Stanford Committee for Professiona Satisfaction and Support (SCPSS) Committee Description The recenty re-named Stanford Committee for Professiona Satisfaction and Support was aunched in 2010 by then Chief of Staff Bryan Bohman in an effort to hep physicians baance the increasing demands of the modern practice environment. Since its inception SCPSS s guiding principe has been that the professiona satisfaction of physicians and other caregivers is inextricaby inked to quaity, safety and patient-centeredness. The committee s work, which spans the physician career continuum, has focused on promoting physician weness and professiona satisfaction as key organizationa priorities. It has brought together those aready working in this arena across the medica center and university, promoting integration and coaboration. Moving forward, it is deveoping new physician support programs based on interna survey data. This brochure highights many of the efforts SCPSS promotes or sponsors as it works to improve the foowing: Persona Heath (Prevention and Heathy Behaviors) Organizationa and Peer Support Community Buiding and Coeagueship Work-Life Integration Persona Resiience and Professiona Satisfaction Organizationa and Persona Vaues Aignment For more information about the Stanford Committee for Persona Satisfaction and Support pease contact: Dr. Bryan Bohman, bbohman@stanfordmed.org or Dr. Dana Wee, dwee@stanfordmed.org 1
Resident and Feow Support Programs Thriving in Residency Interna Medicine In order to thrive during the more intense rotations of the Interna Medicine Residency, Dr. Ron Wittees, Program Director and Dr. Robert Harrington, Chair of Medicine, created a program to promote house staff baance and weness. This program began with a group of medicine chief residents with their ear to the ground, who iteray asked house staff what was the most chaenging for them during the hardest rotations (oncoogy and intensive care unit). The house staff noted that there was a high frequency of difficut outcomes during inpatient oncoogy and the ICU and they were interested in a safe forum for discussion as we as communication skis that coud enhance the care of their patients and their sef-care. In response, the residency program eadership partnered with WeConnect to create a program to promote persona awareness and resiiency. Dr. Lisa Post meets once a month with house staff from our oncoogy and intensive care unit rotations to faciitate discussions regarding unanticipated outcomes and deaths. This is combined with focused teaching on communications in emotionay chaenging situations. For more information about this program pease contact Dr. Stephanie Harman, smharman@stanford.edu or 650-724-7054. Stanford WeConnect The providers at Stanford WeConnect understand there are times when stressors can get in the way of baancing the demands of professiona and persona ife. Without hep, probems can intensify, having an effect on emotiona and physica we-being and professiona success. Under the eadership of Dr. Laura Roberts; a confidentia, 24-hour consutation and referra service was aunched and is managed by Lisa Post PhD and Dr. Mickey Trocke. WeConnect provides residents and feows information and assistance to navigate their menta heath benefits and resources, offering assessment and referra to the foowing services: Individua counseing Coupes counseing Substance abuse assessment and counseing Medication evauation Medication management Facuty can aso access this resource to discuss concerns they may have about trainees. To contact WeConnect yoursef or to make a referra simpy ca our staff at 650-724-1395.f Interna Medicine Residents 2
Baance in Life Surgica Resident Program In 2011, under the eadership of Dr. Tom Krumme and Dr. Raph Greco, the Surgery Department created a Baance in Life program for Genera Surgery residents. This mutifaceted program addresses the physica, psychoogica and socia we-being of the surgica residents. One unique aspect of the program is the meeting each cass has on a weeky rotating basis with Lisa Post, PhD. These cosed meetings are a safe pace for residents to comfortaby discuss a variety of concerns, such as handing difficut outcomes. In addition, this program incudes a Big Sib/Litte Sib mentor reationship, a Stanford After Hours brochure with resident-recommended PMDs, dentists and recreation, and a socia program with panned activities. Fuy supported and funded by the department chair and with input from residents, it has become a substantia part of the cuture, which promotes sef-care, teamwork and resiiency buiding in the surgica residents. For more information, pease contact Dr. Raph Greco at phone number 650-736-1355 or emai him at grecors@icoud.com Resident PEARL Support Program Severa years ago, the Sumit Risk Management Department, deveoped the PEARL process, (Process for Eary Assessment and Resoution of Loss), to assist patients and their famiies invoved in an unexpected cinica outcome. During the risk anaysis residents are queried as to the facts reating to the case. This in-depth review of their work can often be a highy stressfu experience, one that can incude anxiety and sef-doubt foowed by ong-term physician burnout. Mickey TROCKEL To address this situation, SCPSS, working in conjunction with Risk Management, is designing a PEARL Support Program for residents invoved in critica incidents. This program ensures each resident wi be contacted in a timey and supportive manner. Two expert menta heath providers, Dr. Lisa Post and Dr. Mickey Trocke, wi ead the program. Residents invoved wi be offered an opportunity for a confidentia initia meeting and one foow-up meeting with these experts. The Resident PEARL support program is designed to mitigate any detrimenta effects residents face foowing unexpected cinica events by providing critica hep they need eary in their careers to dea with these chaenging situations. Lisa POST For more information pease contact Dr. Mickey Trocke at trocke@stanford.edu 3
