COMPLEX CARE MANAGEMENT PROGRAM
Bridgeport, Connecticut
The Complex Care Management Team was created to provide care to the Primary Care Center patients with multiple, complex medical, social and psychiatric problems, who as a result have repeated Hospitalizations, and ED visits. A team of a social worker, nurse care coordinator, patient navigator, pharmacist, medication health technician and a behavioral and medical advanced practice provider was formed to create individualized treatment plans to this group of patients.
HEALTHCARE WORKER SUPPORT GROUP
Bridgeport, Connecticut
The Bridgeport Hospital HealthCare Worker Support Group came together during the COVID-19 pandemic as a way to offer compassionate support, affirmation and recognition to employees. Through leadership communications, staff meetings, posters, and more, the group sought to support caregivers during this difficult period.
TRAUMA-INFORMED CARE INITIATIVE
Bridgeport, Connecticut
The Trauma-Informed Care (TIC) Initiative offers a framework to address health inequities, racial justice, stigma and bias. The TIC Initiative team approaches their work from four pillars: education, research, clinical practice and policy. The aims of the initiative include: providing staff with trauma-informed care education, building capacity at each hospital in the pursuit of health equity through collaborative trauma-informed care, identifying opportunities for funding and offering technical assistance to advance trauma-informed care to other adult medicine institutions.
YALE NEW HAVEN HEALTH EMPLOYEE WELLBEING CHECK-IN PROGRAM
Bridgeport, Connecticut
The Employee Wellbeing Check-In Program at Yale New Haven Health provides clinicians and staff with pro-active, scheduled check-ins to address coping, stress and mental health needs. The program was initially developed to address the mental health needs of those clinicians and staff impacted by direct patient contact during our the initial COVID-19. It has subsequently evolved into an ongoing effort to support the mental health needs of staff by providing them with proactive, opt-out scheduled check-ins. These are 30-minute screening appointments done by licensed mental health clinicians. The appointments are confidential and consist of a brief screening questionnaire (the validated Acute Stress Scale) followed by a discussion with the licensed mental health clinician. Individuals are then provided resources or referred to further counseling when appropriate.
FAMILY MEETING SUPPORT GROUP
Atlanta, Georgia
The Family Meeting Support Group is weekly support group designed to answer intricate questions about aspects of care. The program is for anyone who has a family member or friend in the Intensive Care Units at Grady. Discussion and questions focus on what families can do for loved ones and how to emotionally navigate difficult health situations. Families and patients are also invited to come back after discharge to share their experiences with others.
THE CIRCLE OF HOPE
Greenwich, Connecticut
The Circle of Hope was created to support, strengthen and foster resiliency in frontline healthcare workers during the COVID-19 pandemic. The program has four main parts: meditation, team-building, experience-sharing, and non-religious blessings. Each Circle contains 12-18 team members within an informal circle. The Circle is open to all staff, is led by a facilitator and lasts no more than 15 minutes.
R.E.S.T.-RESILIENCE EDUCATION SUPPORT TEAM
Fort Myers, Florida
The Resilience Education Support Team (REST) is a multidisciplinary team established to identify significant and/or chronic staff stressors and provide collaborative solutions to help mitigate the short- and long-term effects of these stressors. Teams are made up of multidisciplinary group from a variety of backgrounds at Lee Health dedicated to responding to non-emergent, chronic stressors that may be affecting a team’s coping or resilience. REST deployments meet staff members within 24 hours and use Jeffrey Mitchell’s S.A.F.E.R. model.
MEDISYS TEAM WELLNESS
New York, NY
MediSys Team Wellness integrates creative arts therapy and holistic tools to provide staff interventions. The program includes “Staff Wellness Stations” in high traffic areas staffed by community wellness coordinators and creative arts therapists, a hotline for 24-hour support, “wellness rounds” including aromatherapy, cards, and check-ins, arts-based wellness groups, and wellness coordinators. The program also has “recharge rooms” for staff to participate in video and audio experiences aimed to relax and refresh healthcare workers.
THE CRITICAL CARE LIAISON PROGRAM
Burlington, Massachusetts
The Critical Care Liaison Program was developed during the COVID-19 ICU surge as a way to communicate with families and loved ones of COVID-19 patients. Communication liaisons spoke with families at least once a day to provide clinical updates, guidance through difficult decisions and emotional support. The program ran for 53 days until June 2, 2020, when the surge waned sufficiently to disband. In that time, 65 providers from 19 specialties served in at least one four-day liaison bloc. They included 44 physicians, 19 advanced practitioners, and two psychologists.
FROM DARKNESS COMES LIGHT: NORTHWELL HEALTH’S TEAM LAVENDER PEER SUPPORT PROGRAM
New York, NY
At Northwell, Team Lavender is an interdisciplinary group of professionals dedicated to supporting colleagues during times of stress and/or hardship. Available 24/7, this budget-neutral best practice program provides a moment of pause, reflection, teamwork and peer support. Deployed holistic modalities include but not limited to active listening, empathetic presence, mindfulness, meditation, guided imagery, breathing exercises, interfaith prayer, reiki, reflexology and/or facilitated open discussion. Team Lavender is led and overseen by the system’s Office of Patient & Customer Experience. Any employee can activate a Team Lavender response for either themselves, a colleague and/or their team.
TEAM LAVENDER PEER SUPPORT
New York, NY
Team Lavender Peer Support (TLPS) provides support to teams and departments during time of crisis. An interdisciplinary group trained in Psychological First Aid is available 24/7 for the employees. The staff activates TLPS by calling “CALM”, and a dispatcher answers the call. The dispatcher takes a brief description of the stressful event and other pertinent details. The information is shared with the two responders on call who are sent to the area. The responders arrive within 30-60 minutes. They will assess the needs and offer in the moment psychological first aid and other needs, e.g. clergy, mindfulness, arts therapy etc. TLPS is a volunteer group who are dedicated and committed to the cause.
PEERCARE PEER SUPPORT PROGRAM
Boston, Massachusetts
Peer Support is “emotional first aid” for hospital staff involved in patient-related adverse events and stressful situations. The support is provided by peer supporters, who are fellow colleagues in similar roles. Peer supporters have been specially trained to provide empathetic and nonjudgmental listening, coping skills, and support resources. Two-hour live virtual trainings are offered monthly in addition to a quarterly meeting for ongoing peer supporter training and engagement. Peer support is strictly confidential and designed to provide peer review protection.
KINDNESS MATTERS
Rochester, Minnesota
Karen Bell formed the Kindness Matters Facebook group that became the hub through which donations were communicated, sent, and processed with handwritten thank you cards from volunteers. Team and division deliveries were both in person and via Zoom. In them, staff leadership expressed their appreciation for one another as stories were recounted of the team’s impact to date and a spiritual blessing was shared, along with generous gifts like food treats and staff care items.
ANTI-RACIST, JUSTICE, & HEALTH EQUITY TASK FORCE/OVERSIGHT COMMITTEE
Belmont, Massachusetts
The Anti-Racist, Justice, and Health Equity Oversight Committee oversees the development, implementation, evaluation and advancement of the hospital’s anti-racist strategic plan. The committee was established in the summer of 2020, and is led by Chief Diversity, Equity, and Inclusion Officer Dr. Stephanie Pinder-Amaker. The committee is setting in motion a series of actions with a goal to improve the hospital’s ability to be a diverse and inclusive workplace. Additionally, the team has efforts to address inequities in access the mental health care among Black, Indigenous and people of color communities.
TELE-HEALTH INITIATIVE
Belmont, Massachusetts
In order to fill the need for mental health services and increase access to care for clients during the COVID-19 pandemic, multiple McLean hospital programs developed tele-health and virtual intensive treatment programming as part of the hospital’s tele-health initiative. Included in this effort was the behavioral health partial program, the OCD Institute, the Child and Adolescent OCD Institute, Leader virtual treatment program for first responders and the virtual Belmont Adolescent Partial Hospital Program.
PATIENT/FAMILY EXPERIENCE NAVIGATION TEAM
Humble, Texas
The Patient/Family Experience Navigation Team is a multifaceted approach to improving the experience of patients and families. A dedicated patient relations navigator serves on each clinical unit to link patients and families with the services and resources available to make their experience less stressful. Patients and families receive daily visits with the goal of it the navigators increasing communication to prevent misunderstandings and complaints. Hospital volunteers serve as Patient Advocate Liaisons to assist with non-clinical needs.
CODE LILAC TEAM
Houston, Texas
The Code Lilac team is a multi-disciplinary team of peers who have been trained to provide staff that are experiencing a stressful, emotional or spiritually challenging crisis, with a response. Code Lilac provides crisis intervention on affected units. Code Lilac members are also challenged to be champions for staff support on the units where they currently serve. Code Lilac collaborates with other staff support teams and encourages staff to connect with specialized support available through chaplaincy, wellness programs, and the Employee Assistance Program. Code Lilac implements ideas from various programs including Code Lavender, RISE, Critical Incident Stress Management, The Pause (from UVA) and more.
IPAC OUTREACH PROGRAM
Toronto, Ontario, Canada
The IPAC Outreach Program provided curriculum development, training and professional assistance (including additional staffing) to long-term care homes declared in outbreak with COVID-19 in East Toronto. Infection control and nursing team members, under the guidance of leadership, began efforts to improve outcomes for senior populations.
THE SUMMER OF HOPE
New York, NY
The Summer of Hope included wellness events, emotional support rounds and therapeutic support planned by a multidisciplinary team during the COVID-19 pandemic. Standing debriefs, art and music therapy, creative writing, gardening and crafts were offered to staff as an effort to bring healing and support. Helping Healers Heal rounds also took place within workplaces across the facility. The program was open to all staff in all departments.
COVIDCARE
Oakville, Ontario, Canada
The CovidCARE Support Program consists of a team of de-briefers with members from all three hospitals at Halton Healthcare. Led by Dr. Jonathon Sam (a pediatrician from Oakville Trafalgar Memorial Hospital), this team includes Dr. Meghan Daly (an Emergency Department doctor from Georgetown Hospital), Dr. Deborah Marshall (a hospitalist from Milton Hospital) and Nicole Cemkov (an RN from Oakville Trafalgar Memorial Hospital), with project management support provided by Louisa Nedkov, program manager of KAILO, Halton Healthcare’s Staff and Physician Wellbeing Program. These de-briefers attend department meetings and unit huddles, by invitation, to guide group discussions. The program is offered live, live/virtual, or entirely virtual. Sessions take from 20 to 60 minutes depending upon the needs of the team.
