Selected Podcast
Ep. 11: Feeling Burn-out? Let's examine the pebbles in your shoes
Roxanna Gapstur, President and CEO of WellSpan Health, is joined by Ridge Salter, Medical Director for Quality and Innovation at WellSpan and Chair of Wellbeing Council, to discuss how to improve engagement by reducing burnout and finding joy in your work.
Featuring:
In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn.
Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.
Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.
She was named a “Top 35 Women in Healthcare Leader” by Minnesota Women’s Health Leadership Trust in 2014. Dr. Gapstur has participated as a member and president of non-profit boards, including the Greater Twin Cities United Way, Minnesota Chapter of the National Hemophilia Foundation and the Minnesota Organization of Leaders in Nursing.
Ridge Salter, MD | Roxanna Gapstur, PhD, RN
Ridge Salter, MD is the Medical Director for Quality and Innovation at WellSpan and Chair of Wellbeing Council.In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn.
Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.
Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.
She was named a “Top 35 Women in Healthcare Leader” by Minnesota Women’s Health Leadership Trust in 2014. Dr. Gapstur has participated as a member and president of non-profit boards, including the Greater Twin Cities United Way, Minnesota Chapter of the National Hemophilia Foundation and the Minnesota Organization of Leaders in Nursing.
Transcription:
Michael Carrese (Host): Welcome to Inspiring Health, a series of conversations with Roxanna Gapstur and other WellSpan leaders about WellSpan 2025. I’m Michael Carrese and Roxanna, great to be with you again.
Roxanna Gapstur PhD, RN (Guest): Yeah, it’s great to be with you Michael.
Host: What are we going to be talking about today?
Roxanna: Today, we’re going to be talking about improving employee engagement as a strategic priority and specifically, about burn out and turnover in healthcare as that continues to rise nationally. And the ways that we are addressing that including the Institute for Healthcare Improvements Joy In Work Framework.
Host: Very important stuff. And you have a special guest to help guide us through this.
Roxanna: I do. Dr. Ridge Salter is with us today. He’s the Medical Director for Quality and Innovation and the Chair of the Wellbeing Counsel here at WellSpan and he’s also a practicing Family Medicine Physician in York.
Ridge Salter, MD (Host): Good morning Roxanna and Michael.
Roxanna: Good morning Ridge.
Host: Hi.
Dr. Salter: Happy to be here, thank you.
Host: Great to have you with us. So, Roxanna, why don’t you start by helping us understand how WellSpan is thinking about employee engagement.
Roxanna: We believe it takes inspired people to inspire health in our communities. And through recruiting and retaining talent; that’s one of the key strategies for our 2025 vision. Our engagement survey scores tell us we still have room for improvement in this area and so we want to look at the key areas of helping reduce stress and burnout particularly for our physicians and APCs but for all of the caregivers on our teams.
Host: So, draw that connection between burnout and engagement.
Roxanna: We know nationally, and regionally, that there is a significant amount of burnout among healthcare employees. And that can lead to low levels of engagement. So, nationally, it’s estimated through research studies that about 50% of physicians indicate that they are suffering some symptoms of burnout and that correlates to lower patient experience, certainly lower productivity for our teams and an increased risk of workplace accidents too. So, it’s connected to safety as well.
Host: Dr. Salter, you are Chair of the Wellbeing Counsel at WellSpan. Tell us about that counsel’s purpose.
Dr. Salter: Yeah, the Wellbeing Counsel is a dedicated group of physicians, APCs and administrators who’ve come together for the purpose of improving physician and APC wellbeing by understanding the drivers that lead to burnout and affect wellbeing. By also providing recommendations and oversight of strategic interventions, which fall into three categories, really. One is a culture of wellness and that is issues around communication and recognition. The second is efficiency of practice, so ongoing improvements in our electronic health record, in our workflows, optimizing our staffing and then the last is in personal wellbeing. Then we set metrics and goals and study if our interventions are actually being successful.
Host: And what drew you to this work?
Dr. Salter: Well, like a lot of my colleagues on the Wellbeing Counsel, my passion for this work came through my own burnout. About seven years ago, when I was approaching midcareer, I was working long days, seeing 27, 28 patients a day, trying to get as much work done as possible, then trying to hustle home, have dinner with the family and then off to activities. I would for example, go coach my youngest’s basketball team and then get back late around 9 o’clock and then settle in to do two to three hours of tasks that night. And work as hard as I can to try to get up and do it again the next day. And I remember one night, sitting there with my 17 year old son Nick who was aspiring to be a physician and I got a task to address an abnormal test result ordered by a specialist. The specialist felt they could just discuss that with their family doctor, and I remember slamming my laptop shut and turning to Nick and saying Nick, don’t go into medicine. You work all day, no one respects you, it’s just not worth it. and if you do go into medicine, don’t go into primary care. Because you are not respected and the bleep rolls downhill.
