The Quadruple Aim at UNC: One Year Later Moving from Burnout Assessment to Institutional Change

UNC Health Care, School of Medicine, and Faculty Practice leaders are actively examining which department-specific interventions on health care delivery have been most effective to date in decreasing provider bureaucratic burden and improving clinician satisfaction so they can be part of a forthcoming wide-scale redesign across the institution. The impact of investment in innovative mental health support programs and humanistic education continues to be measured.

Last August, in response to the national epidemic of physician and other provider burnout, the University of North Carolina School of Medicine (SOM) and Health Care System (HCS) formally adopted the Quadruple Aim, introducing a systemic initiative to add wellness as a critical metric to the collective performance measures of the institution.

Since then, we have launched new initiatives to 1) actively measure stress in faculty and trainees, 2) expand and further develop emotional support programs to help those in distress, and 3) develop departmental wellness initiatives. We are pleased that this initiative has created the climate for vigorous dialogue about ways to address burnout and increase engagement.  Importantly, this dialogue across the institution has made clear that next steps should be focused on the structural components of healthcare delivery.

UNC Faculty Practice (FP), SOM and HCS leaders are actively examining which department-specific interventions on health care delivery have been most effective to date in decreasing provider bureaucratic burden and improving clinician satisfaction so they can be part of a forthcoming wide-scale redesign across the institution. We will also continue to measure the impact of investments in innovative mental health support programs and humanistic education to assess the effectiveness of the interventions described below

Institutional Assessment of Stress: Mayo Clinic Well-Being Index

This fall, we will share data from the validated Well-Being Index with all departments.   By including faculty, residents, medical and graduate Burnout Graphsstudents, this tool provides important metrics for the emotional health of our entire institution and allows us to assess our effectiveness in combating these issues.

Results to date mirror findings from the Association of American Medical Colleges (AAMC) Faculty Forward Survey question on burnout. Though rates of burnout among UNC medical students, residents, and physicians are lower than national norms, we still see room for improvement.

Innovative Mental Health Programs: Integrated Emotional Support and Taking Care of Our Own

The Integrated Emotional Support Program is a combination of new and existing programs designed to promote emotional well-being in health care professionals within the UNC HCS and SOM.  

  • Peer Support Program – connects health care professionals with 1:1 trained peer support volunteers after serious adverse or unanticipated patient events.
  • Employee Assistance Program – provides individuals no-cost mental health care with counselors in the community and wellness training programs.
  • Taking Care of Our Own Program – addresses burnout syndrome in physicians and residents through psychoeducation, assessment, and treatment in a confidential and supportive setting.
  • Critical Incident Stress Management Team – provides group-focused and individual support to health care professionals experiencing critical incident-related stress after a traumatic event.

New Humanistic Medical Education and Mind Body Training Opportunities

  • Wellness Committees (departmental, SOM and Office of Graduate Medical Education) are working to inform institutional policy, guide educational needs, and promote best practices.
  • Academy of Educators, a faculty development society focused on education, delivered a series of relevant lectures on physician well being and has more planned.
  • Mind Body Training:  The SOM Mindful Opportunity to Reflect on Experience (MORE) program provides mind body skills training to individuals who agree to bring back to their units what they have learned.
  • Wellness Coach: New Licensed Clinical Social Worker has been hired to serve as a Wellness Coach to support students in both the MD and PhD programs.  This new staff presence extends the scope of current wellness programs for medical and graduate students.

For more information please contact wellnessprograms@med.unc.edu

 

 

 

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