COMMUNITY BASED COVID TESTING
Dallas, Texas
Parkland Health was responsible for testing individuals in the Dallas-Fort Worth and surrounding areas. The locations of the testing/vaccination sites were targeted to the areas of highest need, identified through the Community Health Needs Assessment conducted by Parkland and Dallas County Health and Human Services in 2019. In addition, collaboration with Parkland Center for Clinical Innovation added analytic tools such as geo-mapping, individual risk assessment, and other advanced technology resources to pinpoint those at greatest risk. Parkland’s community relations team worked with community organizations provided support, facilitated placing mega sites, and walk up sites into areas of greatest concern for the most vulnerable populations.
RADY CHILDREN’S ETHICS SUPPORT TEAM (REST)
San Diego, California
REST is comprised of unit-based ethics champions. REST came together as a group of colleagues with the goal to bring ethical education and practice to the front line staff. The team recruits nurses from each inpatient unit and representation from specialty clinics, case management and nurse practitioners. REST currently has representation from social work, developmental services and respiratory therapy and serves as a bridge from the Medical Staff Bioethics Committee to front line staff.
AMBULATORY TRANSFORMATION TEAM
New Haven, Connecticut
In response to the pandemic, Smilow leadership created infrastructure and launched a COVID transformation team, spanning four domains of Inpatient, Ambulatory, Supportive Care and Clinical Research. The Ambulatory Cancer Transformation Team further organized into five teams to address: Care Delivery Workflows, Patient Access, Staffing and Environment, Technology and Communications. The initial pandemic response focused on relocation of ambulatory teams to secure safe and socially distant care for patients and the adoption of telehealth. Examples of pilots include next day access for patients, standardization of telehealth visit criteria, pre-clinic preparation, post-clinic and checkout processes, video-enabled patient education, and infusion scheduling.
SMALL GROUP DEBRIEFING AND RESILIENCY
Englewood, Colorado
Small Group Debriefing and Resiliency Sessions are offered on demand by Schwartz Rounds facilitators to various small groups within the hospital. They can be offered following a stressful or traumatizing event or on demand in response to problems a specific department is facing. These sessions are open to all staff and discussions are kept confidential.
HEALER EDUCATION ASSESSMENT & REFERRAL (HEAR) PROGRAM
San Diego, California
The HEAR Program was created in 2009 with the goal of preventing suicide in medical students, trainees and faculty. The HEAR team provided educational outreach and partnered with the American Foundation for Suicide Prevention to take advantage of their anonymous online interactive screening program (ISP). The ISP provided a safety net to target populations, recognize risk, and deliver referrals in suicide prevention. Over time, HEAR broadened its target audience to include healthcare workers across the health system with counseling, debriefing and peer support training.
COMMUNITY IMMUNIZATION CENTER
San Antonio, Texas
Bill Phillips, senior vice president and chief information officer led the effort to create a vaccination center at the Wonderland of the Americas Mall in San Antonio at the end of 2020. The IT team created an online scheduling system for community members to schedule appointments. The team at University Health also did direct outreach calls to local churches, held virtual town hall meetings on the Texas African American Network and to especially vulnerable patients.
COMPASSION CART
New Orleans, Louisiana
The Spirit of Charity Foundation sponsors the Compassion Cart through private donations. It is filled with comforting items, including earbuds, snacks, journals, t-shirts, phone chargers, skincare items and more. The Pastoral Care team takes the cart to visit teams throughout the hospital to provide extra care and time for pause. Staff in visited areas are encouraged to enjoy an item from the cart with the goal of taking care of one another and thanking one another for providing care to patients.
BALINT GROUPS
Los Angeles, California
A Balint group is a group of clinicians, often physicians, who meet regularly to present clinical cases in order to improve and to better understand the clinician-patient relationship. In a Balint group, the focus is on enhancing the clinician’s ability to connect with and care for the patient. A Balint group session begins with one member’s presenting a case for the group to discuss. The group learns about the patient through the presenter’s story and about how their relationship seems to the clinician. During the facilitated discussion, the group members uncover different and new perceptions about the patient’s and physician’s feelings and their experiences with each other.
PEACEFUL PAUSE
Winston-Salem, North Carolina
Peaceful Pause is a five-minute reflective virtual session guided by medical, behavioral health, other licensed professionals and chaplains. The manager of information technology) and infrastructure services coordinated the program so that a pop-up would appear on all institutional computers twice daily. The sessions included relaxation, mindfulness, music, breathing and other reflective exercises.
SHIFTING WITH POSITIVITY: ALLOWING GRACE IN OURSELVES AND OUR WORK
Winston-Salem, North Carolina
The Shifting with Positivity project was designed and targeted for nursing staff with a goal to shift mindsets at the end of the shift. Staff are asked to write down one negative incident on paper, placing it in water and pausing for a moment to observe the note melting away. The staff then follow the same process noting one to two positive interactions, reflections or incidents and place the paper in a wall pocket as staff leave the unit. Staff can select a note as they return for the next shift.
CARE CODE
White Plains, New York
The Care Code includes staff interventions including aromatherapy, prayer and spirituality practices, meditation and mindfulness, guided imagery and group support. Care Codes were scheduled as monthly visits to teams in different units in the hospital. During the COVID-19 pandemic, White Plains Hospital began offering Care Codes on a on-demand, 24/7 basis. A regularly scheduled Care Code visit was labeled as “Level I,” and an on-demand call was categorized as “Level II.”
CENTER FOR TRAUMATIC STRESS, RESILIENCE AND RECOVERY
New York, NY
The Center for Traumatic Stress, Resilience and Recovery (CTSRR) provides resilience, clinical, and educational services to support Northwell employees and their family members impacted by COVID-19. It is also engaged in research efforts to understand the impact of the stress of healthcare work on employees as well as the intersection of traumatic stress and health related outcomes. A centerpiece program of CTSRR is the adaptation and implementation of Stress First Aid.
