data to date from our 2016 Press Ganey engagement survey, the engagement and alignment scores of our entire medical group have moved from the 62nd and 67th percentiles to the 86th and 90th percentiles, respectively, and the scores of our program participants have reached the 97th percentile on both measures. Clearly, they continue to feel engaged and aligned over time, and there is a certain contagiousness to it. When a leader goes through the program, he or she tends to be a better listener and communicator, and that helps others stay engaged.

The increased engagement, not surprisingly, also appears to be driving improvements in the patient experience. For example, the patient experience scores of providers in our outpatient facilities who have gone through the program have improved significantly. As our nurses go through the program and begin to feel more rejuvenated, we are hoping to see similar trends in our acute care settings, where the patient experience is driven much more by the nursing staff.

Q: Are there refresher courses for those who have gone through the program, to keep them from slipping back into old habits?

A: Old patterns have gravity to them, especially under stressful situations. The program is structured to help keep participants from slipping back. The three-day immersion is the “big bang,” then there are follow-up days monthly for four to six months, and there are social events periodically for graduates. What we are finding now is that because most of our leaders have been through the program, they support one another, even if they were not in the same cohort. They’ve been through the same experience and they share a common language, so the support comes naturally.

Q: How do you introduce the wellness culture to new clinicians?

A: Starting this year, we have built some of the principles into our onboarding process for every new hire. We talk about work-life balance and being present, and we teach them to be proactive right out of the gate. We also assign them mentors for six months. These are people who have gone through the program. So it’s very much woven into the culture of our system.

Q: You don’t like to call the Novant Health Leadership Development Program a burnout program. Why?

A: This is a leadership and wellness program, and we find our professional colleagues are interested in growing in these areas. We believe that providers have some resistance to openly discussing burnout. This program is about promoting resiliency and leadership development. The goal is to nurture and encourage physicians and team members to achieve a healthy work-life balance so that they are able and committed to providing high-quality patient care.