Summa GMEC Wellness Resources

Residents and Fellows: Anxious? Stressed?

Visit an Employee Support Station
The Summa Health Behavioral Health Insititute has launched a place you can receive support and help. Employee Support Stations on each campus now offer confidential emotional coping support, free of charge.

Residents or fellows can stop in at the following times and locations:

- Akron Campus: Main Tower Conference Rooms 1-3 M-Fri 8AM-PM.  (Starts April 14)

- Barberton Campus: Family Waiting Room next to 1 West M-W-Fr 8AM-5 PM.  (Starts April 15)

- St. Thomas Campus: Main Building 4th Floor to right off A elevators across from Summa Psychiatry waiting room M and Wed 8 AM-5 PM.  (Starts April 15)
...Or Call In
A dedicated phone line has been established for any employee, their spouses, partners, and other family members who might be upset and in need of support.

Anyone can call and talk with a behavioral health provider free of charge for supportive counseling and guidance.

The line will be active from 8 a.m. to 6 p.m., Monday through Friday.

This important phone number is
330-379-8192

Listen to the Thrivedoc Podcast

Listen to faculty and residents at Summa Health System talk about what they are feeling and learning as they care for patients during the COVID outbreak. Each "Resilience Moment" is 1-3 minutes long and will help you process your own experience.
Podcast Playlist
Opinions expressed represent the perception of individuals and are not intended to express the mission or intent of the host health care system.

What you can do to stay well during the COVID CRISIS

As we care for patients during the pandemic it is especially important that we became better at self care. What excites, inspires and drives us to be at our best for our patients and care team? What weakens, disheartens or isolates us? Actually, there are steps you can take and skills you can learn to gain resilience even in the face of heightened stress and challenge.
We need to keep physical distance but not social distance. Now more than ever we need connections that help us find meaning in what we are doing and see things from another's perspective.

Consider asking "the second question". When they answer "Fine" to your question of how they are, consider a second question to connect. "What's keeping you positive today?" or "Are you looking forward to anything coming up?" "Anything unexpected happen for you today?"

How they answer can help you connect, whether it's superficial or more of an in-depth response.

Also: Look for 2-5 minute encounters when you can be present and listen in a focused way to a colleague- just the way we try to do with patients. Look for how events are affecting them and make it easy for them to talk about it.

COPE DURING COVID

C ontrol the things you can, not the things you can't

O pen up and share your feelings

P ractice daily stress reduction tactics, including physical activity

E ngage in mindfulness, be here now: worry will not help.

C ount your blessings daily

O verturn negative thoughts to positive

V olunteer to help others

I dentify helpful supports and resources

D o your part to prevent spread of virus

Bern Melnyk, The Ohio State University Office of the Chief Wellness Officer

What’s Resilience?

Resilience is an individual's ability to bounce back after adversity or failure. Isolation, long work hours, losing a patient, feeling out of control, unresolved conflict with a team mate, family issues that are challenging-- all of these challenge our level of resilience. But they don't define it.

How can we build our resilience?

People who appear hardy, unfazed by challenge appear to others to have just been born with the right emotional set-up to be resilient. But Dr. Wiley Souba MD, MBA in the Department of Surgery at Dartmouth has another view:

"What distinguishes them is that they have learned to see, understand and deal with their challenges differently than most people do...Their level of resilience is not so much a function of what they're doing or how they're doing it... it's the result of 'reframing' circumstances to see challenges differently."

Cognitive therapists have identified 'cognitive distortions"- automatic thoughts we have that are self defeating. "I'll never learn this", or "I'm not as good as any of these other people" are examples of overgeneralizing distortions. When we begin to recognize automatic thought patterns that defeat us we can begin to replace them with positive approaches. "I am struggling here; but I can learn this." For more on this, check the references under "Resilience" elsewhere on this resource page.

  1. Souba, W. Resilience- Back to the Future. JAMA Oct 2016 Vol 151 No 10 pp 897-897

On Line Services and Supports For Special needs

Along with on-site counseling support and a one-call dedicated phone line, Summa mental health experts recommend these on line services for special needs you might have during the pandemic. Choose your area of interest and click to see specific resources you can use.
If you are experiencing high level of stress, you can talk with your attending or supervising physician to receive support and help. In addition, here are on line resources to visit:

Resource to help you manage stress from National Center for COVID-PTSD
PTSD Support
Resource to help you provide psychological first aid in disasters.
PTSD Tips in Disasters
Resource for Mental Health and coping: manage anxiety and stress from Centers for Disease Control and Prevention
Manage Anxiety and Stress
There are special stresses happening related to COVID-19 for residents and fellows with families at home. These resources can help you address needs felt by families with at least one health worker who treats hospitalized patients.
Resources for Parents and Families from Ohio's health experts
Family Resources
Resources to address the psychological and emotional impact of the COVID 19 pandemic for children, families, and healthcare staff
Address Child Fears
The Headspace mobile app gives you a personalized approach to reduce burnout, address anxiety and improve resilience. It's use has been made free to health care workers during the pandemic.
Download and use a free mobile app for health care providers during COVID-19
Headspace App

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
Note: References posted are for personal educational use by faculty and residents. Beyond such use, written permission must be requested from the author or publisher.
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.

Download article
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.

Download article
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.

Download article
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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