ANNUAL WELLNESS CONFERENCE SERIES
Akron, Ohio
The Annual Wellness Conference Series promotes open discussion about the difficulties all members of the healthcare organization face in the course of their work. The growing acknowledgement of the challenge of balancing patient care and staff self-care has led to the realization that more resiliency training is needed. In collaboration with organizational leaders, caregivers responded to this need by establishing a series of guest speakers. The speaker series has led to increased implementation of self-care techniques with support from the greater healthcare organization.
HART (HEMATOLOGY/ONCOLOGY/STEM CELL TRANSPLANT ADVANCING RESILIENCY TEAM)
Boston, Massachusetts
The Hematology/Oncology/Stem Cell Transplant Advancing Resiliency Team promotes wellness among the staff members on the hematology, oncology, and stem cell transplant units through a real-time nurse-driven, peer-to-peer education and support system. The program is designed to enhance staff resilience, create a healthier work environment, and improve team morale by offering an easily accessible on-site support program led by nurses.
RESIDENT SUPPORT GROUP FOR BOSTON MEDICAL CENTER FAMILY MEDICINE RESIDENCY
Boston, Massachusetts
The Resident Support Group at Boston Medical Center started as a biweekly meeting for family medicine interns and has since expanded to include separate groups for second- and third-year residents. Internship poses a number of challenges to new medical school graduates, including pressures from their supervisors and an ever-changing patient pool. This group gives them the opportunity to share experiences, to get perspectives on other rotations and interactions with supervisors, and to help each other navigate the difficulties of their new roles.
Early Rehabilitation in the Intensive Care Unit
Detroit, Michigan
The Early Rehabilitation program allows the Henry Ford Hospital to provide superior care to patients admitted to the intensive care unit (ICU). It provides patient-centered care through focused physical and occupational therapy services in the ICU to improve the functional and cognitive outcomes of patients. In addition to being beneficial to the patients, staff have also been positively impacted by seeing improvements in their patients.
Caring for the Caregiver: A Comprehensive Approach to Supporting All Healthcare Professionals at JPS Health Network
Fort Worth, Texas
The John Peter Smith (JPS) Health Network had previous concerns with silos and duplication of resources and programs, so they developed the Caring for the Caregiver Team to support the psychological safety of employees. This team gathered like-minded stakeholders to create a comprehensive plan, brand Caring for the Caregiver initiatives, and create organizationally aligned initiatives to continue supporting all JPS employees. The Caring for the Caregiver team was able to conduct evaluations of all programs, determine the best course of action, present the plan to senior leadership and eliminate duplication of costs.
Helping Healers Heal at NYC Health + Hospitals/Kings County
New York, New York
Helping Healers Heal is a system-wide initiative launched in 2018 that supports NYC Health + Hospitals staff who are second victims—healthcare providers and other staff members who were involved in an adverse event, a medical error, or a patient-related injury and feel traumatized or distressed by that event. The program offers three tiers of support based on an individual’s need, and uses trained peer supporters to offer support without judgment and recommend further assistance.
Free Community Lung Cancer Screening Day
Coeur d'Alene, Idaho
Kootenai Health created a free Lung Cancer Screening Program to provide eligible patients the opportunity to obtain recommended testing. This program has shined a light on a vulnerable patient population that now feels more included and valued. The program also helped bolster the confidence of providers by ensuring that all patients were receiving the best available care. The ability to provide follow-up scans in subsequent years gave the providers the confidence to recommend undergoing initial screening to their patients with the understanding that future scans would be performed free of charge. This confidence helped to engage patients who have previously been skeptical of the healthcare system.
Dying, Death, & Bereavement Worship
Humble, Texas
The Dying, Death, & Bereavement Worship workshop was created to help new graduate nurses in the residency program at Memorial Hermann Northeast Hospital feel more comfortable caring for dying patients and their families. Later, more experienced nurses also expressed interest in the training, as they also felt discomfort with dying, death, and bereavement. Participants in this program have reported higher levels of comfort and competence in caring for patients during challenging end-of-life scenarios.
“The Journey of the Purple Butterfly”
New York, New York
New York Presbyterian/ Lower Manhattan Hospital created the Purple Butterfly Project to alert team members to the presence of patients on comfort care measures prior to entering a room. The goal was to better prepare all team members to perform job duties in a compassionate, patient-centered fashion that is supportive of this patient population. Since the initiation of this project, there have been overwhelmingly positive responses not only from the clinical and non-clinical staff, also from the family members of patients who are on comfort care. They feel it offers an additional layer of support for their loved one.
Compassion-Peace-Renewal: CPR for the Soul
San Diego, California
Compassion, Peace and Renewal: CPR for the Soul was designed to create a caring infrastructure that provides opportunities for the inter-professional healthcare team to be acknowledged for the often difficult, demanding, and emotionally charged work of caring for seriously ill children. The goals of the program are to prioritize clinician well-being, address moral distress in care teams, and provide a safe space to gather, share and reflect on the work of caring for the very sick. Employees have reported that the program has helped them deal with stress and burnout.
"Exploring Ethics"
Chicago, Illinois
The “Exploring Ethics” program was created to address the fact that clinical staff did not know when or how to request an ethics consultation, or have the confidence to do so. The program is structured to provide ethics content and education within a framework of real-time patient care concerns. This approach shows promise for supporting clinicians of all disciplines to build more cohesive teams, to reduce professional distress and to mediate communication conflicts.
