Summa GMEC Wellness Initiative

What’s the GMEC wellness initiative?

The Wellness Initiative began during the first year of designing a Resident Core Curriculum for all of our resident and fellowship programs. It became clear a separate group of educators, residents, therapists and physicians would be needed to design a sustainable approach to wellness in the educational enterprise.

Our Goals

1. Develop a sustained strategy to promote wellness and resilience across all residencies, including faculty and learners.

2.  Track measures of impact, starting with burnout, well being, and later, measures of work efficiency and patient outcomes.

3.  Develop educational expertise in our health system that can benefit the larger institution to improve and sustain high levels of physician well being and retention.

Why this resource?

Members of the Wellness Initiative have access to this page to develop a common resource of reviews, articles and committee projects.

Current Wellness Initiative Projects

Wellness Talking Points Card
(Review but do not distribute until released: subject to study)

This pocket card contains a short guide for program directors, faculty and senior residents to lead an informal conversation with their care team about wellness in the context of rounds or other team based clinical duties.
Talking Points Card

Resident Support Service
(Under development)

A subcommittee of the Wellness Initiative has proposed a pilot project to provide confidential counseling support to any resident in a way that avoids known barriers to receiving support. Read about the project in this document.
Resident Support Pilot
References on Wellness, resilience and burnout
Attending Wellness
Ten Commandments of Physician Wellness

Krall, Edward J. Clinical Medicine & Research Volume 12, Number 1-2: 6-9

An intensely personal perspective with practical insights and tips for individual physicians to build their own resistance. The author believes physicians need to take ownership of their stress and develop a healthy response through a lifetime of practice.

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Burnout prevention
If every fifth physician is affected by burnout, what about the other four?

Zwak et al. Acad Med.2013;88:382-389.

This article seeks to identify health-promoting strategies employed by experienced physicians in order to define prototypical resilience processes and preventative actions others can take. Well organized and useful.

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Wellness Measurement Tools
A brief instrument to assess both burnout and professional fulfilment in physicians: reliability and validity

Trockel et al. Acad Psychiatry (2018) 42:11-24.

Shanafelt and others present a validated tool to briefly assess burnout and professional fulfillment. Unlike the Maslach Burnout Inventory, this tool is calibrated to register changes after interventions in as short a time as three weeks. Unlike the Well Being Index, this tool includes sleep impairment measures. It may be a good candidate for rapid tests of change in a medical workforce.

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Business case for wellness
The business case for investing in physician well-being

Shanafelt T, et al. JAMA Internal Medicine. Online September 25, 2017. E1-7.

Understanding the business case to reduce burnout and promote engagement as well as overcoming the misperception that nothing meaningful can be done are key steps for organizations to take action.

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Institutional Strategies for Wellness
Controlled interventions to reduce burnout in Physicians. A systematic review and meta-analysis.

Panagioti, et al. JAMA Intern Med. 2017;177(2):195-2015

Recent intervention programs for burnout in physicians were associated with small benefits that may be boosted by adoption of organization-directed approaches. This finding provides support for the view that burnout is a problem of the whole health care organization rather than individuals.

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Instituional strategies for wellness
Physician burnout: are we treating the symptoms instead of the disease?

Squires et al. Ann Thorac Surg 2017;104:1117-22.

Healthcare organizations in the United States are implementing committees and support groups in an attempt to reduce burnout among their physicians, but these efforts are typically focused on increasing resilience and wellness among participants rather than combating problematic changes in how medicine is practices in the current era. A call for a shift in the focus of these efforts toward one proposed root cause of burnout.

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Resilience
Building physician resilience

Jensen M et al. Canadian Fam Phys. Vol 54:May 2008 pp 722-29

While some might argue that resilience is a result of inherited personality traits, some of the factors described in this study as contributing to resilience can be learned behaviors.

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Resident wellness
The correlation of stress in residency with future stress and burnout: a 10-year prospective cohort study

This pre-publication study is the first to relate high stress in residency with higher levels of stress in practice.

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Resident wellness
Mental health during residency training: assessing the barriers to seeking care

Aaronson et al. Acad Psychiatry (2018) 42:469-472

Resident and fellow physicians are at higher risk for developing depression compared tot he general population, but they re also less likely to utilize mental health services. This study identifies barriers to receiving care which included lack of time, concerns about confidentiality, concerns about what others would thing, cost, and concern for the effect on one's ability to obtain licensure.

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Resident wellness
Changing the conversation from burnout to wellness: physicians well-being in residency training programs

Eckleberry-Hunt, et al. J Grad Med Ed, December, 2009; 225-230

The benefits of cultural change include providing a more positive educational environment for residents and faculty, raising awareness of burnout and its symptoms, decreasing the stigma associated with burnout symptoms, enabling the development of prevention strategies.

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