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Welcome to the Clinical
Center Grand Rounds,

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a weekly series of educational
lectures for physicians and

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health care professionals
broadcast from the Clinical

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Center at the National
Institutes of Health in

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Bethesda, MD.

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The NIH Clinical Center is the
world's largest hospital totally

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dedicated to investigational
research and leads the global

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effort in training today's
investigators and discovering

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tomorrow's cures.

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Learn more by visiting us online
at http://clinicalcenter.nih.gov

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OUR PRESENTER TODAY IS

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DR. DEBORAH SNYDER WHERE SHE

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WORKS AS THE SENIOR ADVISOR FOR

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THE CONSULTATION LIAISON SERVICE

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TEAM.

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MISS SNYDER RECEIVED HER

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BACHELOR OF ARTS IN PSYCHOLOGY

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FROM - DUKE UNIVERSITY AND A

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MASTERS DEGREE IN SOCIAL WORK

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FROM THE UNIVERSITY OF MARYLAND.

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SHE HAS BEEN AT THE NIH SINCE

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1992, STARTING OFF IN THE

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CLINICAL CENTER DEPARTMENT OF

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SOCIAL WORK AS AN INTEGRATED

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MEMBER OF THE BREAST AND OVARIAN

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CANCER TEAMS.

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IN 2000, SHE MOVED TO NIMH TO

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JOIN THE PSYCHIATRY CONSULTATION

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SERVICE AND ASSISTED WITH

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RESIDENCE EXPE FELLOWSHIP

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TRAINING SINCE THAT TIME.

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MISS SNYDER CONDUCTS

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COLLABORATIVE RESEARCH IN

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SUICIDE RISK VENING IN MEDICAL

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SETTINGS INCLUDING HOSPITALS,

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IN-PATIENT AND OUT-PATIENT

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SETTINGS, SHE HELPED DEVELOP THE

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ASK MEDICAL SUICIDE TOOL FOR THE

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MEDICAL PATIENTS AS WELL AS TOOL

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KIT TO HELP GUIDE INSTITUTIONS

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ON THE IMPLEMENTATION OF SUICIDE

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RISK SCREENING.

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ANOTHER MAJOR FOCUS OF HER

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CAREER HAS BEEN ON TOPICS AT THE

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INTERFACE OF MEDICAL ILLNESS AND

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MENTAL HEALTH.

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SHE IS REGULARLY CONSULTED BOO

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IA A WIDE VARIETY OF CLINICAL

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STAFF AT THE NIH INCLUDING

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PHYSICIANS, NURSES, SOCIAL

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WORKERS AND GENETIC COUNSELORS

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FOR HER EXPERTISE IN

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FACILITATING PROFESSIONAL

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DEVELOPMENT AND CASE BASED

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DISCUSSION GROUPS.

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SHE'S AN ORGANIZATIONAL LEADER

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ON THE TOPIC OF ENHANCED STAFF

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AND TRAINING WELL BEING AND

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SERVES AS THE DEPUTY CHAIR OF

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THE GRADUATE MEDICAL EDUCATION

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SUBCOMMITTEE ON RESIDENT

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WELLNESS.

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IN ADDITION TO ALL SHE DOES, SHE

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WAS RECENTLY RECEIVED AN NIH

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DIRECTORS AWARD FOR HELPING TO

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SPEARHEAD THE NIMH TELEPHONE

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SUPPORT LINE FOR STAFF DURING

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THE COVID-19 PANDEMIC.

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THE TITLE OF HER PRESENTATION

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TODAY IS BUILDING AN INTEGRATED

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WELL BEING PROGRAM, A PATH

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FORWARD FOR RESIDENTS AND

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FELLOWS. 

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PLEASE WELCOME TODAY'S SPEAKER

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DEBBIE SNYDER.

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>>THANK YOU SO MUCH DR.
CHUNG

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FOR THAT LOVELY INTRODUCTION, I

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ALSO WANT TO THANK DR. BURKLOW

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FOR INVITING ME TO BE HERE TODAY

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AND FOR THE LOGISTICS.

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THE TOPIC IS NOT NEW ON THE

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HEALTHCARE SCENE, WHRA'S NEW IS

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THE AWAKENED ATTENTION REALLY TO

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THE PROBLEM, OBVIOUSLY DUE TO

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THE COVID-19 PANDEMIC.

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IT IS GOOD NEWS ABOUT THAT IS

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THAT IT'S CATAPULTED HOSPITALS

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AND HEALTHCARE LEADERS AROUND

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THE URGENCY TO ACT, HOWEVER,

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THERE REALLY REMAIN MANY

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QUESTIONS THAT I AM HOPING WILL

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BE ABLE TO ELUCIDATE AND TALK

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MORE ABOUT TODAY.

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SO THERE REMAIN MANY QUESTIONS

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THOUGH ABOUT THIS LARGE TOPIC

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BUSINESS, FOR EXAMPLE, HOW DO WE

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UNDERSTAND BURN OUT AND WELL

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BEING, ARE WE SPEAKING THE STAIM

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LANGUAGE WITH WE TALK ABOUT THE

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TOPICS, AND WHO'S THE WE THAT

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WE'RE TRYING TO HELP ANYWAY, ARE

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THEY HEALTHCARE CLINICIANS,

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ADMINISTRATIVE STAFF, AN CELLARY

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STAFF, 40,000 EMPLOYEES HERE AT

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THE NIH AND WHO'S IN THE

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DRIVER'S SEATED WITH REGARD TO

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CHANGE?

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WHILE THIS TALK IS GEARED

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TOWARDS CLINICIANS AND

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SPECIFICALLY I MEAN RESIDENTS,

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FELLOWS AND FACULTY, MANY OF THE

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UNDERLYING CONCEPTS ARE BROADLY

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APPLICABLE.

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GO TO THE NEXT SLIDE, PLEASE.

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I HAVE NO FINE ARNL CONFLICTS TO

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DISCLOSE.

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NEXT SLIDE.

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SO AS A GENERAL OUTLINE WHAT I

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HOPE TO DO TODAY IS OFFER A

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MODEL OF CLINICIAN BURN OUT

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INCLUDING DEFINING DRIVER'S OF

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BURN OUT THAT RELATE TO 3

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DOMAINS THESE INCLUDE PERSONAL

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RESILIENCE, CULTURE OF WELLNESS

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AND EFFICIENCY OF PRACTICE.

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I WANT TO TRY TO MAKE THE CASE

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FOR WHY INVESTOR NOTHING WELL

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BEING MATTERS WITH A SPECIFIC

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FOCUS TODAY ON THE REGULATORY

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CASE.

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THIS WILL OFFER TIPS FOR BOTH

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RESIDENTS AND FELLOWS AS WELL AS

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FACULTY ON THE ROLE YOU WILL

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HAVE DURING CLEAR VISITS WITH

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REGARD TO WELL BEING, A SHARED

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MODEL WILL HELP AS WE WORK

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TOGETHER, TOWARDS OBTAINING

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MEDICAL STATUS HERE WHICH HAS

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BEEN A MAJOR UNDERTAKING WITH A

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NURSING AT THE HELM.

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WE AND I WILL SHARE INFORMATION

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ABOUT A TRACKING AND DECREASING

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BURN OUT INITIATIVE THAT WAS

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INITIATED IN 2020 BY THE GMEC

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SUBCOMMITTEE ON WELLNESS TO HELP

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DEFINE A PATH FORWARD FOR

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ACCESSING AND MONITORING AND

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MEANING AROUND DRIVERS OF BURN

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OUT IN RESIDENTS AND FELLOWS

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HERE AT THE CLINICAL CENTER, WE

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WILL LEAVE THE IDEA FOR

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AFFECTING MEANINGFUL CHANGE AND

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FOR THOSE THAT ARE INTERESTED,

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THE GOOD NEWS IS THAT THIS

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PROJECT CAN BE EASILY SCALED TO

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OTHER CLINICAL GROUPS.

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NEXT.

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THE THINGS THAT CARRIED WRITTEN

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BY TIM O'BRIANAEN WHO SURVIVED

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HIS TOUR OF DUTY IN VIETNAM TO

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BECOME A WRITER DETAILS THE

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STRUGGLES BY AMERICAN SOLDIERS,

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THE MEN OF ALPHA COMPANY DURING

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THE VIETNAM ROLE.

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THE PRIMARY THEME IS THE

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EMOTIONAL AND PHYSICAL BURDENS

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AS THEY MARCHED, THE GUNS, THE

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GEAR, THE PHOTOS, THE

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LETTERINGS, THE CANDY, THE HOPE,

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THE FEAR, THE MEMORIES, THE

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GUILTY.

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NEXT IT CARRIED THE SKY, THE

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WHOLE ATMOSPHERE, THEY CARRY

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TODAY, THE HUMIDITY, MONSOONS,

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STINK OF FUNGUS AND DECAY, THEY

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CARRY GRAVITY.

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NEXT.

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THE HARD THING TO SPLIEN TO

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SOMEBODY WHO HASN'T FELT IT, AT

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THE PRESENCE OF DEATH AND DANGER

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AS WAY OF BRINGING YOU FULLY

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AWAKE.

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IT MAKES THINGS VIVID, WHEN

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YOU'RE AFRAID, REALLY AFRAID,

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YOU SEE THINGS YOU NEVER SAW

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BEFORE, YOU PAY ATTENTION TO THE

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WORLD, YOU MAKE CLOSE FRIENDS,

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YOU BECOME PART OF A TRIBE AND

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YOU SHARE THE SAME BLOOD, YOU

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GIVE IT TOGETHER AND YOU TAKE IT

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TOGETHER, NEXT.