Enhanced Recovery After Surgery (ERAS)
Baltimore, Maryland
The Enhanced Recovery After Surgery (ERAS) program was developed and implemented to improve collaboration between departments, to break down departmental silos, and to improve the experience of both patients and providers, giving the former a strong sense of comfort that their providers are all on the same page and giving the latter a strong sense of teamwork. Both patients undergoing surgery and providers working to prepare for, perform, and follow the patients after surgery are involved in the team.
Code Lavender
Stony Brook, New York
Code Lavender is a mechanism to initiate support for staff after unexpected or adverse patient outcomes. The goal is to provide timely emotional, psychological and spiritual support. Team Lavender members (which includes nurses, physicians, and social workers in addition to chaplains and psychology staff) provide respite for those involved with a three-tier response. The program also provides monthly meetings for Team Lavender members, faculty and residents that focus on personal wellness, including therapy dogs, breathing exercises, guided imagery, and reiki therapy.
Conversations with Patients: Talking with Patients about their Experience of Care
Toronto, Ontario, Canada
Conversations with Patients is an opportunity for caregivers to talk with patients in real time about their experiences, hear their stories, learn what is important to them, and then enhance their care based on the shared information. To date, the team has held more than 4,000 conversations with patients and their families. A conversation guide is used, and a summary of the conversations is entered into an electronic tool that enables the information to be made available to the larger healthcare team
Food for Health
Oklahoma City, Oklahoma
The goal of the Food for Health program is to care for patients more than just medically. The team aims to provide the resources needed for long-lasting health and wellness. Caregivers screen for food insecurity and provide a free box of healthy food to the families who screen positively. In addition to the pantry boxes, every positive screening also receives a social work consult and a list of resources for food and other needs (such as utilities, transportation, etc.). The team has also augmented various meal programs for patients still in the hospital. Studies have shown that food is medicine and that food insecurity has significant implications for admission and readmission to the hospital.
Population Health Management - Senior Products Serious Illness Management
Watertown, Massachusetts
The Senior Products Serious Illness management program provides comprehensive, team-based and integrated health services that serve to improve the quality of life of members and families, living and coping with life-limiting and end-stage chronic illness. An interdisciplinary palliative care model aims to provide members with high-quality education, coaching and care to achieve optimal health. The program was designed to help members express their wishes regarding their own medical care.
UAMS NICU Tiny Hands - Love Lives Auxiliary
Little Rock, Arkansas
For over 15 years, the UAMS-Health Tiny Hands and Love Lives Programs have supported patient- and family-centered care in the neonatal intensive care unit (NICU). Tiny Hands originated from community and staff donations to provide support for overnight stay rooms, meal cards and parking for families that had extensive stays with their babies in the NICU. It has expanded its scope to include items such as motion devices, music recorders, developmental items, books, and food. The Love Lives Bereavement Program was developed to promote movement though the stages of grief after the loss of an infant. Together, the programs ensure that families are supported through any circumstance of normal or complicated birth as well as loss.
Healer Education Assessment & Referral (HEAR) Program
San Diego, California
The main goal of the Healer Education Assessment & Referral (HEAR) Program is to prevent suicide and burnout among UCSD’s health science staff (physicians, nurses, pharmacists, residents, fellows, and other clinicians). It was built to provide compassionate, confidential, free and anonymous care for caregivers by supplying ongoing therapeutic support, bridge care, referral resources, and emotional process debriefs after critical incidents. The HEAR program has made a difference by shedding light on the undeniable fact that caregivers suffer and need compassionate care themselves. The program has also impacted the overall culture at UCSD by creating an environment where staff feel heard, valued, and recognized for the work and struggle they deal with on a regular basis.
Grief Dialogues, The Health Care Edition
Seattle, Washington
Caregivers at Virginia Mason Medical Center partnered with a local playwright to host a series of five short plays about grief and loss from the viewpoint of the healthcare worker. Two of the plays were written after meeting with the hospital’s team and hearing their stories. Following the performances, the team hosts a facilitated discussion inviting the audience to share their experiences and what they felt after watching the plays.
Caulfield Hospital Schwartz Rounds
Melbourne, Victoria, Australia
The Schwartz Rounds have been a catalyst for a cultural change across Alfred Health. Schwartz Rounds encourage an open conversation among staff and allows for a safe forum to express thoughts and feelings about patient care with colleagues. As a result, feelings of isolation are reduced, and participants are left feeling better prepared to handle tough or sensitive patient situations.
COMMUNICATING FOR ENGAGEMENT: THE USE OF EMPATHY IN THE CLINICAL ENCOUNTER
Pittsfield, Massachusetts
The mission of the Communicating for Engagement program is to provide trainings in empathic engagement across many aspects of the health system, and is available to medical residents, physicians, nurses, and support staff. Training has also been developed for organization managers, with the goal of teaching them how to bring empathic communication into their relationships with their supervisees. This curriculum in empathy training connects participants with essential knowledge, tools and skills to relate more effectively to each other and to those they serve.
