Abbreviated Burnout Inventory: How often do the following statements describe how you feel about working in healthcare? I deal very effectively with the problems of my patients. Every day times a week week times a times a year Never I feel I treat some patients as if they were impersonal objects. I feel emotionally drained from my work. I feel fatigued when I get up in the morning and have to face another day on the job. I ve become more callus towards people since I took this job. I feel I m positively influencing others people s lives through my work. Working with people all day is really a strain for me. I don t really care what happens to some of my patients. I feel exhilarated after working closely with my patients. I regret my decision to work in healthcare. Adapted from: https://www.aap.org/en-us/documents/soim_abbreviated_maslach_burnout_inventory.pdf Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behavior, 2, 99-113
OhioHealth Abbreviated Burnout Inventory Scoring Key: Every day times a week week times a times a year I deal very effectively with the problems of my patients. (PA) 0 1 2 3 4 5 6 I feel I treat some patients as if they were impersonal objects. (DP) 6 5 4 3 2 1 0 I feel emotionally drained from my work. (EE) 6 5 4 3 2 1 0 I feel fatigued when I get up in the morning and have to face another day on the job. (EE) 6 5 4 3 2 1 0 I ve become more callus towards people since I took this job. (DP) 6 5 4 3 2 1 0 I feel I m positively influencing others people s lives through my work. (PA) 0 1 2 3 4 5 6 Working with people all day is really a strain for me. (EE) 6 5 4 3 2 1 0 I don t really care what happens to some of my patients. (DP) 6 5 4 3 2 1 0 I feel exhilarated after working closely with my patients. (PA) 0 1 2 3 4 5 6 I regret my decision to work in healthcare. (EE) 6 5 4 3 2 1 0 Never Scoring: Red = Emotional Exhaustion (EE) Total: (0-24) - Higher scores indicate greater emotional exhaustion, and greater burnout. Blue = Depersonalization (DP) Total: (0-18) - Higher scores indicate greater depersonalization, and greater burnout. Green = Personal Accomplishment (PA) Total: (0-18) - Lower scores indicate a greater sense of personal accomplishment, and less burnout. Total Score (add up all 3 categories) Total: (0-60) - Higher scores indicate a greater level of burnout. Adapted from: https://www.aap.org/en-us/documents/soim_abbreviated_maslach_burnout_inventory.pdf Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behavior, 2, 99-113
Resilience Action Plan: Step 1: Where should you start? (Based on your observations, experiences, self-burnout inventory. Pick at least one item for each question) - Which aspect of burnout or question on your burnout inventory bothers you the most? - Which aspect(s) of burnout would you like to focus on? Emotional Exhaustion Depersonalization Poor Sense of Personal Achievement - Would many people in your situation or department likely experience similar levels of burnout? Yes No - Do you have the capacity and resources to carry out a department or group-level intervention? Yes No (If you answered yes to both questions, you should consider focusing on an environmental intervention. If you answered no to either question, than an individual intervention may be a better option) - Intervention category: Individual Environmental Step 2: Select intervention(s): (based on step 1; pick 1-3 options, or create your own; see appendix for more details) Individual: Environment: Emotional Exhaustion: Depersonalization: Poor Sense of Personal Achievement: Three Good Things Gratitude Letters Strengths Finder Random Acts of Kindness Mindfulness Three Good Things Exercise Community Service Coaching Mentorship Mindfulness Strategic No Self-Care ( Doctor Days ) Random Acts of Kindness Schwartz Rounds Strengths Finder Mentorship Five Facts Whiteboard Symmetric Awards Active Construction Response One Fact Checkout Positive Leader Rounds Team Building Exercises Meaningful Meals Positive Leader Rounds pg. 1 Hommema and Auciello, OhioHealth Riverside Family Medicine, 2017
Step 3: Create your action plan for implementation: (start your first Plan-Do-Study-Act cycle, Make it SMART! (Specific, Measureable, Achievable, Realistic, Timely) - What is your SPECIFIC aim/goal? (Example: To help combat individual emotional exhaustion in my residency program, I will schedule 3 Doctor Days during the next academic year) - How will you MEASURE if your goal was a success? (Example: I will survey all residents at the end of the academic year asking if they were able to schedule doctor visits or personal commitments during Doctor Days) - Is your goal ACHIEVABLE and REALISTIC? What do you need to do to ensure it is? (Example: I will need to distribute dates at least 3 s in advance, and arrange coverage for resident commitments) - When will you evaluate your intervention? Make it TIMELY! (Example: I will informally survey residents after the 1 st Doctor Day, and review the intervention formally with residents prior to the following academic year) - What barriers do you anticipate? How could you overcome those barriers?: pg. 2 Hommema and Auciello, OhioHealth Riverside Family Medicine, 2017