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THEY CARRIED ALL THEY COULD BEAR

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AND THEN SOME INCLUDING A SILENT

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AWE FOR THE TERRIBLE POWER OF

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THE THINGS THEY CARRIED.

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NEXT.

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YOU HAVE ALL CARRIED THINGS OVER

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THE LAST FEW YEARS NONE MORE

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PUBLIC THAN THE TRAGIC STORY OF

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DR. LORNA BREEN WHO IS WAS

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DIRECTOR OF EMERGENCY DEPARTMENT

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AT THE NEW YORK PRESCRIBING BI

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TERRION HOSPITAL.

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IN THE SPRING OF 2020 AND IN A

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PERIOD OF JUST A SHORT 3 WEEKS

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DR. GREEN FOUND HERSELF TREATING

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COVID PATIENTS AND THEN

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CONTRACTING THE ILLNESS HERSELF

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AND THEN PUSHING HERSELF TO

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RETURN TO HER COLLEAGUES IN ARMS

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AT THE FRONT LINE SO SHE COULD

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HELP THE PATIENTS.

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SHE HAD MADE IT HER LIFE'S

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MISSION TO CARE FOR.

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THIS ALL HAPPENING DURING THE

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TIME OF LIMITED PPE, LIMITED

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SUPPLIES, LIMITED BEDS, PATIENTS

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DYING IN WAITING ROOMS AND IN

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HALLWAYS, MEDICAL TEAMS DECIDING

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WHO WOULD GET VENTILATORS, LIKE

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THE SOLDIERS AND THE THINGS THEY

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CARRY, EXPERIENCE IS ENOUGH TO

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BREAK ANYONE.

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HER BROTHER-IN-LAW COREY FEISS,

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WHO CONFOUNDED THE DR. LORNA

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GREEN FOUNDATION ALONG WITH

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DR. GREEN'S YOUNG OF THE SISTER

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SPOKE IN A RECEIPT NATIONAL

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ACADEMY OF MEDICINE WEBINAR

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SAYING SHE ANSWERED THE CALL FOR

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COUNTRY, FOR CITY BUT WHEN SHE

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NEEDED TO MAKE A CALL FOR

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HERSELF SHE COULDN'T PRIORITIZE

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HER WELL BEING ABOVE HER

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COLLEAGUES AND HER PAIBTS

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BECAUSE STHEE WORRIED IT WOULD

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END HER CAREER, HER PROFESSIONAL

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REPUTATION. 

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AND THE LAST 2 PLUS YEARS ALL

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STAFF IN HOSPITAL SETTINGS HAVE

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GONE ABOVE AND BEYOND THEIR

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ORDINARY OBLIGATIONS TO RESPOND

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TO A THREAT TO NATIONAL AND

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GLOBAL WELL BEING, A HUMAN

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BEINGS ARE NOT INEXHAUSTIBLE.

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NEXT SLIDE.

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THIS OF COURSE LED TO ALL THE

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WRITINGS WE'VE READ ABOUT THE

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GREAT RESIGNATION INCLUDING

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HEGHT CARE WITH OVER A HALF

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MILLION REGISTERED NURSE

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ANTICIPATED TO RETIRE BY THE END

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OF 2020, THE U.S. BURRO OF LABOR

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STATISTICS PROJECTS THE NEED FOR

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1.1 MILLION NEW RNs ACROSS THE

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COUNTRY WITHIN THE NEXT 5 YEARS,

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THE COUNTRY FACES A PROJECTED

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NATIONAL SHORTAGE OF MORE THAN

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3 MILLION LOW WAGE HEALTHCARE

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00:08:43,360 --> 00:08:46,520
WORKERS AND THE AAMC, OCCASIONER

261
00:08:46,520 --> 00:08:48,320
OF AMERICAN MEDICAL COLLEGES

262
00:08:48,320 --> 00:08:49,120
PROJECTS THAT PHYSICIAN DEMAND

263
00:08:49,120 --> 00:08:50,640
WILL CONTINUE TO GROW FASTER

264
00:08:50,640 --> 00:08:51,720
THAN SUPPLY, LEADING TO A

265
00:08:51,720 --> 00:08:55,760
SHORTAGE OF UP TO 139,000

266
00:08:55,760 --> 00:09:01,200
PHYSICIANS BY 2033 WITH THE 

267
00:09:01,200 --> 00:09:03,280
ALARMING GAPS OCCURRING IN

268
00:09:03,280 --> 00:09:03,760
PRIMARY CARE.

269
00:09:03,760 --> 00:09:06,320
MEDICINE IS AT A RISK OF AN

270
00:09:06,320 --> 00:09:08,040
AVISITINGERATING DEPARTURE OF

271
00:09:08,040 --> 00:09:10,440
HIGHLY TRAINED HARD WORKING

272
00:09:10,440 --> 00:09:10,760
CLINICIANS.

273
00:09:10,760 --> 00:09:12,840
THE TRICKLE DOWN EFFECTS ARE

274
00:09:12,840 --> 00:09:13,680
ENORMOUS, SIGNATURES 95 IMPACT

275
00:09:13,680 --> 00:09:14,960
ON PATIENT CARE, TRAINING ON

276
00:09:14,960 --> 00:09:16,200
CAREER PROGRESSION AND THE WORK

277
00:09:16,200 --> 00:09:19,440
LOAD OF THE COLLEAGUES REMAIN.

278
00:09:19,440 --> 00:09:20,920
PANDEMIC FELL ON A WORKFORCE

279
00:09:20,920 --> 00:09:22,040
THAT WAS ALREADY UNDER STRESS

280
00:09:22,040 --> 00:09:24,800
FROM THE BURDENS OF WORKING IN

281
00:09:24,800 --> 00:09:25,720
ENVIRONMENTS LADEN WITH CLINICAL

282
00:09:25,720 --> 00:09:28,280
RISKS, TO THE MEASURES OF BEING

283
00:09:28,280 --> 00:09:30,240
UNABLE TO DELIVER CARE TO THE

284
00:09:30,240 --> 00:09:31,440
HIGH STANDARDS TO WHICH THEY

285
00:09:31,440 --> 00:09:33,840
HAVE BEEN TRAINED AND THE

286
00:09:33,840 --> 00:09:36,040
FRUSTRATION OF CHRONIC

287
00:09:36,040 --> 00:09:37,040
UNDERRESOURCING, UNDERRESOURCING

288
00:09:37,040 --> 00:09:38,960
AND SYSTEM SYSTEM FAILURES THAT

289
00:09:38,960 --> 00:09:42,320
HAVE RESULTED IN PATIENT ARMS.

290
00:09:42,320 --> 00:09:42,600
NEXT.

291
00:09:42,600 --> 00:09:44,600
THERE'S BEEN A GROWING MOVEMENT

292
00:09:44,600 --> 00:09:46,480
UNDERWAY AND THAT'S THE GOOD

293
00:09:46,480 --> 00:09:48,680
NEWS, THE ORGANIZATIONS LIKE THE

294
00:09:48,680 --> 00:09:51,200
INSTIEWT IN HEALTHCARE AND

295
00:09:51,200 --> 00:09:52,040
IMPROVEMENT BEGIN TO INDGREAT

296
00:09:52,040 --> 00:09:52,960
PHYSICIAN WELL BEING AND TO

297
00:09:52,960 --> 00:09:54,400
THEIR CALL FOR ACTION, MOVING

298
00:09:54,400 --> 00:09:57,320
FROM THEIR TRIPLE AIM OF BETTER

299
00:09:57,320 --> 00:09:57,920
POPULATION HEALTH, BETTER

300
00:09:57,920 --> 00:10:02,480
EXPERIENCE OF CARE AT LOWER

301
00:10:02,480 --> 00:10:04,640
COST, PUBLISH INDEED 2007 TO

302
00:10:04,640 --> 00:10:05,560
RECOGNIZE THIS TRIPLE AIM COULD

303
00:10:05,560 --> 00:10:07,160
NOT BE DONE WITHOUT ADDING

304
00:10:07,160 --> 00:10:08,920
PHYSICIANS, I'M GOING TO BROADEN

305
00:10:08,920 --> 00:10:11,080
THAT TO CLINICIANS WELL BEING IN

306
00:10:11,080 --> 00:10:13,520
2017 AS AN IMPORTANT COMPASS FOR

307
00:10:13,520 --> 00:10:15,480
OPTIMIZING HEALTH SYSTEMS

308
00:10:15,480 --> 00:10:15,840
PERFORMANCE.

309
00:10:15,840 --> 00:10:18,040
I WANT TO EMPHASIZE THE POINT

310
00:10:18,040 --> 00:10:21,000
THAT VALUES BASED CARE MUST

311
00:10:21,000 --> 00:10:23,160
INCLUDE THE CLINICIANS.

312
00:10:23,160 --> 00:10:23,920
NEXT SLIDE.

313
00:10:23,920 --> 00:10:25,760
THE NATIONAL ACADEMY OF MEDICINE

314
00:10:25,760 --> 00:10:27,320
CREATED THE NATIONAL ACTION

315
00:10:27,320 --> 00:10:30,200
ALLIANCE ON CLINICIAN WELL BEING

316
00:10:30,200 --> 00:10:31,640
AND RESILIENCE.