SAGE'S SONG: MUSIC THERAPY INTERVENTION WITH THE PACIFIER ACTIVATED LULLABY (PAL)
Boston, Massachusetts
The Music Therapy program at Boston Children’s Hospital has implemented the Pacifier Activated Lullaby (PAL) to serve the youngest NICU patients and their families. PAL creates clinical applications of music with the help of current technologies; this device allows access to the power of music in the most individualized way as mothers, fathers and caregivers are encouraged to take active part in singing to their children. In this therapeutic process, caregivers serve vulnerable patients and their families by supporting them in a natural and non-pharmacological way during their most difficult and challenging trials. The PAL device is one of many music therapy interventions used at Boston Children’s Hospital.
CARILION CLINIC’S SCHWARTZ ROUNDS
Roanoke, Virginia
The Carilion Clinic began the Schwartz Rounds program in 2013 with the aim of mitigating moral distress and fostering moral resilience. Since its inception, the program has impacted thousands of caregivers. In conjunction with the Clinic’s educational department, the program is promoted to all staff to help improve communication and encourage empathy.
BEADS I'M FINE: FEELINGS INSIDE NOT EXPRESSED
Atlanta, Georgia
The I’m Fine workshop was developed by Beads of Courage and was launched as a collaborative effort with Dr. David Sadker and Children’s Healthcare of Atlanta (CHOA). The Beads program at CHOA has received strong support at all levels and has been embraced as a transformational learning experience. By practicing open reflection in a safe space, CHOA has seen staff grow in their understanding of the value of reflective practice, the importance of sharing personal experience for self-growth and resolution of traumatic stress, and the impact of this on interpersonal empathy between staff and with patients and families.
RISE (RESILIENCY, INTEGRATED ETHICS, STAFF SUPPORT, AND ETHICS EDUCATION) TEAM
Dallas, Texas
The RISE team is an interdisciplinary team trained in understanding the impact of moral distress and moral residue, pediatric bioethics, conflict transformation, caregiver grief, and resiliency practices. The RISE team integrates ethics into daily practice by creating a workplace environment that recognizes the impact of moral distress, fosters resilience, and encourages discussion and collaboration among teams. Through the RISE consult service, which creates readily available moral spaces in the midst of challenging situations and facilitated ethics discussions, the team aims to broaden perspectives, improve patient care, empower moral agency and enhance team communication.
HELPING OUR PEERS ENDURE STRESS (HOPES) TEAM
New Hyde Park, New York
In an effort to address the stress of their practice environment in the division at Cohen Children’s Medical Center, the Helping Our Peers Endure Stress (HOPES) team was developed. This is an all-volunteer multidisciplinary peer-support team that includes physicians (faculty and trainees), nurses, nurse practitioners, social workers, psychologists, clergy and child life specialists. The team responds to critical incident stress in real-time, are available 24/7, and are trained by the International Critical Incident Stress Foundation to conduct individual and group interventions. The program has been perceived as an effective means of addressing the previously unmet needs of staff to process and learn to adaptively cope with critical incident stress, and has significantly increased staff cohesion, communication and inter-professional support.
The Center for Resiliency
Austin, Texas
The Center for Resiliency supports physicians, medical residents, medical students, advance practice providers and all associates in the pediatric setting, including some who work with families in the adult setting. Over 90% of the active medical staff at the Dell Children’s Medical Center have participated in at least one experience with the Center for Resiliency; some have participated in multiple, including retreats, a six-session resiliency course, monthly Resiliency Rounds, resiliency research (four IRB studies are currently running), the Professional Boundaries and Burnout course, individual counseling or coaching, and Schwartz Rounds. The Center addresses not simply the personal practices of mindfulness or self-care, but hospital-wide processes around difficult conversations, conflict management, and considerations around 24/7 coverage for resource-limited practice groups; resiliency is not limited to individual transformation but is a systemic transformation that supports the whole person, team and community.
GENESIS HEALTHCARE COMPASSIONATE CAREGIVER OF THE YEAR
Kennett Square, Pennsylvania
NO ONE DIES ALONE
Falls Church, Virginia
No One Dies Alone (NODA) is a program at Inova Fairfax Medical Campus that supports the core value of caring for people and the community by radicalizing end-of-life care in the hospital. NODA volunteers are available to comfort dying patients in their final hours, and these Compassionate Companions provide a reassuring presence, whether it is verbally assuring them they are not alone, sitting silently by their bedside, holding the patient’s hand, playing music, singing, or praying with them. The program’s volunteers include hospital employees and members of the community who work with the support of the hospital staff to provide the most valuable gift: a dignified death.
MEETING WITH DAD (DEBRIEFING AFTER YOUR DAY)
Atlantis, Florida
The Debriefing After Your Day program aims to address residents’ and faculty members’ emotional needs and to decrease the burnout and depression rate associated with being a physician-in-training. In addition, the program serves as social outlet for residents, students and staff, and is vital in reenergizing all participants to achieve a sense of belonging, meaning and shared purpose and vision in their work.
ADDRESSING A HIGH-RISK POPULATION: THE JPS HEALTH NETWORK RESIDENT PHYSICIAN CHECK-IN INITIATIVE
Fort Worth, Texas
GRATITUDE SCHWARTZ ROUNDS
Palo Alto, California
COMPASSIONATE COMMUNICATION: BUILDING A CULTURE OF RESPECT, COMPASSION AND TEAMWORK
Boston, Massachusetts
MASTERING CONVERSATIONS THAT MATTER
Winston-Salem, North Carolina
Compassion-Peace-Renewal: CPR for the Soul
San Diego, California
Compassion, Peace and Renewal: CPR for the Soul was designed to create a caring infrastructure that provides opportunities for the inter-professional healthcare team to be acknowledged for the often difficult, demanding, and emotionally charged work of caring for seriously ill children. The goals of the program are to prioritize clinician well-being, address moral distress in care teams, and provide a safe space to gather, share and reflect on the work of caring for the very sick. Employees have reported that the program has helped them deal with stress and burnout.
ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL SOMERSET "SAFETY TOGETHER"
Somerville, New Jersey
RESIDENT AND HOSPITALIST SIMULATION TRAINING IN DIFFICULT CONVERSATIONS AND GOALS OF CARE
New York, New York
Voice of the Patient
Manchester, New Hampshire
In an effort to collect alternate viewpoints, particularly from patients using patient-family advisor (PFA) volunteers, Catholic Medical Center created the volunteer rounding program. PFA volunteers visit patients at their bedside during their hospital stay and collect data that will authentically improve the experience, safety and quality of care for all patients. This program was created by former patients to serve current patients.
code lilac
Houston, Texas
Code Lilac at Children’s Memorial Hermann Hospital helps treat debilitating emotional distress among caregivers following a traumatic patient event. When a Code Lilac is called, affected caregivers are provided with a safe space to meet with their peers and specially trained colleagues who help them gain clarity and perspective. Seventy-five staff members have completed extensive training on emotional diffusing – the same training used by the Red Cross, firefighters and police to help their team members return to a functional level of service – and volunteer to facilitate Code Lilac sessions for their colleagues.
wchn palliative care program
Danbury, Connecticut
Danbury Hospital created this program for the palliative care team to be able to address and treat the patient as a whole person. In addition to alleviating suffering, the teams are experts in symptom management and communication skills that are necessary to elicit “what matters most” from patients and families to align their medical treatment with their preferences. This program promotes an inter-professional palliative care team to provide the best patient experience.
Schwartz Rounds Program
Glendale, Colorado
Donor Alliance launched their Schwartz Rounds® in 2016 to support staff wellness and combat fatigue. The program has been well-received and well-attended by staff. They are creating an evaluation tool to track their goals of supporting staff health and well-being, increasing compassion among staff, improving resiliency and reducing fatigue.
Improving Recovery-Based Nursing Care through Language
Bedford, Massachusetts
When dealing with clients, it is imperative to focus on client-centered language to drive their care. A course was taught to improve nursing staff’s recovery-based language practice, which would be reflected in client-focused care. An eight-month program was implemented with five levels of tasks to be mastered: learning language, hearing and speaking, writing, application to clients, and an ongoing recovery-language group for clients. Pre- and post-test surveys were administered to all staff who participated, which validated the anecdotal reports of success.
Coping Kit Program
Concord, Massachusetts
Emerson Hospital’s Coping Kit Program was started to help children cope effectively with their hospital experience. Coping Kits are colorful, toy-filled bags given to pediatric patients who enter as inpatients in the emergency department. The toys are carefully selected by members of the Pediatric Intervention Team to support universal coping and stress reduction. Used together, these items empower a child to become a more active participant in his or her healthcare and help transform the intimidating medical world into an environment that a child can understand and master.
Leveraging Technology to Enhance Nurse Leader Rounding
Concord, Massachusetts
As the first hospital in Massachusetts to use Orchid-CipherHealth’s rounding application, Emerson Hospital’s inpatient nurse managers use an app on iPads to round on patients utilizing best practice evidence based questions. The process supports the ability to set patient expectations, send immediate complimentary comments to staff, and provide notifications to other departments such as dietary and environmental services for service recovery. The tool not only helps Emerson improve on patients’ experiences during their hospital stay, it also has a positive impact on HCAHPS scores and provides important trends and data that can be used to enhance patients’ overall hospital experiences immediately, as well as over time.
Compassion and Customer Experience Campaign
Boston, Massachusetts
Through various campaigns, Genesis’ program promotes the recognition and use of compassion as the key driver of customer experience and focuses on the mutually beneficial nature of the patient-caregiver experience. Through posters, newsletters, videos and a caregiver recognition program, over 100 skilled nursing centers and assisted living communities have participated in compassion campaigns. Its supplementary video series defines compassion and was accompanied by a discussion guide for managers to easily help staff integrate and apply the information.
Threads of Care Comprehensive Bereavement Program
Memphis, Tennessee
Le Bonheur’s comprehensive bereavement program was created in an attempt to ease grief for families who have lost a child as well as for the staff who cared for them. For families, it offers physical presence at the time of death, invitations for multidisciplinary review in the weeks to months after the death of a child, counseling resources as needs are identified on phone calls and an annual Celebration of Remembrance. Personalized cards on significant dates are sent and for those who reside within 30 miles of the hospital the team offers home bereavement visits. For staff, bereavement boxes are placed on the units where a child has died so the staff may also write personal cards to the family. This provides staff members with an outlet for their feelings and an opportunity to share heartfelt condolences with their patients’ families. Within days after a loss, the team also provides food, listening and a safe place for staff to process the loss of their beloved patients.
Pet Partner Therapy
Maywood, Illinois
Loyola’s pet therapy program provides compassionate love and support through weekly rounds to the clinical caregivers on units. Every Wednesday, Zoey, an eleven-year-old national pet therapy partner and her pet partner and director of pastoral care and chaplain, Marie Coglianese, round the patient care units, blood bank, core lab, pharmacy, GI lab, radiology and emergency departments. True to Loyola University Health System’s tag line, “We also treat the Human Spirit,” health system president Wendy Luetgens also joins rounding on “Zoey Wednesdays,” which speaks to the hospital’s commitment to the compassionate care of the staff’s spirits.
