Staying STEADY: A Model for Resiliency

Elevating the Human Experience in Healthcare

Staying STEADY: A Model for ResiliencyAudrey Cortez MSN, RN, CPXP | Director of Patient Experience, Peterson Health

February 4, 2020

- The Beryl Institute

Defining Patient Experience

Learn more at www.theberylinstitute.org/CPXPPrep

Certified Patient Experience Professional (CPXP) Preparation CourseJoin The Beryl Institute’s Learning & Professional Development faculty for an interactive workshop reviewing the four domains outlined in the job classification on which the CPXP examination is based. CPXP Workbook included.

Live OnlineFebruary 13 - March 5, 2020February 27 - March 19, 2020Four live, online facilitator-led sessions

In-PersonSunday, April 19, 2020 - 9:00 AM - 4:30 PM ET Hilton Orlando Bonnet Creek • Orlando, FL

Live OnlineAugust 6 - August 27, 2020September 3 - September 24, 2020September 3 - September 24, 2020Four live, online facilitator-led sessions

Keynote Speakers

Pre-Conference Workshops

April 20 – 22 ▪ Hilton Orlando Bonnet Creek▪ Orlando, Florida

Community Gatherings and Add-On Options

Patient Advocacy CommunityPatient and Family Advisors Community

Pediatric CommunityPhysician Community

CPXP Prep Course WorkshopHospital Tour

Networking Dinner & Reception – Mango’s

Compassion Matters: Building a Culture of Compassion and Support Through Schwartz RoundsBeth A. Lown and Stephanie Adler Yuan – The Schwartz Center for Compassionate Healthcare

A Structured Approach to Creating Organizational Excellence in Person-Centered Care Jill Golde and Sara Guastello – Planetree International and Language of Caring, a branch of Planetree International

Creative, Sustainable Strategies for Building Resiliency & Decreasing BurnoutJaniece Gray and Pamela Hessler – DTA Associates, Inc.

Breakout Sessions and Poster Presentations

Shola RichardsAuthor and Advocate on Workplace Bullying

Cathleen WheatleyPresident, Wake Forest Baptist Medical Center

Shimi KangHarvard-Trained Physician, Author and Global Social Entrepreneur

Rolf BenirschkePatient, Author and Retired NFL Player

Nora McInernyGrief Expert and Widow

Learn more at www.theberylinstitute.org

Housekeeping

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• All participant phone lines are muted.• The presentation will run approximately 50 minutes with time at the end for Q&A.• Q&A will be conducted through the chat pod. Please submit questions to the host

for a facilitated Q&A after the presentation.• Chat pod for sharing of ideas, asking questions, interacting with presenters and

attendees and not for promoting services and products.• Receive follow up email tomorrow afternoon with webinar materials and session

recording.

PX Continuing Education Credits

www.theberylinstitute.org

• This program is approved for 1 PXE.

• In order to obtain patient experience continuing education credit, participants must attend the program in its entirety and complete the evaluation within 30 days.

• The planning committee members and presenters have disclosed no relevant financial interest or other relationships with commercial entities relative to the content of the educational activity.

• No off label use of products will be addressed during this educational activity.

• No products are available during this educational activity, which would indicate endorsement.

This webinar is eligible for 1 patient experience continuing education (PXE) credit. Participants interested in receiving PXEs must complete the program survey within 30 days of attending the webinar. Participants can claim PXEs and print out PXE certificates through Patient Experience Institute. As an on demand webinar, it offers PXE for two (2) years from the live broadcast date.

Our Speaker

Audrey Cortez MSN, RN, CPXPDirector of Patient ExperiencePeterson Health

www.theberylinstitute.org

Staying STEADY: A Model for Resiliency

Audrey Cortez RN, MSN, CPXP

For the first time ever, the top challenges identified in healthcare are stress and burnout.

(Press Ganey, 2017)

Research says…..