Physician Weness Survey Measurement The first annua Stanford Physician Weness Survey for a physicians on the medica staffs of Stanford SHC and LCPH physicians was conducted in August 2013 under the eadership of committee member Mickey Trocke. Over 800 physicians competed the survey, which assessed the foowing: Meaningfu professiona engagement (meaningfuness of patient care and positive emotiona state at work) Burnout (emotiona exhaustion and depersonaization) Work-reated strain on persona reationships Seep-reated daytime impairment Depression and anxiety Workpace anxiety Workpace environmenta determinants of physician burnout vs. meaningfu professiona engagement: Vaues aignment Perceived appreciation Work-reated socia support from coeagues Perceived contro of schedued and pace of work Hasses contributing to inefficiency at work Number and distribution of work hours. Anayses of survey responses are underway and SCPSS wi utiize the resuting data to inform our evoving program evauation and deveopment. An executive report summarizing survey resuts wi be distributed to the medica staff. 4
Weness Programs and Work-Life Fit Academic Biomedica Career Customization (ABCC) At the Schoo of Medicine (SoM), one of the top two reasons facutyconsider eaving is the search for greater work-ife integration. In addition, work-work confict (competing demands across missions) is a significant source of facuty stress. To address this diemma, the SoM deveoped the Academic Bio medica Customization (ABCC) piot program to support facuty in addressing their specific work-ife and work-work conficts as an integra part of their career deveopment and success. Hannah VALANTINE Jennifer RAYMOND ABCC mode incorporates two major eements: Customized Career Deveopment: A yeary one-on-one career deveopment conversation between individua facuty and their department chair, supported by coaching and the active provision of information on avaiabe institutiona resources to support the career deveopment and work-ife integration of each facuty. A banking system to formaize tradeoffs within teams: Impemented at the team eve, this recognition system provides concrete support for facuty who engage in activities that support the work-ife integration of their team. The ABCC piot has so far been impemented within 4 cinica and 2 basic science teams. Christy SANDBORG Caroine SIMARD The eadership team of the initiative incudes Hannah Vaantine, MD, Christy Sandborg, MD, Jennifer Raymond, PhD, and Caroine Simard, PhD. For more information pease contact Caroine Simard at csimard@stanford.edu Partnerships with University and Hospita Weness Program Satisfied caregivers make for satisfied patients SCPSS works cosey with the University and Hospita weness initiatives incuding HIP, BeWe, and HeathySteps to aign common interests and buid synergy wherever possibe. Partnership exampes incude: inking the SHALA with the PWC Weness Survey; inking with HIP/BeWe to offer biometric screening and advising; encouraging house staff to participate in the HeathySteps to Weness program and supporting other weness programs that exist within the medica center. HIP provides partia funding to support the Physician Weness Survey and programs that wi benefit medica Residents, Post-docs, and other cinica care providers. For more information: Stanford University Benefits Eigibe Empoyees: bewe@stanford.edu LPCH & SHC Benefit Eigibe Empoyees: heathysteps@stanfordmed.org 5
Weness and Resiiency Programs Anesthesia Resiiency Program This innovative program was co-founded in 2010 by committee member Dr. Emiy Ratner and her coeague Dr. Tara Cornaby, with the purpose of promoting resiiency, sef-care and peer support for Anesthesioogy Residents. Incorporated into the educationa curricuum, this unique aspect of the residency program has been described as transformative and ife changing. First year residents attend a vountary offsite weekend retreat, where facuty faciitated sma groups are formed. Experientia exercises invoving modaities that promote resiiency comprise the majority of the retreat. As there s no one size fits a approach to resiiency, residents are exposed to mutipe techniques to deveop stress management skis and sef-awareness, with mindfuness as the foundation of the program. Subsequenty, residents not attending the retreat are incorporated into these sma groups, which meet reguary throughout the duration of the residency program with trained faciitators. Sessions are conducted in a confidentia, safe, and nonjudgmenta environment, where residents are encouraged, but not required, to share their persona or professiona concerns. Their recognition that their strugges are shared, couped with the deveopment of new coping and communication skis hep form the cornerstones for a strong, peer supported cuture. For additiona information, pease contact Co-founding Directors: Emiy Ratner, MD or Tara Cornaby, MD at eratner@stanford.edu or tcornaby@stanford.edu Facuty Weness Piot Program Based on the successfu Anesthesia Resiiency Program, this Schoo of Medicine (SoM) sponsored year ong piot program VALANTINE was offered in order to foster sef-care, deveop sef-awareness, and buid a mode to promote community support in facuty members. Under the guidance of Senior Associate Dean of Diversity and Leadership, Hannah Vaantine, MD, SoM facuty were eigibe to appy, and ten individuas from the Departments of Anesthesioogy, Medicine, Pediatrics, Radioogy, and Surgery (ER Division) participated. Representative facuty from