317
00:10:31,640 --> 00:10:33,120
COMMISSIONING A CONSENSUS STUDY

318
00:10:33,120 --> 00:10:34,440
TO EVALUATE AVAILABLE EVIDENCE

319
00:10:34,440 --> 00:10:36,800
ON CLINICIAN BURN OUT AND WELL

320
00:10:36,800 --> 00:10:39,240
BEING, EVIDENCE OF PREVENTIVE

321
00:10:39,240 --> 00:10:42,160
LANCE VARIES BUT MAN REFERENCES

322
00:10:42,160 --> 00:10:44,200
THAT 35-54% OF NURSES AND

323
00:10:44,200 --> 00:10:47,240
PHYSICIANS AND 45-60% OF MEDICAL

324
00:10:47,240 --> 00:10:48,720
STUDENTS AND RESIDENTS

325
00:10:48,720 --> 00:10:49,360
EXPERIENCE SUBSTANTIAL SYMPTOMS

326
00:10:49,360 --> 00:10:52,840
OF BURN OUT AND THIS WAS ALL

327
00:10:52,840 --> 00:10:54,280
WELL BEFORE COVID.

328
00:10:54,280 --> 00:10:57,120
THIS CONSENSUS STUDY REPORT

329
00:10:57,120 --> 00:10:59,200
IDENTIFIES CLINICIAN BURN OUT AS

330
00:10:59,200 --> 00:11:00,840
SIGNIFICANT QUALITY OF CARE AND

331
00:11:00,840 --> 00:11:02,480
HIGHLIGHTS THE NOTION THAT

332
00:11:02,480 --> 00:11:03,520
MOUNTING SYSTEMS PRESSURES

333
00:11:03,520 --> 00:11:04,960
WITHIN THE U.S. HEALTHCARE

334
00:11:04,960 --> 00:11:07,080
SYSTEM HAVE CONTRIBUTED TO AN

335
00:11:07,080 --> 00:11:07,880
IN-BALANCE WHICH THE DEMANDS OF

336
00:11:07,880 --> 00:11:09,680
THE JOB ARE GREATER THAN THE

337
00:11:09,680 --> 00:11:12,000
RESOURCES AND SUPPORT AVAILABLE.

338
00:11:12,000 --> 00:11:13,800
SINCE AND DURING THE PANDEMIC

339
00:11:13,800 --> 00:11:15,080
THE CLINICIAN WELL BEING

340
00:11:15,080 --> 00:11:16,040
COLLABORATIVE HAS DOUBLED DOWN

341
00:11:16,040 --> 00:11:17,800
ON THEIR EFFORTS WITH CONTINUED

342
00:11:17,800 --> 00:11:19,600
EMPHASIS ON THE NATIONAL PLAN

343
00:11:19,600 --> 00:11:22,040
FOR ACTION OFFERING A ROADMAP

344
00:11:22,040 --> 00:11:22,480
FOR CHANGE.

345
00:11:22,480 --> 00:11:24,240
IN FACT THEY HELD AN ONLINE

346
00:11:24,240 --> 00:11:26,680
EVENT JUST A MONTH AGO CALLING

347
00:11:26,680 --> 00:11:31,000
FOR PUBLIC INPUT.

348
00:11:31,000 --> 00:11:31,320
NEXT.

349
00:11:31,320 --> 00:11:32,400
THE CONSEQUENCES OF CLINICIAN

350
00:11:32,400 --> 00:11:33,800
BURN OUT FOR VAST AND WELL

351
00:11:33,800 --> 00:11:36,120
DOCUMENTED AND I WON'T GO INTO

352
00:11:36,120 --> 00:11:39,200
THESE IN MUCH DETAIL, THIS WAS

353
00:11:39,200 --> 00:11:41,000
LISTED WELL BEFORE THE PANDEMIC

354
00:11:41,000 --> 00:11:43,920
HIT, AND IT'S INCLUDED TO YOU,

355
00:11:43,920 --> 00:11:46,080
INCLUDING QUALITY ERRORS QUALITY

356
00:11:46,080 --> 00:11:48,000
PROFESSIONALISM AND REDUCED

357
00:11:48,000 --> 00:11:49,560
PATIENT SATISFACTION, TURNOVER

358
00:11:49,560 --> 00:11:52,160
IN STAFF, REDUCED MORAL AND ITS

359
00:11:52,160 --> 00:11:54,120
IMPACT ON PRODUCTIVITY,

360
00:11:54,120 --> 00:11:54,800
THREATENED ORGANIZATION

361
00:11:54,800 --> 00:11:57,480
REPUTATIONS AND ALL THE

362
00:11:57,480 --> 00:11:58,640
INDIVIDUAL PROBLEMS THAT COME

363
00:11:58,640 --> 00:12:00,440
WITH LIKE MOTOR VEHICLE

364
00:12:00,440 --> 00:12:02,360
ACCIDENTS, NEAR MISSES

365
00:12:02,360 --> 00:12:04,440
DEPRESSION AND SUICIDAL

366
00:12:04,440 --> 00:12:06,400
IDEATION, MORAL INJURY AND SO

367
00:12:06,400 --> 00:12:07,960
FORTH.

368
00:12:07,960 --> 00:12:10,000
THIS IS NOT NEW TO OTHER

369
00:12:10,000 --> 00:12:12,640
HEALTHCARE PROFESSIONALS.

370
00:12:12,640 --> 00:12:14,360
NEXT SLIDE.

371
00:12:14,360 --> 00:12:18,160
ON MAY 23rd, CERTAIN MEDICAL

372
00:12:18,160 --> 00:12:20,360
FOWBD THE MOST RECENT ARK LARM

373
00:12:20,360 --> 00:12:22,080
HIGHLIGHTING THE NEED TO ADDRESS

374
00:12:22,080 --> 00:12:23,720
BURN OUT CRISIS ACROSS THE

375
00:12:23,720 --> 00:12:25,800
COUNTRY AND YET AGAIN THERE ARE

376
00:12:25,800 --> 00:12:27,640
REAL QUESTIONS THAT EMERGE FROM

377
00:12:27,640 --> 00:12:29,240
THIS TOPIC LIKE WHAT DOES IT

378
00:12:29,240 --> 00:12:31,840
MEAN TO ADDRESS THE PROBLEM AS

379
00:12:31,840 --> 00:12:33,880
BIG AND HUGE AMORPHIC AS BURN

380
00:12:33,880 --> 00:12:35,080
OUT AND STRESS AND WELL BEING.

381
00:12:35,080 --> 00:12:36,880
IS IT OUR JOB TO MANAGE THESE

382
00:12:36,880 --> 00:12:38,400
ISSUES FOR OUR STAFF AT WORK,

383
00:12:38,400 --> 00:12:40,200
WHAT PARTS ARE PRIVATE AND WHAT

384
00:12:40,200 --> 00:12:42,320
PARTS SPILL INTO THE WORKPLACE,

385
00:12:42,320 --> 00:12:44,080
WHAT PARTS ARE FOR SUPER VISORS

386
00:12:44,080 --> 00:12:45,280
AND COLLEAGUES TO ACT ON AND

387
00:12:45,280 --> 00:12:47,360
WHAT PARTS ARE FOR THE

388
00:12:47,360 --> 00:12:48,360
INDIVIDUALS.

389
00:12:48,360 --> 00:12:49,480
OUR HEALTHCARE SYSTEMS

390
00:12:49,480 --> 00:12:50,280
INTERVENING WHERE THEY SHOULD BE

391
00:12:50,280 --> 00:12:52,400
OR JUST ON THE LOW HANGING

392
00:12:52,400 --> 00:12:52,760
FRUIT.

393
00:12:52,760 --> 00:12:55,200
WHAT SHOULD BE OFFERED AND TO

394
00:12:55,200 --> 00:12:58,520
WHOM, AND WILL 1 SIZE FIT ALL,

395
00:12:58,520 --> 00:12:59,960
NEXT SLIDE.

396
00:12:59,960 --> 00:13:03,880
FOR SURE THIS TOPIC FEELS LIKE A

397
00:13:03,880 --> 00:13:05,160
3 LEGGED BEHEMOTH, TERMS LIKE

398
00:13:05,160 --> 00:13:09,160
WELL BEING AND BURN OUT CAN BE

399
00:13:09,160 --> 00:13:10,080
AMBIGUOUSLY DEFINED, THEY ARE

400
00:13:10,080 --> 00:13:11,440
LIMITS TO WHAT THEY MEAN, THERE

401
00:13:11,440 --> 00:13:12,600
ARE LIMITS TO WHAT WE CAN

402
00:13:12,600 --> 00:13:14,560
CONTROL AND WHAT WE CHANGE THE

403
00:13:14,560 --> 00:13:16,520
THERE ARE MANY SYSTEMS IN PLACE,

404
00:13:16,520 --> 00:13:17,800
1 OF THE PRIMARY CHALLENGES

405
00:13:17,800 --> 00:13:19,920
THOUGH IS IN GETTING A READOT

406
00:13:19,920 --> 00:13:21,680
PROBLEM, SORT OF PULSEOX

407
00:13:21,680 --> 00:13:23,040
IMPEDIMENTSITTER NOT JUST FOR

408
00:13:23,040 --> 00:13:25,760
THE INDIVIDUAL BUT FOR THE WORK,

409
00:13:25,760 --> 00:13:27,680
UNIT, TEAM, DEPARTMENT, THE

410
00:13:27,680 --> 00:13:28,880
ENTIRE ORGANIZATION, WE NEED

411
00:13:28,880 --> 00:13:31,520
SYSTEMATIC AND RIGOROUS WAYS OF

412
00:13:31,520 --> 00:13:34,840
MEASURING WHAT I CALL

413
00:13:34,840 --> 00:13:35,680
ORGANIZATIONAL VITAL SIGNS.