And there was silence. And I realized then that I wasn’t in a good place and I needed to make change. Thankful for me, this medical director role came along and now I can spend 50% of my time working with physicians and colleagues, especially in the area of wellbeing to try to improve my colleague’s wellbeing so they don’t get to the place where I was.
Host: So, that must feel pretty satisfying for you.
Dr. Salter: It is very satisfying work. I think it’s incredibly rewarding if we can get physicians and APCs as well as other caregivers back to the passion of doing what is incredibly rewarding work and that is taking care of people.
Host: Yeah and you’ve been leading the Joy In Work Cohort within the medical group. What’s that all about?
Dr. Salter: Yeah, there’s many different ways to approach wellbeing because there’s many different factors that affect wellbeing. This Joy In Work cohort through our Lift Collaborative is one way we can address the wellbeing of not just our physicians and APCs but the entire care area. And the IHI Framework really provides a simple structure and it asks two questions. What are the pebbles in your shoes that affect your daily care? And what brings you joy in your work? And then you are asked to select a project, set goals, study it scientifically and apply countermeasures for ongoing improvement.
Host: And what were some of the results of that pilot?
Dr. Salter: We were able to expand the initial pilot work into more than 50 practices so far. And over the last two years, we’ve carried out this work in four month intervals. And in aggregate, the practices have shown a 10% improvement in the question I regularly feel burnt out from my work and an 11% improvement in the question I’ve become more callous towards others both personally and professionally.
Host: And that’s pretty encouraging.
Dr. Salter: Yeah, it’s great to see that advancement that when you institute something, it really starts to make a difference in the care area.
Host: So, Roxanna, I’m curious listening to Dr. Salter, what your reaction is.
Roxanna: I think it’s really important that we acknowledge how real this burnout issue is in our care teams and in our organization as well as nationally. And that we allow our teams the time and space to work on having increasing joy in work so that we see improvements in that burnout over time. We know that that’s something that’s probably a long term journey. It’s not going to happen overnight. But I think the strides we’ve already made are very encouraging.
Host: And can you tell us what’s happening in addition to the Joy of Work work?
Roxanna: Yes. We’re doing many things to engage and inspire our teams. We have lots of leadership engagement around recognizing our staff for their individual accomplishments, making sure that our teams know how much we value the work that they are doing and that they are very important to our success. So, one of the things we did in August was something called 30 Days of Fun which was really just thanking our teams for the fact that we had such a great year in fiscal year 2019. And we also did a I Am Thankful Campaign in November to just bring gratitude to the surface in our organization and we also just celebrated National Fun At Work Day which is pausing to have some fun and use some themes like around Superbowl and tailgating and team celebration so that people can have fun together at work. So, if we want to work as one, I think we also want to have fun as one.
Host: Absolutely. So, Dr. Salter, back to you. You have found some success with the IHI Joy In Work framework. Is this a tool that’s available to others in the system?
Dr. Salter: It certainly is. The framework is one of the science of improvement and it’s easily reproducible in any of our are areas. And while we’ve done this mostly in the outpatient space, this can be easily done in the inpatient space as well. The framework really allows our leaders to understand the concerns and make improvements in the work lives of their health caring professionals. I strongly believe that if we support and care for our health caring professional; they’ll take great care of our patients. And that takes listening, empowering, and enacting on their input. If anyone is interested in implementing this, there’s a Joy In Work video available on the INet and Chris Amy from Aligning Forces for Quality is a great resource.
Host: And Roxanna, what do you want employees to take away from the discussion today?
Roxanna: I’d love for our employees to think about what Ridge has talked about today. those pebbles in our shoes. How can we help each other with that? What are the things we can bring forward in our team huddles, our LDMS boards and any other avenues that we have that can help our own team do a better job and have a smoother day. Those kinds of things are really important. I would also suggest take advantage of 30 Days of Fun, National Fun At Work Day and other celebrations to really value your team members and let them know how much you appreciate the work that you are doing and try to build in every day, kind of checking in with each other and reflecting on your own Joy In Work. Be self-aware about how you yourself are doing. We’d also like our teams and caregivers to know they can reach out to their leader any time, to their site director or to their manager to help them identify resources that will assist with burnout.