every rank (Instructor, Assistant Professor, Cinica Associate Professor, etc.) first attended an offsite retreat, and monthy meetings were panned for the remainder of the year. Trained facuty faciitators ed group activities based on mindfuness principes at the inaugura retreat in 2013. Athough monthy sessions were panned to foow, the participating facuty chose to meet twice per month, as their mutua connection and sessions together became such a high priority. A attendees reported the experience exceeded their expectations. Enthusiastic, positive feedback after the retreat incuded the foowing: [This was] the most remarkabe network creation I have ever known; truy network or bond or even friendship does not being to cover my experience. This was one of the best experiences of my ife. Life changing. This ended the sense of socia isoation I ve fet at Stanford. The mind body skis decrease stress, continued on page 7 6
Weness Programs Medica Student Weness The Office of Medica Student Weness aims to hep Stanford medica students thrive by providing individua counseing, weness programming, and earning environment initiatives. A member of the committee, Rebecca Smith-Coggins, MD, Associate Dean for Medica Student Life Advising, eads the Office. Kerri Wakefied, PhD, serves as the Associate Director for Student Weness. Individua Counseing Medica students may contact us to discuss sensitive or persona topics or to obtain advice of a non-academic nature in a comfortabe and confidentia environment. Students are encouraged to bring issues that impact their ife decisions, we-being, and academic performance. Weness Programming We aso partner with students to deveop and impement a wide range of programs and events to promote weness. Exampes incude: Stanford Widerness Experience Active Trip (SWEAT), a 3-day pre-orientation widerness trip for incoming first years. Stanford Medica Schoo Cup (SMS Cup), a fied day encouraging friendy competition between earning communities throughout a series of events. Ears for Peers (E4P), a student-to-student peer istening group that provides free and confidentia counseing to MD, MSTP, and MOM students. Transition to Cerkship Retreat, an event for students to ceebrate the competion of their cassroom education and earn about ife in cerkships. Question, Persuade and Refer (QPR) Training, an initiative to train students and educators how to recognize and respond to a psychoogica emergency. Piot Program from page 6 increase focus and hep productivity. Professionay, [this has heped me have] more patience and compassion for both patients and coeagues. For additiona information, pease contact the Director, Emiy Ratner, MD at eratner@stanford.edu or Sponsor Hannah Vaantine, MD, at hvvk@stanford.edu Learning Environment Finay, we are committed to promoting positive earning environments by monitoring and responding to incidents of student mistreatment as Supporting caregivers promotes exceent patient care we as increasing awareness of earning environment issues at a eves of medica education. For more information pease contact Rebecca Smith-Coggins, MD, at smithcog@stanford.edu 7
Additiona Communications Facuty Attending Physician Peer Support WeMD Website The website for the committee, WeMD, (http:// wemd.stanford.edu), deveoped by Harise Stein, MD serves as a resource for facuty, house staff and medica students. Aong with inks to sefassessment tests, it contains contact information for groups, casses and vounteering opportunities. One particuary usefu feature is a constanty updated Caendar of events incuding weness-reated CME offerings. In addition, extensive sef-hep information is incuded on exercise and fitness, stress and burnout (incuding itigation stress), depression, mindfuness, resiience, and work-ife baance. Each of these sections incudes practica advice and oca resources as we as research artices specificay reating to physicians and physicians-in-training. One of the most significant stressors physicians face is persona invovement in an unexpected bad patient outcome or other negative critica incident. To hep our coeagues through this chaenging time, the Committee pans to impement a Peer Support Program in eary 2014. A trained physician coeague wi serve as the peer supporter and the one-on-one conversations within this program wi be protected from discovery in any ega proceedings. We are working with Dr. Jo Shapiro, eader of the Center for Professionaism and Peer Support at Brigham and Women s Hospita and a nationay recognized authority in this fied. On October 11th, Dr. Shapiro met with SHC, LPCH and SOM eaders incuding the Dean, as we as the group that is currenty deveoping our Peer Support program. This initiative is encouraged and supported by the Dean s Office and Risk Management. A Get Hep page provides immediate crisis contact information as we as suggestions for handing difficut situations with a coeague or trainee. Bryan BOHMAN, Loyd MINOR, Jo SHAPIRO, Dana WELLE WeMD Monthy Newsetter The Committee Newsetter aunched in January 2012 and is distributed eectronicay each month to facuty, house staff and medica students at SHC and LPCH. The newsetter serves as a vehice for the committee to communicate projects, speakers, events, and items of note going on at the medica center and pertinent to the work of the committee. Each month features a coumn on a timey topic, such as visits from weness experts, the aunch of our medica staff survey, or various department piot projects/ programs of which other departments may want to be aware. A caendar section of the newsetter notes important educationa, physica activity or socia events, and a research section highights recent artices reating to the heath and satisfaction of physicians at a stages of ife. 8