Deconstructing Stigma: A Change in Thought Can Change a Life
Belmont, Massachusetts
McLean Hospital’s mental health public awareness and anti-stigma campaign showcases a series of larger-than-life photographs and interviews with people from across the United States who have been affected by mental illness. Told through the eyes of its participants, the campaign aims to tear down the misconceptions of what those with mental illness look like. Its initial 235-foot physical installation opened in December 2016 at Boston’s Logan International Airport. The installation, website and companion book serve to capture the complexity of living with a psychiatric disorder, seeking treatment, navigating insurance and healthcare systems and facing stigma.
The Art of Caring for an Oncology Staff: An Innovative Support Group
New York, New York
A monthly staff oncology support group was implemented to combat compassion fatigue among the oncology nurses and the associated healthcare team in the MSKCC Urgent Care Center and Clinical Decision Unit. The nurse-led group, which is structured as a safe place to share experiences, focuses on a variety of therapeutic techniques based on a monthly theme. The purpose is to promote healing of the mind, body and spirit as well as to enhance team-building.
Mindfulness Based Interventions
Cambridge, Massachusetts
Burnout, emotional exhaustion, depersonalization and low personal accomplishment have been correlated with negative patient, professional and organizational outcomes. A team at Mount Auburn set out to engage a diverse group of employees to determine whether either of two brief mindfulness-based interventions could help to reduce burnout. Interventions were either a downloaded four-minute focused breath meditation that participants would listen to daily for 30 days at a time of their own choosing, or attendance at four weekly one-hour sessions of a facilitated small group held conveniently at the workplace. They found that both interventions were significant with the independent meditation having the greatest impact on emotional exhaustion and improvement in depersonalization.
Second Victim Peer Support Program
Columbus, Ohio
The Second Victim Peer Support program centers on providing rapid emotional support for all staff who have experienced or been impacted in an unanticipated or adverse patient event. This is a peer support approach; members have been trained to provide support to their colleagues. Nationwide Children’s Hospital is now near the end of an 18-month research project to characterize the negative impact of errors or adverse events on healthcare providers, and evaluate the effectiveness of the second victim peer support program.
The Ken Hamilton Caregivers Center
Mount Kisco, New York
The Ken Hamilton Caregivers Center at Northern Westchester Hospital was created in 2006 to provide free emotional support and respite to family caregivers. Listening with a non-judgmental ear allows family caregivers to feel heard and can help ease their stress. A relaxing physical space allows them to rest and recharge. In 2016, a “Stay in Touch” program was launched to maintain an ongoing, supportive relationship with the family caregiver in the home. By periodically touching base, trained caregiver coaches will provide emotional support and referrals to community resources as appropriate. Support will continue for as long as the caregiver finds it helpful.
Culture of C.A.R.E.
New Hyde Park, New York
Northwell Health has been undergoing a cultural transformation grounded in Connectedness, Awareness, Respect and Empathy (C.A.R.E.). This framework supports their execution strategy focusing on culture, care delivery, hospitality and accountability pillars. It embodies a holistic approach to patient experience by leveraging innate passions, listening to the “voice” of their patients and families, designing with intent and caring for professional caregivers. Highlights of their approach include an emphasis on storytelling, the creation of a culture leader role that is tasked with executing the patient and customer experience strategy, staff education, first impression projects, humanism initiatives, holistic integrative medicine programs, Schwartz Rounds™, relationship-centered communication and leadership rounding.
ACCEPTS
Chicago, Illinois
ACCEPTS (Aware Compassionate Communication: an Experiential Provider Training Series) is a multimodal program designed to enhance provider resilience and communication. Didactic and experiential exercises are delivered in a group format over the course of eight weeks. Providers engage in discussion and value-clarification exercises, learn cognitive behavioral models of stress and coping, practice mindfulness and participate in a number of communication exercises.
Bereavement Program
Weymouth, Massachusetts
To enhance bereavement services in the acute care setting, South Shore Hospital created their bereavement program, which adopted the initiative “No One Dies Alone (NODA),” — a bedside vigil program where volunteers are trained to play music, read and attend to patients as they move toward a safe and dignified death. Their program also includes the Bereavement & Resource Line, offering families and staff around-the-clock access to referrals for community support groups and counseling, grief materials and phone support. The Comfort Tote replaces the standard hospital belongings bag and allows families to take their loved one’s items home in a more dignified manner and contains a resource guide to help families cope after a loss.
Cultivating a Culture of COMPASSION through Schwartz Rounds® Program
Toronto, Ontario, Canada
During the organization’s stakeholder consultation for a quality strategic plan, patients, families and staff rated compassion and humane aspects of care as a top priority, equally as important as safety. Sunnybrook adopted the Schwartz Rounds program as an intervention and enabler to advance a culture of compassion. To show that modeling compassion starts with hospital leaders, the CEO introduced the first Schwartz Rounds session and the CMO closed the session.
Structured Interprofessional Bedside Rounding (SIBR)
Seattle, Washington
The University of Washington Medical Center’s program improves and strengthens interprofessional collaborative practice among caregivers, patients and families. It provides an opportunity for patients and families to engage with the medical team, and to establish shared knowledge and goals. This team approach promotes patient safety and high-quality care through improved communication, with the goal of co-creating the best plan of care for the patient. Clinicians, educators, researchers, students and patient advisors collaborated to achieve the goal of implementing SIBR and improving “The Triple C” — compassionate, collaborative care.