Anxiety and depression Emotional exhaustion Depersonalization Lack of personal accomplishment Lack of professional fulfillment Anger and resentment towards patients

(Mealer et al, 2009)

Being in healthcare is stressful…..

Burnout affects patient experience!

Burnout and stress can lead to decreased patient safety and decreased patient satisfaction. (Spence et al, 2006)

Employee Burnout and Stress

Patient Safety &

Satisfaction

Burnout affects patient experience!

Burnout affects patient experience!

Cumulative stress caused by the depletion of a persons ability to cope within one’s environment

(Montgomery, 2014)

Physical, emotional and mental exhaustion Dread over returning for a shift Compassion fatigue Sadness, depression, anxiety, feeling of self

doubt Rampant among health care professionals(Montgomery, 2014)

Peterson Health Burnout Scale1 2 3 4 5

•Minimal stress •Moderate stress •Moderate stress •High stress •High Stress

•No burnout •No burnout •Slight burnout •Moderate burnout •High Burnout

•Some anxiety •Anxiety •Extreme anxiety

• Some depression •Depression •Depression

•No difficulty sleeping

•Occasional difficulty sleeping

•Difficulty sleeping •Difficulty sleeping •Insomnia

•Occasional irritability at work

•Often feel irritable at work

•Often feel irritable at work

•Frequently irritable at work

•Look forward to your work most days

•Enjoy work overall but dread some shifts

•Dread work frequently•May be questioning career choice

•Dread going to work

•Questioning career choice

• Seeking another career

•High functioning and effective at work and home

•High functioning at work and home

•Functioning but feel stress

•Work and home affected

•Affects home and work

•Can barely function

•Guilt •Guilt•Depersonalizationand withdrawal

•Depersonalizationand withdrawal

Resiliency

The ability of an individual, a group, an

organization, or even an entire population to

rapidly and effectively rebound from

psychological and/or behavioral perturbations

associated with critical incidents, terrorism, and

even mass disasters.

(Kaminsky et al. 2006)

Resiliency

Learned skill Positive mindset Flexible, avoid judgment Support group Self efficacy Healthy lifestyle

Is NOT:

Having a life without difficulty Thick skin Toughing it out Ignoring issues Dwelling on problems Sugar coating Chronic complaining

Resiliency

Problems are to the mindwhat exercise is to themuscles, they toughen andmake you strong.

Norman Vincent Peale

Resiliency and Self Efficacy

How do we grow our ability to withstand life’s struggles?

Peterson Resiliency Model: STEADY and RAISE

A Resiliency Model for Staff

Seek StoriesTurn around thoughtsEmpathizeAvoid JudgmentDon’t take ANYTHING personallyYou (What you do matters)

Staying STEADY:

Stories— Seek the story in each person

Each person is unique Wondering What is beyond the behavior? Ways of being

(Koloroutis and Trout, 2012) and (The Arbinger Institute, 2015)

STEADY: A Resiliency Model for Staff

Turn around thoughts

You have control of your thoughts Consciously reframe negative thoughts Always “Assume good intent” Circle of Influence vs. Circle of Control

(Covey, 2004)

STEADY: A Resiliency Model for Staff

Empathize

Empathy vs Sympathy ‘Being with’ vs. ‘fixing it’

Accept each person as they are Empathetic Statements Develop self awareness and emotional

maturity

STEADY: A Resiliency Model for Staff

Be aware of Personal Bias (We ALL have them!) Practice Self Awareness: The conscious knowledge

of one's own character, feelings, motives, and desires.

Develop Emotional Intelligence: the capacity to be aware of, control, and express one's emotions, and to handle interpersonal relationships judiciously and empathetically

Research shows that persons with a high level of emotional intelligence are more successful both personally and professionally!

Self Awareness

Avoid Judgment

Judgment can burn you to a crisp Person vs. object Be aware of labels….

STEADY: A Resiliency Model for Staff

Don’t take ANYTHING personally!

QTIP and Wonder Always assume good intent Remember, most of the time it is not

about you Have respectful communication to

address

STEADY: A Resiliency Model for Staff

You—What you do matters!!!