414
00:13:35,680 --> 00:13:38,000
THE EASY CASES ARE EASY, WHERE

415
00:13:38,000 --> 00:13:39,840
THERE'S PULSE OX ON THE LOW 80S,

416
00:13:39,840 --> 00:13:41,080
IT'S CLEAR WE HAVE A PROBLEM BUT

417
00:13:41,080 --> 00:13:42,480
WHAT ABOUT THE TOUGH CASES, WHAT

418
00:13:42,480 --> 00:13:44,760
ABOUT WHEN WE'RE NOT SO SURE?

419
00:13:44,760 --> 00:13:46,280
FOR EXAMPLE WITH THE CHIEF

420
00:13:46,280 --> 00:13:47,960
RESIDENT WHO EXTERNALLY LOOKS

421
00:13:47,960 --> 00:13:52,120
LIKE HE'S COMPLETELY GOT HIS ACT

422
00:13:52,120 --> 00:13:54,120
TOGETHER BUT SOMETHING UNTWARD

423
00:13:54,120 --> 00:13:55,760
HAPPENS AND WE SAID WE HAVE NO

424
00:13:55,760 --> 00:13:57,160
IDEA, EVEN THOUGH WE WORKED

425
00:13:57,160 --> 00:13:59,160
CLOSELY WITH HIM EVERY DAY AND

426
00:13:59,160 --> 00:14:00,200
JUST BECAUSE WE KNOW ABOUT A

427
00:14:00,200 --> 00:14:01,920
READING IN THE LOW 80S HOW DO WE

428
00:14:01,920 --> 00:14:02,600
GO ABOUT UNDERSTANDING THE

429
00:14:02,600 --> 00:14:04,960
DRIVERS OF BURN OUT IN A

430
00:14:04,960 --> 00:14:07,280
MEANINGFUL WAY, IN AN EVIDENCE

431
00:14:07,280 --> 00:14:09,840
INFORMED WAY.

432
00:14:09,840 --> 00:14:10,280
NEXT.

433
00:14:10,280 --> 00:14:13,200
SO THERE ARE 5 CASES TO BE MADE

434
00:14:13,200 --> 00:14:14,840
FOR WHY HEALTHCARE ORGANIZATIONS

435
00:14:14,840 --> 00:14:16,120
SHOULD INVEST IN A WELL BEING

436
00:14:16,120 --> 00:14:18,080
PROGRAM AND I WILL NOT GO INTO

437
00:14:18,080 --> 00:14:19,040
THESE IN DEPTH, I'VE ALREADY

438
00:14:19,040 --> 00:14:21,240
MADE THE CASE FOR A TRAGIC CASE,

439
00:14:21,240 --> 00:14:23,160
1 DEATH OF SUICIDE IS 1 TOO

440
00:14:23,160 --> 00:14:24,560
MANY, THE MORAL CASE, WELL IT'S

441
00:14:24,560 --> 00:14:26,120
JUST THE RIGHT THING DO TO TAKE

442
00:14:26,120 --> 00:14:27,280
CARE OF OUR OWN.

443
00:14:27,280 --> 00:14:28,440
THIS CASE IS REALLY AN

444
00:14:28,440 --> 00:14:31,360
INTERESTING 1 AND MORE SO WITH

445
00:14:31,360 --> 00:14:34,000
THE GREAT RESIGNATION, ON ARE

446
00:14:34,000 --> 00:14:35,600
RETURN ON INVESTMENT ASTRIGZ IS

447
00:14:35,600 --> 00:14:36,600
DOUBLE AMONG PHYSICIANS

448
00:14:36,600 --> 00:14:37,600
EXPERIENCING PROFESSIONAL BURN

449
00:14:37,600 --> 00:14:39,120
OUT AND COSTS AVERAGE BETWEEN

450
00:14:39,120 --> 00:14:41,040
HALVING A MILLION AND 1 MILLION

451
00:14:41,040 --> 00:14:42,840
TO REPLACE A PHYSICIAN, CAN YOU

452
00:14:42,840 --> 00:14:44,520
CALCULATE THE COST FOR NURSES,L

453
00:14:44,520 --> 00:14:45,280
FORM CYSTS, SOC WORKERS AND

454
00:14:45,280 --> 00:14:47,040
THE LIST GOES ON.

455
00:14:47,040 --> 00:14:48,520
RECRUITMENT AND RETENTION IS AT

456
00:14:48,520 --> 00:14:52,520
THE FOREFRONT OF EVERY HOSPITAL

457
00:14:52,520 --> 00:14:53,800
LEADERS MINE, AND WHAT ARE WE

458
00:14:53,800 --> 00:14:56,720
DOING TO ADDRESS THE BEST AND

459
00:14:56,720 --> 00:14:58,520
BRIGHTEST TO KEEP THEM HERE, 8%

460
00:14:58,520 --> 00:15:00,440
OF HOSPITALS AROUND THE CASE

461
00:15:00,440 --> 00:15:01,960
HAVE MAGNET STATUS, REALLY SMALL

462
00:15:01,960 --> 00:15:04,000
NUMBERS AND NURSING HERE HAS

463
00:15:04,000 --> 00:15:05,960
DONE A YOMAN'S JOB UNDER THE

464
00:15:05,960 --> 00:15:07,600
LEADERSHIP OF DR. BARBARA JORDAN

465
00:15:07,600 --> 00:15:09,600
AND RACHEL KOOMS AND THEIR TEEM

466
00:15:09,600 --> 00:15:11,000
AND MANY OTHERS INTEGRATING WELL

467
00:15:11,000 --> 00:15:12,960
BEING INTO THE VERY FABRIC OF

468
00:15:12,960 --> 00:15:14,960
THE WORK BUT I'M HERE TO TALK

469
00:15:14,960 --> 00:15:17,760
ABOUT THE REGULATORY CASE.

470
00:15:17,760 --> 00:15:17,960
NEXT.

471
00:15:17,960 --> 00:15:23,000
IN TWEBT 15 AND 2016 THE

472
00:15:23,000 --> 00:15:24,160
ACCREDITATION COUNCIL FOR

473
00:15:24,160 --> 00:15:25,080
GRADUATE MEDICAL EDUCATION, ALSO

474
00:15:25,080 --> 00:15:27,840
KNOWN AS TD ACGHE ORGANIZED

475
00:15:27,840 --> 00:15:29,640
THEIR FIRST AND SECOND SYMPOSIA

476
00:15:29,640 --> 00:15:31,320
ON PHYSICIAN WELL BEING.

477
00:15:31,320 --> 00:15:34,120
ON JULY 1st 2017, THE ACGME

478
00:15:34,120 --> 00:15:36,560
PROVIDES SECTION 6 C OF A COMMON

479
00:15:36,560 --> 00:15:38,040
PROGRAM REQUIREMENT TO ADDRESS

480
00:15:38,040 --> 00:15:39,840
WELL BEING MORE COMPREHENSIVELY.

481
00:15:39,840 --> 00:15:41,400
THAT'S A FANCY WAY OF SAYING,

482
00:15:41,400 --> 00:15:43,920
THEY BAKE THIS IN AS A

483
00:15:43,920 --> 00:15:45,320
REQUIREMENT, NOT JUST FOR

484
00:15:45,320 --> 00:15:46,400
PHYSICIAN TRAINEES BUT

485
00:15:46,400 --> 00:15:47,560
INTERESTINGLY ALSO FOR FACULTY.

486
00:15:47,560 --> 00:15:50,000
AND THEY DID THAT BECAUSE

487
00:15:50,000 --> 00:15:51,840
RESIDENTS AND FACULTY AS I'VE

488
00:15:51,840 --> 00:15:52,880
SAID HAVE INCREASED RISK FOR

489
00:15:52,880 --> 00:15:54,560
BURN OUT WHEN COMPARED TO THE

490
00:15:54,560 --> 00:15:55,600
GENERAL POPULATION.

491
00:15:55,600 --> 00:15:56,640
PROGRAMS HAVE THE SAME

492
00:15:56,640 --> 00:15:58,320
RESPONSIBILITY TO ADDRESS WELL

493
00:15:58,320 --> 00:16:00,320
BEING AS THEY DO TO EVALUATE

494
00:16:00,320 --> 00:16:02,680
OTHER ASPECTS OF RESIDENTS

495
00:16:02,680 --> 00:16:04,040
COMPETENCE LIKE MEDICAL

496
00:16:04,040 --> 00:16:06,240
KNOWLEDGE AND PATIENT CARE, AND

497
00:16:06,240 --> 00:16:08,120
PERSONAL COMMUNICATION AND

498
00:16:08,120 --> 00:16:08,960
SYSTEMS BASED PRACTICE AND SO

499
00:16:08,960 --> 00:16:11,760
FORTH MPLET I WANT TO HIGHLIGHT

500
00:16:11,760 --> 00:16:13,200
FACULTY HERE BECAUSE THIS

501
00:16:13,200 --> 00:16:13,800
REPRESENTS AN AREA OF

502
00:16:13,800 --> 00:16:15,960
OPPORTUNITY HERE AT THE NIH AND

503
00:16:15,960 --> 00:16:16,800
WE'RE CONSTANTLY LOOKING FOR

504
00:16:16,800 --> 00:16:18,680
PARTNERS SO I WILL DO A FEW

505
00:16:18,680 --> 00:16:20,280
PUBLIC SERVICE ANNOUNCEMENTS TO

506
00:16:20,280 --> 00:16:23,280
GET YOU ALL ON BOARD, NEXT

507
00:16:23,280 --> 00:16:23,920
SLIDE.