Host: Well it’s a great thought to end on. Roxanna, we’re going to have to leave it there for today. You’ve been listening to Inspiring Health, a series of conversations with Roxanna Gapstur and other WellSpan leaders about WellSpan 2025. Roxanna’s guest today was Dr. Ridge Salter, Medical Director for Quality and Innovation at WellSpan and Chair of the Wellbeing Counsel. I’m Michael Carrese. Thanks for joining us.
Michael Carrese (Host): Welcome to Inspiring Health, a series of conversations with Roxanna Gapstur and other WellSpan leaders about WellSpan 2025. I’m Michael Carrese and Roxanna, great to be with you again.
Roxanna Gapstur PhD, RN (Guest): Yeah, it’s great to be with you Michael.
Host: What are we going to be talking about today?
Roxanna: Today, we’re going to be talking about improving employee engagement as a strategic priority and specifically, about burn out and turnover in healthcare as that continues to rise nationally. And the ways that we are addressing that including the Institute for Healthcare Improvements Joy In Work Framework.
Host: Very important stuff. And you have a special guest to help guide us through this.
Roxanna: I do. Dr. Ridge Salter is with us today. He’s the Medical Director for Quality and Innovation and the Chair of the Wellbeing Counsel here at WellSpan and he’s also a practicing Family Medicine Physician in York.
Ridge Salter, MD (Host): Good morning Roxanna and Michael.
Roxanna: Good morning Ridge.
Host: Hi.
Dr. Salter: Happy to be here, thank you.
Host: Great to have you with us. So, Roxanna, why don’t you start by helping us understand how WellSpan is thinking about employee engagement.
Roxanna: We believe it takes inspired people to inspire health in our communities. And through recruiting and retaining talent; that’s one of the key strategies for our 2025 vision. Our engagement survey scores tell us we still have room for improvement in this area and so we want to look at the key areas of helping reduce stress and burnout particularly for our physicians and APCs but for all of the caregivers on our teams.
Host: So, draw that connection between burnout and engagement.
Roxanna: We know nationally, and regionally, that there is a significant amount of burnout among healthcare employees. And that can lead to low levels of engagement. So, nationally, it’s estimated through research studies that about 50% of physicians indicate that they are suffering some symptoms of burnout and that correlates to lower patient experience, certainly lower productivity for our teams and an increased risk of workplace accidents too. So, it’s connected to safety as well.
Host: Dr. Salter, you are Chair of the Wellbeing Counsel at WellSpan. Tell us about that counsel’s purpose.
Dr. Salter: Yeah, the Wellbeing Counsel is a dedicated group of physicians, APCs and administrators who’ve come together for the purpose of improving physician and APC wellbeing by understanding the drivers that lead to burnout and affect wellbeing. By also providing recommendations and oversight of strategic interventions, which fall into three categories, really. One is a culture of wellness and that is issues around communication and recognition. The second is efficiency of practice, so ongoing improvements in our electronic health record, in our workflows, optimizing our staffing and then the last is in personal wellbeing. Then we set metrics and goals and study if our interventions are actually being successful.
Host: And what drew you to this work?
Dr. Salter: Well, like a lot of my colleagues on the Wellbeing Counsel, my passion for this work came through my own burnout. About seven years ago, when I was approaching midcareer, I was working long days, seeing 27, 28 patients a day, trying to get as much work done as possible, then trying to hustle home, have dinner with the family and then off to activities. I would for example, go coach my youngest’s basketball team and then get back late around 9 o’clock and then settle in to do two to three hours of tasks that night. And work as hard as I can to try to get up and do it again the next day. And I remember one night, sitting there with my 17 year old son Nick who was aspiring to be a physician and I got a task to address an abnormal test result ordered by a specialist. The specialist felt they could just discuss that with their family doctor, and I remember slamming my laptop shut and turning to Nick and saying Nick, don’t go into medicine. You work all day, no one respects you, it’s just not worth it. and if you do go into medicine, don’t go into primary care. Because you are not respected and the bleep rolls downhill.
And there was silence. And I realized then that I wasn’t in a good place and I needed to make change. Thankful for me, this medical director role came along and now I can spend 50% of my time working with physicians and colleagues, especially in the area of wellbeing to try to improve my colleague’s wellbeing so they don’t get to the place where I was.