Connect back to purpose Exceptional, compassionate, and patient centered

care You are enough. You are not alone if you are feeling

stressed. Peterson Health cares about you.

STEADY: A Resiliency Model for Staff

RAISE: A support model for leaders

Relationship

Acknowledge struggles

Investigate causes of stress

Support staff

Evolve

Implementation:

Engaged senior leadership Shared data with leaders Six hour training for directors and senior

leaders (LDI) One and a half hour training for physicians and

nurses One hour training for other staff Quarterly resiliency session for physicians Coaching 101 classes, using RAISE model for

supervisors and shift leader RNs Monthly culture focus

52.1

58.9

0

10

20

30

40

50

60

70

80

90

100

National Average Peterson Health

My organization helps me deal with stress and burnoutPercentage of employees answered positively in 2019 Employee Engagement

Survey

69

74

81

88

90

50

55

60

65

70

75

80

85

90

95

2015 2016 2017 2018 2019

Rate HospitalNational Percentile Ranking per fiscal year

Rate Hospital

Audrey Cortez RN, MSN, CPXP830-258-7841

acortez@petersonhealth.com

Resources Arbinger Institute. (2015). The anatomy of peace: Resolving the heart of conflict.Bohman, B., Dyrbye, L., Sinsky, C. A.,

Linzer, M., Olson, K., Babbott, S., … Trockel, M. (2017, April 26). Physician well-being: The reciprocity of practice efficiency, culture of wellness, and personal resilience. NEJM Catalyst.

Covey, S. (2004), The seven habits of highly effective people. New York: Free Press. Charney DS. Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation

to extreme stress. American Journal of Psychiatry, 61:195-216. Kaminsky et al. (2006) An Evidence-Informed Model of Human Resistance, Resilience, and Recovery: The Johns

Hopkins' Outcome-Driven Paradigm for Disaster Mental Health Services. Brief Treatment and Crisis Intervention 2007 7(1):1-11; doi:10.1093/brief-treatment/mhl015

Koloroutis and Trout (2012) See me as a person: Creating therapeutic relationships with patients and their families. Creative Health Care Management, Inc., Minneapolis, MN

Mealer M, Burnham E, Goode C, Rothbaum B, Moss M. (2009)The prevalence and impact of posttraumatic stress disorder and burnout syndrome in nurses. Depression and Anxiety, 26:1118-1126.

Montgomery A. The inevitability of physician burnout : Implications for interventions. Burnout Research 2014; 1: 50–6.

Perez, G. K, Haime, V., Jackson, V., Chittenden, E., Mehta, D. H., Park, E. R. (2015). Promoting resiliency among palliative care clinicians: stressors, coping strategies, and training needs. Journal of Palliative Medicine, 19 (4):332-337.

Press Ganey archives and database Spence et al. (2006) The impact of nursing work environments on patient safety outcomes: The mediating role

of burnout/engagement. Journal of Nursing Administration, 36 (5), 259-267

• This program is approved for 1 PXE

• In order to obtain PXE, participants must attend the program in its entirety and complete evaluation within 30 days.

• Use the PXE code at the end of the evaluation to claim PXE credit at the Patient Experience Institute’s PXE Portal.

• Look for email with instructions next day

PX Continuing Education Credits

www.theberylinstitute.org

Upcoming Offerings

WEBINARS

February 6| Healthcare is Changing. Why Aren’t Your Patient Experience Scores?

February 18| Implementing a Simulation-Based Program for Nurse Leader Patient Rounding

February 25| Embracing Consumerism by Bridging PFACs and Huddles to Improve Patient Satisfaction

March 3| Hidden Opportunities to Design a Better Experience

March 19| Teaching without VolunTelling - Passion and Growth with Train the Trainer Rollouts

TOPIC CALLS

February 11| How can you use real-time patient feedback to coach physicians?

May 12| How do you create an engaged and effective Patient & Family Advisory Council?

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the patient experience.

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