508
00:16:23,920 --> 00:16:25,360
AS OF 2021, ALL SPECIALTY

509
00:16:25,360 --> 00:16:27,240
PROGRAMS HAVE ROLLED OUT FORMAL

510
00:16:27,240 --> 00:16:29,280
MILESTONES FOR WELL BEING UNDER

511
00:16:29,280 --> 00:16:30,000
PROFESSIONALISM AS A HEADER AND

512
00:16:30,000 --> 00:16:32,320
I WANT TO USE THIS EXAMPLE FROM

513
00:16:32,320 --> 00:16:33,640
INFECTIOUS DISEASE WE FOR SURE

514
00:16:33,640 --> 00:16:36,320
KNOW THEY HAVE BEEN WORKING HARD

515
00:16:36,320 --> 00:16:37,320
OVER THE LAST 3 YEARS.

516
00:16:37,320 --> 00:16:39,640
SO FROM LEVEL 1 TO 5 AND I'M

517
00:16:39,640 --> 00:16:42,320
GOING TO SAY NEXT YEAR RITA CAN

518
00:16:42,320 --> 00:16:43,720
POP THOSE OUT, LEVEL 1 IS

519
00:16:43,720 --> 00:16:46,240
RECOGNITION OF THE PROBLEM.

520
00:16:46,240 --> 00:16:48,600
LEVEL 2 IS IDENTIFYING LIST OF

521
00:16:48,600 --> 00:16:50,200
RESOURCES, THAT'S A BIT OF A

522
00:16:50,200 --> 00:16:51,760
CHALLENGE HERE BECAUSE WE'RE

523
00:16:51,760 --> 00:16:52,800
BOTH AN EMBARRASSMENT THE OF

524
00:16:52,800 --> 00:16:54,240
RICHES, WE IS A LOT OF PEOPLE

525
00:16:54,240 --> 00:16:55,800
DOING GREAT WORK IN THIS SPACE

526
00:16:55,800 --> 00:16:57,440
BUT THERE ARE SIGNIFICANT

527
00:16:57,440 --> 00:16:58,640
CHALLENGES KNOWING WHERE TO FIND

528
00:16:58,640 --> 00:16:58,920
NRGZ.

529
00:16:58,920 --> 00:17:00,880
LEVEL FREE IS PROPOSING A PLAN

530
00:17:00,880 --> 00:17:02,120
TO PROMOTE PERSONAL AND

531
00:17:02,120 --> 00:17:04,000
PROFESSIONAL WELL BEING, LEVEL 4

532
00:17:04,000 --> 00:17:05,080
DESCRIBES INSTITUTIONAL LEVEL

533
00:17:05,080 --> 00:17:07,480
FACTORS THAT AFFECT WELL BEING,

534
00:17:07,480 --> 00:17:09,800
AND LEVELS 5 DESCRIBES

535
00:17:09,800 --> 00:17:12,080
INSTITUTIONAL PROGRAMS DESIGNED

536
00:17:12,080 --> 00:17:13,480
TO EXAMINE SYSTEMIC SCRIEWBTORS

537
00:17:13,480 --> 00:17:14,920
TO BURN OUT, SO IF YOU'RE HERE

538
00:17:14,920 --> 00:17:16,000
FOR THIS TALK, I CAN SAY THAT

539
00:17:16,000 --> 00:17:18,160
YOU WILL BE ABLE TO GET TO AT

540
00:17:18,160 --> 00:17:20,400
LEAST A LEVEL 4 IN TERMS OF YOUR

541
00:17:20,400 --> 00:17:21,720
UNDERSTANDING AROUND WHAT THIS

542
00:17:21,720 --> 00:17:23,400
TOPIC IS ALL ABOUT.

543
00:17:23,400 --> 00:17:25,880
BUT THESE MILESTONES OFFER A

544
00:17:25,880 --> 00:17:27,280
BASIC GUIDANCE, THEY OFFER BASIC

545
00:17:27,280 --> 00:17:29,720
GUIDANCE, THEY DON'T OFFER A

546
00:17:29,720 --> 00:17:30,520
PATH FORWARD.

547
00:17:30,520 --> 00:17:32,200
THAT MEANS IT'S BEEN UP TO OUR

548
00:17:32,200 --> 00:17:34,240
PROGRAMS INDIVIDUALLY TO FIGURE

549
00:17:34,240 --> 00:17:35,560
OUT HOW TO OPERATIONALIZE THIS.

550
00:17:35,560 --> 00:17:37,360
THAT'S NOT A VERY EFFICIENT WAY

551
00:17:37,360 --> 00:17:42,120
OF MEETING THESE CHALLENGES,

552
00:17:42,120 --> 00:17:43,600
NEXT SLIDE.

553
00:17:43,600 --> 00:17:44,880
THE ACGME ESTABLISHED THEIR

554
00:17:44,880 --> 00:17:46,920
PROGRAMS IN 2017 TO PROVIDE

555
00:17:46,920 --> 00:17:48,280
GRADUATE MEDICAL EDUCATION

556
00:17:48,280 --> 00:17:49,640
COMILTEES AND EXECUTIVE LEADERS

557
00:17:49,640 --> 00:17:52,760
OF HOSPITAL MEDICAL CENTERS AND

558
00:17:52,760 --> 00:17:54,600
OTHER CLINICAL SETTINGS TO GET

559
00:17:54,600 --> 00:17:56,440
FEEDBACK AIMED AT IMPROVING

560
00:17:56,440 --> 00:17:58,560
PATIENT CARE WHILE OPTIMIZING

561
00:17:58,560 --> 00:17:59,840
OUR CLINICAL LEARNING

562
00:17:59,840 --> 00:18:01,080
ENVIRONMENT IN 6 IMPORTANT CROSS

563
00:18:01,080 --> 00:18:02,560
CUTTING AREAS AND THOSE ARE

564
00:18:02,560 --> 00:18:04,840
IDENTIFIED ON THIS TABLE OF

565
00:18:04,840 --> 00:18:05,320
CONTENTS THERE.

566
00:18:05,320 --> 00:18:12,520
THOSE IMPROVE THINGS LIKE

567
00:18:12,520 --> 00:18:14,800
PATIENT WELL BEING, AND THEY

568
00:18:14,800 --> 00:18:15,880
DON'T INCLUDE PEOPLE IN

569
00:18:15,880 --> 00:18:17,320
HOSPITALS BUT THEY INCLUDED WELL

570
00:18:17,320 --> 00:18:19,520
BEING AND I HIGHLIGHTED 6 WELL

571
00:18:19,520 --> 00:18:22,280
BEING PATHWAYS AGAIN HERE WHICH

572
00:18:22,280 --> 00:18:23,960
AMRI TO RESIDENTS AND FACULTY AS

573
00:18:23,960 --> 00:18:31,280
WELL,  WHEN CLER DOES A VISIT

574
00:18:31,280 --> 00:18:32,840
THEY KNOW WHAT WE'RE DOING HERE,

575
00:18:32,840 --> 00:18:34,840
WE ARE MAINTAINING WELL BEING

576
00:18:34,840 --> 00:18:37,240
WHILE FULFILLING PROFESSIONAL

577
00:18:37,240 --> 00:18:38,280
OBLIGATIONS TO DEMONSTRATE

578
00:18:38,280 --> 00:18:40,520
SPECIFIC EFFORTS TO WELL BEING

579
00:18:40,520 --> 00:18:42,480
AND RESIDENTS FELLOW FACULTY AND

580
00:18:42,480 --> 00:18:43,200
DEMONSTRATE SYSTEMS BASED

581
00:18:43,200 --> 00:18:46,280
ACTIONS AND SO FORTH.

582
00:18:46,280 --> 00:18:47,720
DEFINING OUR TERM SYSTEM AN

583
00:18:47,720 --> 00:18:50,120
IMPORTANT FIRST STEP IS A BIT OF

584
00:18:50,120 --> 00:18:50,440
A CHALLENGE.

585
00:18:50,440 --> 00:18:51,760
LET'S GO TO THE NEXT SLIDE.

586
00:18:51,760 --> 00:18:55,240
BURN OUT, WELL BEING,

587
00:18:55,240 --> 00:18:56,120
SELF-VALENTINEDDUATION,

588
00:18:56,120 --> 00:18:58,440
COMPASSION FACAS FEEING,

589
00:18:58,440 --> 00:18:59,600
ENGAGEMENT, SATISFACTION,

590
00:18:59,600 --> 00:19:01,400
MEANING, STRESS, EMOTIONAL

591
00:19:01,400 --> 00:19:03,680
EXHAUSTION, MORAL INJURY, JOY,

592
00:19:03,680 --> 00:19:04,840
DEPRESSION, WHAT EXACTLY ARE WE

593
00:19:04,840 --> 00:19:06,720
SUPPOSED TO BE MEASURING IN

594
00:19:06,720 --> 00:19:09,280
ORDER THAT WE KNOW, WE ARE

595
00:19:09,280 --> 00:19:10,240
CAPTURING THE FUNDMENTAL DRIVERS

596
00:19:10,240 --> 00:19:12,280
OF BURN OUT IN THIS PARTICULAR

597
00:19:12,280 --> 00:19:13,160
SETTING, IN OUR PARTICULAR

598
00:19:13,160 --> 00:19:16,200
CULTURE, THAT IS A FEDERALLY

599
00:19:16,200 --> 00:19:17,320
FUNDED CLINICAL RESEARCH

600
00:19:17,320 --> 00:19:18,760
FACILITY WITH A GIVING--YOU

601
00:19:18,760 --> 00:19:19,560
NATIONAL LIBRARY OF MEDICINOUS

602
00:19:19,560 --> 00:19:21,560
MISSION TO CURE ALL THAT AILS

603
00:19:21,560 --> 00:19:28,160
PEOPLE IN THE CONTEXT OF

604
00:19:28,160 --> 00:19:28,600
ENORMOUS INSTITUTIONAL

605
00:19:28,600 --> 00:19:28,920
COMPLEXITY.

