Prioritizing Clinician Wellbeing: The University of Virginia's Compassionate Care Initiative

Susan Bauer-Wu, Dorrie Fontaine, Susan Bauer-Wu, Dorrie Fontaine

Abstract

Background: Working in healthcare is increasingly challenging for nurses, physicians, and other health professionals. Ongoing high stress takes a toll on clinicians and interferes with the quality of their patient care. Fostering clinician wellbeing needs to be a priority; if not, the human and financial consequences are significant.

Objective: To describe the University of Virginia (UVA) School of Nursing's Compassionate Care Initiative (CCI) as an example of an organizational case study that is engaged in multipronged efforts to cultivate a resilient healthcare workforce committed to high-quality, compassionate, relationship-based care.

Methods: This case report describes the development, implementation, and evaluation of the CCI at UVA. Various elements of the program are reviewed, which include harnessing talents and interests of the larger institution in the establishment of Compassionate Care Ambassadors, outreach to the community, innovative student-specific educational activities, and a national media program.

Conclusion: The UVA CCI is a successful model of an organizational effort to promote clinician wellbeing and resilience. Aspects from this program can be adapted to other organizations that are committed to addressing this critical issue in US healthcare today.

Keywords: Resilience; academic health sciences; burnout; clinician wellbeing; compassionate care; healthy work environment; interprofessional; nursing education; relationship-based care.

References

    1. American Association of Colleges of Nursing. Nursing shortage fact sheet. 2011. . Accessed July 22, 2015.
    1. American Association of Medical Colleges. Physician supply and demand through 2025: key findings. 2015. . Accessed July 22, 2015.
    1. Pendry PS. Moral distress: recognizing it to retain nurses. Nurs Econ. 2007;25(4):217–21.
    1. Egues AL, Leinung EZ. The bully within and without: strategies. Nurs Forum. 2013;48(3):185–91.
    1. Wilson BL, Diedrich A, Phelps CL, Choi M. Bullies at work. J Nurs Adm. 2011;41(11):453–8.
    1. Sandi C. Stress and cognition. Wiley Interdiscip Rev Cogn Sci. 2013;4: 245–61.
    1. McHugh MD, Kutney-Lee A, Cimiotti JP, Sloane DM, Aiken LH. Nurses' widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff (Millwood). 2011;30(2):202–10.
    1. Shanafelt TD, Boone S, Tan L. et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012. October 8; 172(18):1377–85.
    1. Spickard A, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2015;288(12):1447–50.
    1. Maslach C. Burned-out. Can J Psychiatr Nurs. 1979;20(6):5–9.
    1. Toppinen-Tanner S, Ojajärvi A, Väänaänen A, Kalimo R, Jäppinen P. Burnout as a predictor of medically certified sick-leave absences and their diagnosed causes. Behav Med. 2005;31(1):18–32.
    1. Larrabee J, Janney MA, Ostrow CL, Withrow ML, Hobbs GR, Burant C. Predicting registered nurse job satisfaction and intent to leave. J Nurs Adm. 2003;33(5):271–83.
    1. Vahey D. C., Aiken L. H., Sloane D. M., Clarke S. P., Vargas D. Nurse burnout and patient satisfaction. Med Care. 2004;42(2 Suppl): 57–66.
    1. Shanafelt TD, Bradley K a, Wipf JE, Back a L. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136(5):358–67.
    1. National Patient Safety Foundation Lucien Leape Institute. Through the eyes of the workforce: creating joy, meaning, and safer health care. . Accessed July 22, 2015.
    1. Kutney-Lee A, McHugh MD, Sloane DM. et al. Nursing: a key to patient satisfaction. Health Aff (Millwood). 2009. Jul-Aug; 28(4):w669–77.
    1. Cimiotti J, Aiken L, Sloane D, Wu E. Nurse staffing, burnout, and health care-associated infection. Am J Infect Control. 2012;40(6):486–90.
    1. Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood). 2008;27(3):759–69.
    1. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient. Ann Fam Med. 2014;12(6):573–6.
    1. Fontaine DK, Rushton CH, Sharma M. Wisdom leadership in academic health care centers: leading positive change.: Plews-Ogan M, Beyt G. editors Wisdom leadership in academic health care centers: leading positive change. London: Radcliffe Publishing; 2014:92–110.
    1. Sharma M. Contemporary leaders of courage and compassion: competencies and inner capacities. Transformational leaders series-part one. Kosmos. 2012; (Spring/Summer):4–11.
    1. Sharma M. From personal to planetary transformation. Kosmos. 2007; (Fall/Winter):31–5.
    1. Bartels J. The pause. Crit Care Nurse. 2014. February; 34(1):74–5.
    1. Sivilli T, Pace T. The human dimensions of resilience: a theory of contemplative practice and resilience. Garrison, NY: Garrison Institute; 2014.
    1. Oxford Dictionaries. Resilient. . Accessed July 1422 2015.
    1. Bauer-Wu S. Seeds of hope: blossoms of meaning. Oncol Nurs Forum. 2005;32(5):927–33.
    1. Kabat-Zinn J. Full catastrophe living. Revised. New York: Bantam; 2013.
    1. Bauer-Wu S. Leaves falling gently: living fully with serious and life-limiting illness through mindfulness, compassion and connectedness.Oakland, CA: New Harbinger; 2011.
    1. Cohen-Katz J, Wiley SD, Capuano T. et al. The effects of mindfulness-based stress reduction on nurse stress and burnout. Holist Nurs Pract. 2005;19(2):78–86.
    1. Krasner MS, Epstein RM, Beckman H. et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009;302(12):1284–93.
    1. Jha AP, Krompinger J, Baime MJ. Mindfulness training modifies subsystems of attention. Cogn Affect Behav Neurosci. 2007;7(2):109–19.
    1. Crumpton NM. Secondary traumatic stress and mindfulness training. J Emerg Nurs. 2010;36(1):3–4.
    1. Shapiro SL, Astin JA, Bishop SR, Cordova M. Mindfulness-based stress reduction for health care professionals: results from a randomized trial. Int J Stress Manag. 2005;12(2):164–76.
    1. Epstein RM. Mindful practice. J Am Med Assoc. 1999;282(9):833–39.
    1. Back AL, Bauer-Wu SM, Rushton CH, Halifax J. Compassionate silence in the patient—clinician encounter: A contemplative approach. J Palliat Med. 2009;12(12):1113–7.
    1. Beach MC, Sankar A, Roter D. et al. A multicenter study of physician mindfulness and health care quality. Ann Fam Med. 2013;11(5):421–28.
    1. Brady S, O'Connor N, Burgermeister D, Hanson P. The impact of mindfulness meditation in promoting a culture of safety on an acute psychiatric unit. Perspect Psychiatr Care. 2012;48(3):129–37.
    1. The American Association of Critical-Care Nurses. AACN standards for establishing and sustaining healthy work environments: a journey to excellence. . Accessed July 22, 2015.
    1. Ulrich BT, Lavandero R, Woods D, Early S. Critical care nurse work environments 2013: a status report. Crit Care Nurse. 2014;34(4):64–79.
    1. Fontaine D, Koh E, Carroll T. Promoting a healthy workplace for nursing faculty and staff. Nurs Clin North Am. 2012;47(4):557–66.
    1. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513–1516.
    1. Lown Institute. Overuse 101. . Accessed July 22, 2015.
    1. Charon R. Narrative medicine: honoring the stories of illness. Oxford, UK: Oxford University Press; 2008.
    1. Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Heal Sci Educ. 2009;14(4):595–621.
    1. 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. April; 174(4):527–33.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться