Choosing Resilience The Key to Thriving Through Change Wayne M. Sotile, Ph.D. Founder CENTER FOR PHYSICIAN RESILIENCE Davidson, North Carolina Crucial Questions How happy are you? Who are you to the ones you love and work with? What s It Like to Work in Healthcare Today? Toxic Stress High Demand Low Control Low Support 1
Emergency Medicine Internal Medicine - General Neurology Family Medicine Otolaryngology Orthopedic Surgery Anesthesiology Obstetrics and Gynecology Radiology Physical medicine and Rehab Average Burnout All Physicians Participating General Surgery Internal Medicine Subspecialty Ophthalmology General Surgery Subspecialty Urology Psychiatry Neurosurgery Pediatric Subspecialty Other Radiation Oncology Pathology Pediatrics - General Dermatology Prev Med/Occupat Med/Enviro Med % Reporting Burnout Wayne M. Sotile, Ph.D, 2016 The Most Pervasive, Unchecked Risks to Safety, Quality, Profitability, and Satisfaction? Burnout & Psychosocial Distress 7395 Medline Publications Burnout 600 500 400 300 # Pub 200 100 0 1977 1982 1987 1992 1997 2002 2007 2012 2017 Updated September 29, 2014 MESH: STRESS, PSYCHOLOGICAL 1983-89, STRESS, PSYCHOLOGIC 1969-72 Burnout by Specialty Shanafelt, Boone, Tan, Drybe, Sotile et al. Arch Intern Med. 2012; 172(18):1377-85 0 10 20 30 40 50 60 70 2
Keys to Resilience Use Realistic Roadmaps Assess Yourself Coping, Leadership Change Psychology Build Resilience Toolkits Realistic Roadmap or Cajun Logic? The Mythical Balanced Life Work Anxious Family Self Angry Guilty Intimate Relationship Use Realistic Roadmaps Best Predictor of Clinical and Operational Outcomes Across Hospital Settings? % of Team Showing Burnout Bryan Sexton, Ph.D. Duke Center for Patient Safety 3
Resilience Matters Aiken LH et al. JAMA. 2002;288:1987-1993. N = 10,184 Staff Nurses 234,342 Patients As Nurse Burnout Rates Patient Survival Rates Does Burnout Matter? Burnout adversely affects quality of care Wallace JE et al. Lancet. 2009;374:1714-21 Medical Errors Williams ES et al. Health Care Manage Rev. 2007;32:203-212 Firth-Cozens J & Greenhalgh J. Soc Sci Med. 1997;44:1017-1022. Shanafelt TD et al. Ann Intern Med. 2002;136:358-67. Medical Malpractice Suits Jones JW et al. J Appl Psychol. 1988;73:727-35. Patient Compliance DiMatteo MR et al. Health Psychol. 1993;12:93-102. Patient Satisfaction Linn LS et al. Med Care. 1985;23: 1171-78 Haas JS et al. J Gen Intern Med. 2000;15:122-128 Medical Family Discord Sargent MC, Sotile WM, Sotile MO, et al. J of Bone and Joint Surgery. 2009. 91;2395-405. Make the Case Crucial Cross-Correlations: Work Outcomes / Provider Health Quality of Collaboration Career Satisfaction Your Family s Satisfaction with You Your Happiness Sotile W.M. & Sotile M.O. The Resilient Physician. AMA Press, 2002 Sotile W.M. & Sotile M.O. Letting Go of What s Holding You Back. Harry Abrams, 2007 4
Beware of Cajun Logic Treating Paradoxes Like Problems Problem (has a clear solution) Paradox (a situation, person, or thing that combines contradictory features or qualities) Ralph Jacobson Resilience Keys: Use Realistic Roadmaps Hardiness Character Teamwork Emotional Intelligence Choosing Resilience Simonds G & Sotile WM. Promoting Resilience in Neurosurgery Residents, 2015. Emotional Intelligence Self Management Self-Awareness Self-Regulation Motivation Relationship Skills Empathy Social Skill Capacity for Influence Positive Psychology Wellbeing Meta Factors Positive Emotions Engagement Relationships Meaning Accomplishment Resilience 5