606
00:19:28,920 --> 00:19:30,160
IT IS NOT A SMALL UNDERTAKING.

607
00:19:30,160 --> 00:19:32,720
BURN OUT IS A TERM THAT'S BEEN

608
00:19:32,720 --> 00:19:36,640
CHARACTERIZED SINCE THE NEEB

609
00:19:36,640 --> 00:19:40,240
70S, HISTORICALLY HERBERT

610
00:19:40,240 --> 00:19:41,320
FROYDENBURGER IS CREDITED OF

611
00:19:41,320 --> 00:19:42,840
DEFINING BURN OUT IN THE CONTEXT

612
00:19:42,840 --> 00:19:44,440
OF THE ORIGINAL WORKPLACE.

613
00:19:44,440 --> 00:19:45,840
IN HIS 1974 ARTICLE, HE

614
00:19:45,840 --> 00:19:48,520
DESCRIBES THE STATE OF BEING

615
00:19:48,520 --> 00:19:52,520
BURNT OUT AS BECOMES EXHAUSTED

616
00:19:52,520 --> 00:19:53,600
BY MAKING EXCESSIVE DEMANDS ON

617
00:19:53,600 --> 00:19:55,920
ENERGY OR STRENGTH OR RESOURCES

618
00:19:55,920 --> 00:19:56,520
IN THE WORKPLACE.

619
00:19:56,520 --> 00:19:58,400
THE W. H. O. HAS DEFINED BURN

620
00:19:58,400 --> 00:20:00,960
OUT AS A PROBLEM ASSOCIATED WITH

621
00:20:00,960 --> 00:20:03,040
CHRONIC WORKPLACE STRESS, NOT A

622
00:20:03,040 --> 00:20:04,080
MENTAL HEALTH DIAGNOSIS, IT'S

623
00:20:04,080 --> 00:20:05,600
IMPORTANT TO NOTE HOWEVER, THAT

624
00:20:05,600 --> 00:20:08,040
BURN OUT, DEPRESSION AND SUICIDE

625
00:20:08,040 --> 00:20:10,040
IDEATION ARE SEPARATE BUT

626
00:20:10,040 --> 00:20:10,720
RELATED ENTITIES.

627
00:20:10,720 --> 00:20:11,800
BURN OUT LIKE OTHER STRESSORS

628
00:20:11,800 --> 00:20:13,560
MAY CONTRIBUTE TO THE

629
00:20:13,560 --> 00:20:15,520
DEVELOPMENT OF DEPRESSION IN

630
00:20:15,520 --> 00:20:21,400
SUSCEPTIBLE INDIVIDUALS.

631
00:20:21,400 --> 00:20:22,120
NEXT SLIDE.

632
00:20:22,120 --> 00:20:24,640
DEPRESSION AND BURN OUT SHARE

633
00:20:24,640 --> 00:20:25,960
SIMILARITIES AND ALTHOUGH THEY

634
00:20:25,960 --> 00:20:27,440
SHARE OVERLAPPING SYSTEMS THEY

635
00:20:27,440 --> 00:20:28,720
ARE NOT SIN OPEN MEETING NOWS,

636
00:20:28,720 --> 00:20:33,880
BURN OUT IS AN OCCUPATIONAL

637
00:20:33,880 --> 00:20:35,480
STRESS SYNDROME AND PSYCHIATRIC

638
00:20:35,480 --> 00:20:37,800
DIAGNOSIS THAT IS GLOBALLY

639
00:20:37,800 --> 00:20:46,160
PERVASIVE AS AN EXAMPLE, MOST

640
00:20:46,160 --> 00:20:47,800
BURN OUT ASSOCIATIONS, IS

641
00:20:47,800 --> 00:20:49,240
INCREASED RISK OF SELF-REPORTED

642
00:20:49,240 --> 00:20:50,400
MEDICAL ERRORS AND DEPRESSION IS

643
00:20:50,400 --> 00:20:50,560
NOT.

644
00:20:50,560 --> 00:20:53,240
BURN OUT AND DEPRESSION MANIFEST

645
00:20:53,240 --> 00:20:54,920
SIMILARLY AND MAY EVEN CO EXIST

646
00:20:54,920 --> 00:20:56,160
AMONG SOME PHYSICIANS AND

647
00:20:56,160 --> 00:20:57,760
CLINICIANS, HOWEVER, SINCE THEY

648
00:20:57,760 --> 00:20:59,680
ARE SEPARATE AND DISTINCT

649
00:20:59,680 --> 00:21:01,960
CONDITIONS, THEY REQUIRE

650
00:21:01,960 --> 00:21:03,560
DIFFERENT INTERVENTIONS.

651
00:21:03,560 --> 00:21:04,240
INTERVENTIONS TARGETING

652
00:21:04,240 --> 00:21:05,760
OCCUPATIONAL BURN OUT ARE NOT

653
00:21:05,760 --> 00:21:07,160
ONLY ON AN INDIVIDUAL LEVEL OR

654
00:21:07,160 --> 00:21:09,600
MORE IMPORTANTLY ON A SYSTEM

655
00:21:09,600 --> 00:21:10,760
LEVEL, TARGETING THINGS LIKE

656
00:21:10,760 --> 00:21:13,560
LACK OF CONTROL AND AUTONOMY.

657
00:21:13,560 --> 00:21:17,080
SO THINGS FOR EXAMPLE, PATIENT

658
00:21:17,080 --> 00:21:17,600
NONCOMPLIANCE AND ON THE

659
00:21:17,600 --> 00:21:18,680
PHYSICIAN WHO MIGHT HAVE MINIMAL

660
00:21:18,680 --> 00:21:24,880
CONTROL OVER WHAT THEY CAN DO IN

661
00:21:24,880 --> 00:21:26,720
THEIR DECISION MAKING, A LACK OF

662
00:21:26,720 --> 00:21:29,400
INFLUENCE OVER SCHEDULING

663
00:21:29,400 --> 00:21:30,200
PATIENTS, INCONGRUOUS VALUES

664
00:21:30,200 --> 00:21:31,480
BETWEEN CLINICIANS AND

665
00:21:31,480 --> 00:21:32,120
HEALTHCARE ADMINISTRATORS MPLET

666
00:21:32,120 --> 00:21:34,520
BOTH BURN OUT AND DEPRESSION MAY

667
00:21:34,520 --> 00:21:38,880
LEAD TO REGULAR USE OF ALCOHOL

668
00:21:38,880 --> 00:21:40,760
OR OTHER SELF-MEDICATION, AND A

669
00:21:40,760 --> 00:21:41,840
STUDY FOUND THAT WOMEN

670
00:21:41,840 --> 00:21:43,440
EXPERIENCING BURN OUT ARE AT

671
00:21:43,440 --> 00:21:45,280
HIGHER RISK OF ALCOHOL

672
00:21:45,280 --> 00:21:47,000
COMSUMPTION THAN ARE MEN AS AN

673
00:21:47,000 --> 00:21:47,320
EXAMPLE.

674
00:21:47,320 --> 00:21:48,600
MANY FACTORS CONTRIBUTING TO

675
00:21:48,600 --> 00:21:49,880
BURN BURN OUT AMONG MEN AND

676
00:21:49,880 --> 00:21:53,520
WOMEN PHYSICIANS BY THE WAY ARE

677
00:21:53,520 --> 00:21:55,400
SIMILAR, PREVENTION AND

678
00:21:55,400 --> 00:21:58,040
INTERVENTION STRATEGIES AIMED AT

679
00:21:58,040 --> 00:21:59,120
MITIGATING THESE FACTORS SHOULD

680
00:21:59,120 --> 00:22:01,280
BENEFIT ALL, HOWEVER SOME

681
00:22:01,280 --> 00:22:03,640
EXTERNAL FACTORS DIFFERENTIALLY

682
00:22:03,640 --> 00:22:04,240
IMPACT.

683
00:22:04,240 --> 00:22:04,440
NEXT.

684
00:22:04,440 --> 00:22:06,240
THAT SAID, THE PANDEMIC HAS

685
00:22:06,240 --> 00:22:10,120
SINCE AFFECTED THE MENTAL HEALTH

686
00:22:10,120 --> 00:22:11,040
OF HEALTHCARE WORKERS NATIONWIDE

687
00:22:11,040 --> 00:22:12,560
WITH MORE THAN 50% RECORDING

688
00:22:12,560 --> 00:22:15,240
SYMPTOMS OF AT LEAST 1 MENTAL

689
00:22:15,240 --> 00:22:16,400
HEALTH CONDITION SUCH AS

690
00:22:16,400 --> 00:22:17,480
ANXIOUS, DEPRESSION AND

691
00:22:17,480 --> 00:22:19,280
INCREASED LEVEL OF PROAOF THE

692
00:22:19,280 --> 00:22:22,520
TRAUMATIC STRESS DISORDER, NEXT

693
00:22:22,520 --> 00:22:23,200
SLIDE.