pg. 3 Hommema and Auciello, OhioHealth Riverside Family Medicine, 2017
OhioHealth Burnout Inventory and Resilience Action Plan Intervention Appendix Domain: Intervention: Description: Examples of Implementation: Three Good Things Random Acts of Kindness (Individual, Environment) Exercise Write down three things that went well for you that day, and provide an explanation for why they went well. It is important to create a physical record of your items by writing them down; it is not enough simply to do this exercise in your head. Find one wholly unexpected kind thing to do and just do it. Any self or organized physical fitness. Stating, out loud, as a group during huddle, three good things. And tracking what is said on a board in this same area. http://www.dukepatientsafetycenter. com/ Organize a charity day. Ask associates to bring food and clothing items to donate to the needy. Mapping out a 1 mile loop at clinic site and walking it during breaks. Yoga. Emotional Exhaustion (EE) Mentorship Program Wellness Benefits Strategic No Self-Care Days Active and Constructive Response Team Building Exercises Positive Leader Rounds A two-way relationship in which a more experienced or more knowledgeable person helps to guide a less experienced or less knowledgeable person. Powerfree, mutually beneficial. Utilizing resources already available to associates within a system or offering new ones. Think about an ask and make sure it is reasonable, high-value, and you are the right person prior to saying yes. A specific day or time period within normal business hours reserved to complete tasks normally difficult to do. Respond to good news in an active (rather than passive) and constructive (rather than destructive) manner. Group fun activities aimed at building relationships and relieving tension between team members Leaders asking about what is going well and who deserves special recognition for it. Attitude shift. A staff member wants to be a manager one day; allow them to meet with a manager of another department and shadow for a few hours. Setting up all associates with their first of 3 trainer sessions at fitness facility. Free nutritional assessments. For tasks that will require a large time commitment, make a system for determining value and need prior to saying yes. One afternoon every 3 s when residents/staff excused, can schedule doctor appointment, oil change, etc. Share the joy in good news, rather than just congratulating. Enthusiastic authentic support with eye contact. http://www.gostrengths.com/what-isactive-and-constructive-responding/ Bowling, Frisbee golf, park day, etc. Every day at the end/beginning of rounds, asking each team member about one thing that was done well today.
OhioHealth Burnout Inventory and Resilience Action Plan Intervention Appendix Depersonalization (DP) Sense of Personal Achievement (PA) Mindfulness (Individual, also applies to EE) Community Service 5 Facts Whiteboard 1 Fact Checkout Schwartz Rounds Gratitude Letters Meaningful Meals (Environmental) Symmetric Awards Strength Finders (Individual, Environment) Coaching A mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique. Organized or individual effort to reach a community in need. Include interesting facts about patient on whiteboard, helps connect with patient, and see as a human Add one interesting/unique fact about each patient. A structured forum where all staff, clinical and non-clinical, come together regularly to discuss the emotional and social aspects of working in healthcare. Write a letter to someone who has helped you along the way in your career or life. May choose to give it to them or keep it. Gathering outside of work with people from different disciplines/roles to talk about something they share in common related to work and then just spending time to get to know each other. Celebrate the good work done every day that is normally unrecognized or overshadowed by mistakes or bad outcomes. Identify and use your strengths daily. Maximize what you do well, and identify others who have complementary strengths. A trained or informal coach helps develop specific skills for tasks, provides challenges. Training all staff in mindfulness, practicing mindfulness exercises in groups. Volunteer at free clinic, outreach and children s hospital. Adding facts to whiteboard during rounds each morning. During handoff, include one fact with each patient, can add line item Weekly debriefing sessions with a multidisciplinary team. At ly staff meetings, having staff write a gratitude letter for 5 minutes. Plan and schedule a ly dinner to get together and talk about 1 shared work related item (EMR, patient flow, etc.) and then spend time getting to know each other. Citation: Mayo clinic Have each associates write one recognition of good work with a specific example per week for another associate in the department. Have all associates take the Strength Finders evaluation and do team analysis on how to incorporate those strengths on a daily basis. http://strengths.gallup.com/110440/a bout-strengthsfinder-20.aspx Start formal coaching program, hire trained coach.