VOLUME 34, ISSUE 1

Priscilla J. Garcia, M.D., MHA, FASA

Associate Professor, Department of Anesthesiology
Perioperative and Pain Medicine
Texas Children’s Hospital,
Baylor College of Medicine
Houston, TX

Stephanie Jones-Wood, MPH, CPHQ

Program Director
Houston Methodist Provider Engagement and Resilience
Houston, TX

Alicia M. Kowalski, M.D., CWO, CPE

Professor, Department of Anesthesiology & Peri-Operative Medicine
The University of Texas MD Anderson Cancer Center
Adj Professor, Center for Professionalism
Baylor College of Medicine
Houston, TX

Imelda Tija, M.D., MSHS

Chair, Quality and Outcomes Committee
Co-Chair, Practitioner Health and Wellbeing Committee
Associate Professor, Department of Anesthesiology, Perioperative and Pain Medicine
Texas Children’s Hospital
Baylor College of Medicine
Houston, TX

Wellness Strategies Implemented in the Texas Medical Center

Studies cite that the most important factors for job satisfaction in Anesthesiology include autonomy, control of the work environment, professional relationships, leadership and organizational justice1. Conversely, factors such as difficulty balancing personal and professional life and poor attention to wellness can lead to burnout. Burnout is triggered by constant levels of high stress1. One study showed a national burnout rate of 46% among physicians in practice, both academic and private practice settings 1,2. With burnout, there is concern regarding physician’s wellbeing on performance, productivity, absenteeism, job turnover, early retirement, and reduced revenue as well as the impact on patient safety1. Several institutions in the Texas Medical Center have organized wellness committees to develop strategies to advocate for physicians’ wellbeing at both the organizational and individual level. Here are some programs that may be helpful to your organization as well.

MD Anderson Cancer Center

  • Compassionate Professional Renewal – Partnering with the Jung Center for Mind Body Spirit, a customized curriculum for MD Anderson was developed consisting of 12 monthly modules. Each module has a unique topic on resilience delivered in 1-hour didactic lesson, 8 “office hours” per month distributed in 15 – 30 min increments, a contribution to a newsletter based on the topic, and an additional experiential webinar lesson.
  • Med Tac – Partnering with Safety Leaders (https://www.safetyleaders.org/), we disseminated across our organization the on-line educational module focused on handling Corona virus related issues in the home. (https://www.medtacglobal.org/coronavirus-response/) This provided any participants the opportunity to identify a plan should any family member become sick (zones of containment in the home, necessary equipment, etc.)
  • Institutional Platform, “Pebbles in the Shoe” – Through an Employee Engagement Council, people across MD Anderson can bring up any issues or concerns that may be small but translate into major impacts in the work environment. For example, Institutional Mandatory Training (IMT) was felt to be confusing and overwhelming. In partnership with the Education Center, there is now a plan to highlight “IMT Season”. This will identify start and stop dates, as well as which modules are required, allowing individuals to plan accordingly.
  • Burnout to Brilliance is a national Continuing Medical Education program accredited through MD Anderson in collaboration with the Baylor College of Medicine Office of Professionalism. Historically these annual meetings have been held in person, however, in response to the Covid related limitations, we have converted the program to monthly webinars.
  • BeWell Efforts – This is a monthly newsletter focused on information and tips across the domains of Eat Well, Move Well, Sleep Well, Save Well, Feel Well & Live Well.

Houston Methodist

  • Mindfulness Initiative – multi-year initiative aimed at raising awareness of mindfulness as a combined workforce resilience and patient safety strategy. Since inception, this initiative has trained more than 1000 clinicians and non-clinicians in the practice of mindful living and its connection to safer patient outcomes. Educational offerings include: a 2 hour continuing education course entitled Introduction to Mindfulness, a 4 week Resilience Workshop, and an 8 week intensive mindfulness-based stress reduction course.
  • Comfort Rounds – intensive high reliability rounding for resiliency to support clinician workforce in COVID response and beyond.
  • It’s All Good Here® – a Positive Psychology platform integrated into our Healthy Directions Employee Wellness and Benefits program. To date we have interacted with more than 15,000 Houston Methodist employees and spouses who are participating in evidence based multi-day or multi-week challenges scientifically proven to improve resiliency and positivity.
  • VITAL Physician Peer Coach Pilot – a small pilot offering 6 weeks of life coach support to employed physicians by physician peers with specialized training in coaching.
  • Digital Learning Boards – Digital technology that helps work settings to operationalize high reliability principles into everyday work. Includes a focus on daily management and huddling, leader walkarounds, and driving process improvement and employee engagement through open and transparent communications.

Texas Children’s Hospital

  • Parallel Program for Peer Support – Confidential coaching program created to provide emotional respite and support for frontline health care workers. It is a source for practical advice and assistance with problem solving.
  • Respite Rooms – Respite rooms across the organization where employees have a quiet place to go to remove their face masks and other personal protective equipment to relax. These rooms are equipped with a variety of self-care supplies to help employees take care of their own personal well-being such as essential oils for aromatherapy, coloring books, massage chair, yoga mats, stress balls and guides on stretching techniques to achieve optimal relaxation.
  • Safe Ride Home Program – Program in partnership with Uber for members of the medical staff, residents, and fellows who are concerned about their ability to safely get home due to fatigue or stressors following a shift. The cost of the transportation from any hospital location will be charged directly to the Hospital’s account (users are responsible for tips/gratuity). A return trip is allowed for individuals who leave their vehicles at work while using Uber home.
  • Food Options – Discounts are provided on food court purchases by displaying a hospital badge. A selection of snack foods is delivered daily to resident lounges.
  • Well-Being Index – Anonymous well-being tool that provides practitioners the opportunity to assess their current level of well-being.

Anesthesiologists in particular consistently are under high levels of stress due to urgent and emergent situations. Identifying strategies to advocate for physician well-being can help increase resilience and reduce the risk of burnout. ♦

Works Cited

  1. Saadat, Haleh, Kain, Zeev. Wellness interventions for anesthesiologists. Curr Opin Anaesthesiol. 2018;31(3):375-381.
  2. Daskivich TJ, Jardine DA, Tseng J, et al. Promotion of wellness and mental health awareness among physicians in training: perpective of a national, multidisciplinary panel of resident and fellows. J Grad Med Educ 2015; 7: 143-147.

Next