Keys to Resilience Use Realistic Roadmaps Resilience matters No perfect Respect paradox It s a journey! Character Teamwork EQ Keys to Resilience Use Realistic Roadmaps Assess Yourself Coping Leadership Change Psychology Does Problem Solving Motivate? Identifies problem Conducts analysis of cause Brainstorms solutions Develops action plans http://appreciativeinquiry.case.edu/ 6
Choosing Resilience The absence of hassles (or paradoxes) does not predict resilience Content Structure Process How can we use our resources to build resilience and deepen our relationships? What Drives Satisfaction? Culture Recognition/ Appreciation Compassion Communication Conversation / Inclusion Re-thinking Re-framing Assess Yourself Your relationships won t feel any better than you do 7
Does Your Leadership Really Matter? Biggest correlation with staff work satisfaction? The perception of supervisor support Studer Group. Work Life Balance Among Women in Healthcare Survey. 2008 Impact of Organizational Leadership on Physician Burnout and Satisfaction N = 2813 employed physicians and scientists Vital Leadership Behaviors? Inform Engage Inspire Develop Recognize Shanafelt TD et al. Mayo Clin Proc. 2015:1-9. Provider Ratings of Division/Department Chair 11% of variance in burnout 47% of variance in satisfaction with the organization Choosing Resilience Assess Yourself Your relationships won t feel any better than you do 8
The Psychological Underbelly of Changing for Good The Yea, Not Really Mentality 25 Keys to Resilience Use Realistic Roadmaps Assess Yourself Are you a smart motivator? Focus on structure & process Streeeeetch, don t strain Expect Yeanotreally Practice wonderment Keys to Resilience Use Realistic Roadmaps Assess Yourself Build Resilience Toolkits 9
Wonderment.seeing the familiar in unfamiliar ways Re-Think Balance Working fewer hours in a job you re not engaged in will resolve none of your work/life balance issues. Engagement is the key! Wayne & Mary Sotile. Letting Go of What s Holding You Back.. 2007 29 Shaping Resilience Resilience Meta Factor: Counter Daily Hassles with Daily Uplifts 10
Resilience Meta Factor The 3:1 Ratio of Uplifts : Hassles Joy Gratitude Serenity Hope Interest Amusement Inspiration Awe Pride Love Fredrickson, B. Positivity. (2009) Combine Problem Solving with Appreciative Inquiry Problem Solving + Identifies problem Conducts analysis of cause Brainstorms solutions Develops action plans http://appreciativeinquiry.case.edu/ Appreciative Inquiry Appreciates What gives life? Imagines What might be? Determines What should be? Creates What will be? Keys to Resilience Recalling what s been right about our past helps to create Shared Notions/Images About Our Desired Future Leadership Tool 11
Shaping Resilience Resilience is Not an Event -Self-check -Made adjustments -Self-check -Make adjustments -Self-check -Make adjustm.. Just showing up is not enough.. Be a Hero A hero is someone who creates safe spaces for other people The Resilient Physician. Sotile & Sotile, 2002 12
When you end a dysfunctional legacy, you justify your lifetime. Wayne & Mary Sotile. Letting Go of What s Holding You Back.. 2007 Keys to Personal Resilience 1. Protect Happiness 2. Use Coping Realistic Roadmaps 3. Recognize Your Risks 4. Manage Your Change Psychology 5. Counter Hassles With Uplifts 6. Believe in Something Bigger than Yourself 7. Deepen Your Relationships 8. Manage Your Coping Style 9. Rethink The Balanced Life 10. Be a Hero Lessons from My Grandparents Believe in Yourself Appreciate Each Other Be Generous Be Gracious 39 13
Thank You! Wayne Sotile, Ph.D. CENTER FOR PHYSICIAN RESILIENCE www.theresilientphysician.com Email: Sotile@SotileMail.com 336/794-0230 14