Host: So, that must feel pretty satisfying for you.
Dr. Salter: It is very satisfying work. I think it’s incredibly rewarding if we can get physicians and APCs as well as other caregivers back to the passion of doing what is incredibly rewarding work and that is taking care of people.
Host: Yeah and you’ve been leading the Joy In Work Cohort within the medical group. What’s that all about?
Dr. Salter: Yeah, there’s many different ways to approach wellbeing because there’s many different factors that affect wellbeing. This Joy In Work cohort through our Lift Collaborative is one way we can address the wellbeing of not just our physicians and APCs but the entire care area. And the IHI Framework really provides a simple structure and it asks two questions. What are the pebbles in your shoes that affect your daily care? And what brings you joy in your work? And then you are asked to select a project, set goals, study it scientifically and apply countermeasures for ongoing improvement.
Host: And what were some of the results of that pilot?
Dr. Salter: We were able to expand the initial pilot work into more than 50 practices so far. And over the last two years, we’ve carried out this work in four month intervals. And in aggregate, the practices have shown a 10% improvement in the question I regularly feel burnt out from my work and an 11% improvement in the question I’ve become more callous towards others both personally and professionally.
Host: And that’s pretty encouraging.
Dr. Salter: Yeah, it’s great to see that advancement that when you institute something, it really starts to make a difference in the care area.
Host: So, Roxanna, I’m curious listening to Dr. Salter, what your reaction is.
Roxanna: I think it’s really important that we acknowledge how real this burnout issue is in our care teams and in our organization as well as nationally. And that we allow our teams the time and space to work on having increasing joy in work so that we see improvements in that burnout over time. We know that that’s something that’s probably a long term journey. It’s not going to happen overnight. But I think the strides we’ve already made are very encouraging.
Host: And can you tell us what’s happening in addition to the Joy of Work work?
Roxanna: Yes. We’re doing many things to engage and inspire our teams. We have lots of leadership engagement around recognizing our staff for their individual accomplishments, making sure that our teams know how much we value the work that they are doing and that they are very important to our success. So, one of the things we did in August was something called 30 Days of Fun which was really just thanking our teams for the fact that we had such a great year in fiscal year 2019. And we also did a I Am Thankful Campaign in November to just bring gratitude to the surface in our organization and we also just celebrated National Fun At Work Day which is pausing to have some fun and use some themes like around Superbowl and tailgating and team celebration so that people can have fun together at work. So, if we want to work as one, I think we also want to have fun as one.
Host: Absolutely. So, Dr. Salter, back to you. You have found some success with the IHI Joy In Work framework. Is this a tool that’s available to others in the system?
Dr. Salter: It certainly is. The framework is one of the science of improvement and it’s easily reproducible in any of our are areas. And while we’ve done this mostly in the outpatient space, this can be easily done in the inpatient space as well. The framework really allows our leaders to understand the concerns and make improvements in the work lives of their health caring professionals. I strongly believe that if we support and care for our health caring professional; they’ll take great care of our patients. And that takes listening, empowering, and enacting on their input. If anyone is interested in implementing this, there’s a Joy In Work video available on the INet and Chris Amy from Aligning Forces for Quality is a great resource.
Host: And Roxanna, what do you want employees to take away from the discussion today?
Roxanna: I’d love for our employees to think about what Ridge has talked about today. those pebbles in our shoes. How can we help each other with that? What are the things we can bring forward in our team huddles, our LDMS boards and any other avenues that we have that can help our own team do a better job and have a smoother day. Those kinds of things are really important. I would also suggest take advantage of 30 Days of Fun, National Fun At Work Day and other celebrations to really value your team members and let them know how much you appreciate the work that you are doing and try to build in every day, kind of checking in with each other and reflecting on your own Joy In Work. Be self-aware about how you yourself are doing. We’d also like our teams and caregivers to know they can reach out to their leader any time, to their site director or to their manager to help them identify resources that will assist with burnout.
Host: Well it’s a great thought to end on. Roxanna, we’re going to have to leave it there for today. You’ve been listening to Inspiring Health, a series of conversations with Roxanna Gapstur and other WellSpan leaders about WellSpan 2025. Roxanna’s guest today was Dr. Ridge Salter, Medical Director for Quality and Innovation at WellSpan and Chair of the Wellbeing Counsel. I’m Michael Carrese. Thanks for joining us.