694
00:22:23,200 --> 00:22:24,240
GIVEN THE CURRENT EVIDENCE BASE

695
00:22:24,240 --> 00:22:24,920
AND PHYSICIANS, IT IS DIFFICULT

696
00:22:24,920 --> 00:22:27,440
TO KNOW WHETHER THERE ARE REAL

697
00:22:27,440 --> 00:22:28,720
OR PERSISTENT GENDER RELATED

698
00:22:28,720 --> 00:22:30,000
DIFFERENCES IN THE RATES OF BURN

699
00:22:30,000 --> 00:22:31,680
OUT, THEY ARE NOT CONSISTENTLY

700
00:22:31,680 --> 00:22:33,440
ADDRESSED IN STUDIES OF

701
00:22:33,440 --> 00:22:35,720
PHYSICIAN BURN OUT, MOST STUDIES

702
00:22:35,720 --> 00:22:38,880
DO NOT ADDRESS GENDER IDENTITY

703
00:22:38,880 --> 00:22:40,720
OR SEXUAL ORIENTATION, FURTHER

704
00:22:40,720 --> 00:22:42,480
MORIT IS NOT CLEAR IF BURN OUT

705
00:22:42,480 --> 00:22:45,000
AND MORE CLEAR AMONG WOMEN OR IF

706
00:22:45,000 --> 00:22:46,120
GENDER BASED DIFFERENCES IN ITS

707
00:22:46,120 --> 00:22:48,400
EXPRESSION MAKE IT EASIER TO

708
00:22:48,400 --> 00:22:48,960
IDENTIFY AMONG WOMEN.

709
00:22:48,960 --> 00:22:51,600
SO EVEN IF WOMEN AND MEN REPORT

710
00:22:51,600 --> 00:22:56,160
THE SAME SOURCES ON QUANTITATED

711
00:22:56,160 --> 00:22:56,920
SURVEYS, THEIR QUALITATIVE

712
00:22:56,920 --> 00:22:58,760
EXPERIENCES OF BURN OUT MAY

713
00:22:58,760 --> 00:23:00,200
DIFFER.

714
00:23:00,200 --> 00:23:02,320
IN 1 STUDY BY [INDISCERNIBLE]

715
00:23:02,320 --> 00:23:04,440
AND COLLEAGUES WOMEN WERE MORE

716
00:23:04,440 --> 00:23:06,080
LIKELY TO IDENTIFY EMOTIONAL

717
00:23:06,080 --> 00:23:07,280
EXHAUSTIAN AS THEIR PRIMARY AREA

718
00:23:07,280 --> 00:23:09,000
OF BURN OUT WHEREAS MEN WERE

719
00:23:09,000 --> 00:23:10,520
MORE LIKELY TO DESCRIBE

720
00:23:10,520 --> 00:23:10,800
CYNICISM.

721
00:23:10,800 --> 00:23:13,480
BOTH MEN AND WOMEN REPORT THAT

722
00:23:13,480 --> 00:23:15,040
CHALLENGES AND WORK LIFE

723
00:23:15,040 --> 00:23:16,120
INTEGRATION CONTRIBUTE TO BURN

724
00:23:16,120 --> 00:23:17,960
OUT HOWEVER THEY DEFINE THIS

725
00:23:17,960 --> 00:23:18,320
DIFFERENTLY.

726
00:23:18,320 --> 00:23:19,720
JOLLY AND COLLEAGUES LOOK AT

727
00:23:19,720 --> 00:23:21,760
GENDER DIFFERENCES IN TIME SPENT

728
00:23:21,760 --> 00:23:23,760
ON PARENTING AND DOMESTIC

729
00:23:23,760 --> 00:23:25,240
RESPONSIBILITIES BY HIGH

730
00:23:25,240 --> 00:23:26,160
ACHIEVING YOUNG PHYSICIAN

731
00:23:26,160 --> 00:23:27,160
RESEARCHERS AND NOTE THAT WOMEN

732
00:23:27,160 --> 00:23:28,920
ARE MORE LIKELY THAN MEN TO HAVE

733
00:23:28,920 --> 00:23:32,040
PARTNERS WHO ARE EMPLOYED

734
00:23:32,040 --> 00:23:32,680
FULL-TIME.

735
00:23:32,680 --> 00:23:34,040
WOMEN EMPLOYED FULL-TIME SPENT

736
00:23:34,040 --> 00:23:35,800
AND AND HALF ADDITIONAL HOURS

737
00:23:35,800 --> 00:23:38,840
PER WEEK ON CHILD CHAIR AND

738
00:23:38,840 --> 00:23:39,960
OTHER DOMESTIC ACTIVITIES:  ON

739
00:23:39,960 --> 00:23:41,480
AVERAGE WOMEN WHO ARE EMPLOYED

740
00:23:41,480 --> 00:23:43,360
AND WHOSE PARTNERS ALSO WORK

741
00:23:43,360 --> 00:23:44,960
PERFORMANCE ARKSZ DITIONAL 2

742
00:23:44,960 --> 00:23:48,000
HOURS OF WORK AT HOME PERDAY AND

743
00:23:48,000 --> 00:23:49,400
INCREASE 3 TIMES HIGHER THAN

744
00:23:49,400 --> 00:23:51,160
THAT REPORTED BY MEN WHO PARTNER

745
00:23:51,160 --> 00:23:53,120
WORK, MEN IN THESE CIRCUMSTANCES

746
00:23:53,120 --> 00:23:54,200
NOTE THEIR DOMESTIC WORK

747
00:23:54,200 --> 00:23:56,120
INCREASE BY AN AVERAGE OF 40

748
00:23:56,120 --> 00:23:56,480
MINUTES.

749
00:23:56,480 --> 00:23:58,360
THE INTERSECTION OF BURN OUT AND

750
00:23:58,360 --> 00:24:01,600
GENDER AGE, RACE, ETHNICITY AND

751
00:24:01,600 --> 00:24:03,080
RELIGIONS LIMITED BY SURVEY SIZE

752
00:24:03,080 --> 00:24:04,040
RESPONSE RATES AND UNDER

753
00:24:04,040 --> 00:24:12,560
REPORTING AND THESE FOR SURE

754
00:24:12,560 --> 00:24:14,040
REQUIRE FURTHER INVESTIGATION.

755
00:24:14,040 --> 00:24:14,360
NEXT SLIDE.

756
00:24:14,360 --> 00:24:15,680
LET'S GET BACK TO THE DEFINITION

757
00:24:15,680 --> 00:24:17,000
OF SURN OUT, WITH WELL BEING ON

758
00:24:17,000 --> 00:24:18,480
THE LEFT AND STRESS?

759
00:24:18,480 --> 00:24:19,920
THE MIDDLE AND OCCUPATIONAL ON

760
00:24:19,920 --> 00:24:20,720
THE RIGHT.

761
00:24:20,720 --> 00:24:28,520
NEXT, YOU CAN GO NEXT, THERE WE

762
00:24:28,520 --> 00:24:28,720
GO.

763
00:24:28,720 --> 00:24:31,280
THE INVENTORY IN MEASURING BURN

764
00:24:31,280 --> 00:24:34,560
OUT DEFINES IT AS THE TRIAD OF

765
00:24:34,560 --> 00:24:36,760
EXHAUSTION, CYNICISM, FEELINGS

766
00:24:36,760 --> 00:24:37,640
OF DIMINISHED ACCOMPLISHMENT ON

767
00:24:37,640 --> 00:24:38,800
THE WORK ENVIRONMENT.

768
00:24:38,800 --> 00:24:40,960
OT LEFT SIDE YOU SEE WELL BEING

769
00:24:40,960 --> 00:24:43,400
AS DEFINED AGAIN, IS THAT

770
00:24:43,400 --> 00:24:44,920
PROFESSIONAL FULFILLMENT,

771
00:24:44,920 --> 00:24:45,480
SATISFACTION, ENGAGEMENT OR

772
00:24:45,480 --> 00:24:46,680
MOANING BUT THAT'S THE GENERAL

773
00:24:46,680 --> 00:24:48,040
IDEA, ALTHOUGH BURN OUT IS A

774
00:24:48,040 --> 00:24:49,240
SIGN OF CLINICAL STRESS AND A

775
00:24:49,240 --> 00:24:52,200
BARRIER TO WELL BEING, IT'S

776
00:24:52,200 --> 00:24:55,680
ABSENCE IS NOT CONFER A SAFE

777
00:24:55,680 --> 00:25:03,920
WELL BEING, IT'S  BURN OUT IS 1E

778
00:25:03,920 --> 00:25:04,400
MORE NOTABLE CONDITIONS.

779
00:25:04,400 --> 00:25:09,200
LET'S GO TO THE NEXT SLIDE.

780
00:25:09,200 --> 00:25:10,960
SO, IN THIS 2015 ARTICLE BY

781
00:25:10,960 --> 00:25:11,720
[INDISCERNIBLE] AND COLLEAGUES

782
00:25:11,720 --> 00:25:15,240
WE LOOK AT BURN OUT ALONG THE

783
00:25:15,240 --> 00:25:18,040
X-AND Y AXIS AND I WILL HAVE YOU

784
00:25:18,040 --> 00:25:20,120
HIT NEXT, RITA, THE X-AXIS IF

785
00:25:20,120 --> 00:25:22,640
YOU CAN HIT NEXT RITA IS SHOWING

786
00:25:22,640 --> 00:25:26,480
BURN OUT AND  SATISFACTION IS ON

787
00:25:26,480 --> 00:25:29,320
THE Y-AXIS WITH WORK LIFE

788
00:25:29,320 --> 00:25:32,880
INTEGRATION OF THE Y-AXIS, THIS

789
00:25:32,880 --> 00:25:34,520
SAY STUDY DONE IN 2014 BEFORE

790
00:25:34,520 --> 00:25:37,440
COVID, CAN YOU SEE THAT VARYING

791
00:25:37,440 --> 00:25:37,960
SPECIALTIES HAVE VERYYING

792
00:25:37,960 --> 00:25:39,320
REPORTS ON THE PERCENTAGES OF

793
00:25:39,320 --> 00:25:40,360
THOSE THAT ARE BURN OUT AND

794
00:25:40,360 --> 00:25:42,800
THOSE THAT ARE SATISFIED WITH

795
00:25:42,800 --> 00:25:44,520
THEIR WORK LIFE BALANCE.

796
00:25:44,520 --> 00:25:46,600
OCCUPATIONAL MEDICINE IS WAY UP

797
00:25:46,600 --> 00:25:49,640
THERE ON THE LEFT CORNER AND

798
00:25:49,640 --> 00:25:52,040
SAFETY DOG IT WELL, NEUROLOGIC

799
00:25:52,040 --> 00:25:54,280
SURGERIES HAVING A HARD TIME BUT

800
00:25:54,280 --> 00:25:57,280
THIS WAS 2014 DATA BEFORE COVID.

801
00:25:57,280 --> 00:25:59,880
SO THE TAKE HOME HERE IS THAT

802
00:25:59,880 --> 00:26:01,760
THERE ARE VARYING STRESSORS

803
00:26:01,760 --> 00:26:02,760
ACROSS SPECIALTIES, MAKING THE

804
00:26:02,760 --> 00:26:04,200
POINT THAT WHAT AILS DIFFERENT

805
00:26:04,200 --> 00:26:05,080
GROUPS ARE DIFFERENT AND THEY

806
00:26:05,080 --> 00:26:10,200
NEED TO BE MEASURED EFFECTIVELY

807
00:26:10,200 --> 00:26:12,160
AND THEY NEED TO BE INTERVENED

808
00:26:12,160 --> 00:26:13,360
DIFFERENTLY AND THAT'S TRUE FOR

809
00:26:13,360 --> 00:26:14,120
EACH GROUP.

810
00:26:14,120 --> 00:26:15,560
LET ME GO MORE DEEPLY INTO THIS

811
00:26:15,560 --> 00:26:16,520
WITH THE NEXT SLIDE.

812
00:26:16,520 --> 00:26:18,400
SO IN THE BOOK, STRATEGIES TO

813
00:26:18,400 --> 00:26:20,720
REDUCE BURN OUT MAKE THE POINT

814
00:26:20,720 --> 00:26:22,880
THAT STRESSORS IMPACT HEALTHCARE

815
00:26:22,880 --> 00:26:24,520
PROVIDERS AS I MENTIONED

816
00:26:24,520 --> 00:26:25,040
DIFFERENTIALLY, THE BLACK

817
00:26:25,040 --> 00:26:27,680
SECTION HERE IN THE CIRCLE

818
00:26:27,680 --> 00:26:28,880
IDENTIFIES STRESS POINTS IN THE

819
00:26:28,880 --> 00:26:31,240
SYSTEM SO FOR EXAMPLE, POORLY

820
00:26:31,240 --> 00:26:33,520
FUNCTIONING CARE TEAM AND POOR

821
00:26:33,520 --> 00:26:36,160
MANAGEMENT AND LEADERSHIP AND

822
00:26:36,160 --> 00:26:38,320
INCONGRUENT VALUES COMPLEX CAN

823
00:26:38,320 --> 00:26:39,840
IMPACT HEALTHCARE PROVIDERS

824
00:26:39,840 --> 00:26:40,320
DIFFERENTIALLY.

825
00:26:40,320 --> 00:26:43,280
NEXT, IF YOU LOOK AT THE OUTER

826
00:26:43,280 --> 00:26:46,920
PART OF THE CIRCLE HERE THEY

827
00:26:46,920 --> 00:26:48,640
HIGHLIGHT WHAT STRESSORS

828
00:26:48,640 --> 00:26:49,920
INFLUENCE PARTICULAR HEALTHCARE

829
00:26:49,920 --> 00:26:50,280
PROVIDERS.

830
00:26:50,280 --> 00:26:54,000
THAT IS BLUE REPRESENTS STRESSOR

831
00:26:54,000 --> 00:26:56,320
FORS PHYSICIANS LIKE MALPRACTICE

832
00:26:56,320 --> 00:26:58,640
SUITS AND EXCESSIVE WORK HOURS

833
00:26:58,640 --> 00:27:01,080
AND ACADEMIC PROMOTION AND THE

834
00:27:01,080 --> 00:27:03,400
PURPLE REPRESENTS STRESSORS MORE

835
00:27:03,400 --> 00:27:06,160
RELEVANT TO NURSES, LIKE

836
00:27:06,160 --> 00:27:06,600
INADEQUATE STAFFING,

837
00:27:06,600 --> 00:27:07,520
MISTREATMENT BY OTHERS ON THE

838
00:27:07,520 --> 00:27:08,560
CARE TEAM AND SO FORTH.

839
00:27:08,560 --> 00:27:11,520
IF WE GO IN THE NEXT SLIDE, IN

840
00:27:11,520 --> 00:27:13,400
THIS 2019 ARTICLE, THEY MAKE A

841
00:27:13,400 --> 00:27:16,440
POINT THAT 1 SIZE DOES NOT FIT

842
00:27:16,440 --> 00:27:16,760
ALL.

843
00:27:16,760 --> 00:27:19,760
IF YOU GO NEXT, AGAIN, IT'S

844
00:27:19,760 --> 00:27:21,600
BROKEN DOWN BY VARYING

845
00:27:21,600 --> 00:27:22,480
SPECIALTIES NOT JUST WITHIN

846
00:27:22,480 --> 00:27:24,000
MEDICINE BUT I WANT TO POINT

847
00:27:24,000 --> 00:27:26,600
WITH LITTLER DISCIPLINES CAN YOU

848
00:27:26,600 --> 00:27:31,440
SEE WITH THIS REGARD, ALLIED

849
00:27:31,440 --> 00:27:33,440
PROFESSIONALS, PRACTICE

850
00:27:33,440 --> 00:27:34,480
PROFESSIONALS, AND NONCLINICAL

851
00:27:34,480 --> 00:27:35,960
ALLIED STAFF, CAN YOU SEE THE

852
00:27:35,960 --> 00:27:39,920
VARYING SPECIFIC EXAMPLES THAT

853
00:27:39,920 --> 00:27:41,520
COME UP, AMBIGUITY AND LIMITED

854
00:27:41,520 --> 00:27:43,360
OPPORTUNITY FOR PROFESSIONAL

855
00:27:43,360 --> 00:27:45,320
DEVELOPMENT, SO DIFFERENT FOLKS

856
00:27:45,320 --> 00:27:47,240
HAVE DIFFERENT STRESSORS, NEXT

857
00:27:47,240 --> 00:27:47,440
SLIDE.

858
00:27:47,440 --> 00:27:48,920
LET ME MAKE AN ANALOGY THAT

859
00:27:48,920 --> 00:27:50,720
MIGHT BE MORE RELATABLE, SO

860
00:27:50,720 --> 00:27:53,040
HUNDREDS OF YEARS AGO,

861
00:27:53,040 --> 00:27:54,080
PHYSICIANS DESCRIBES FLUID

862
00:27:54,080 --> 00:27:54,600
ABNORMALITIES NORMALLY

863
00:27:54,600 --> 00:27:57,240
ACCUMULATING THROUGHOUT THE BODY

864
00:27:57,240 --> 00:28:00,280
AS DROP C WHICH IS NOW CALLED

865
00:28:00,280 --> 00:28:01,680
EDEMA, WHICH IS NOW AS A

866
00:28:01,680 --> 00:28:05,040
DIAGNOSE IS THAT IT CAN BE

867
00:28:05,040 --> 00:28:06,680
RELIABLE IDENTIFIED, THAT'S THE

868
00:28:06,680 --> 00:28:07,680
PITTING WHEN THERE'S EXTERNAL

869
00:28:07,680 --> 00:28:09,280
PRESSURE PLACED ON THE SKIN.

870
00:28:09,280 --> 00:28:12,040
THE PROBLEM THOUGH S&P THAT
IT'S

871
00:28:12,040 --> 00:28:14,360
NOT A DISEASE BUT RATHER A

872
00:28:14,360 --> 00:28:17,680
SYMPTOM WITH ANY NUMBER OF

873
00:28:17,680 --> 00:28:22,360
CAUSES, THE CAUSES COULD BE

874
00:28:22,360 --> 00:28:24,400
MOUNTAIN SICKNESS OR PROTEIN

875
00:28:24,400 --> 00:28:27,240
DEFICIENCY, AND THAT'S IMPORTANT

876
00:28:27,240 --> 00:28:32,520
BECAUSE DIFFERENT TREATMENTINGS

877
00:28:32,520 --> 00:28:34,040
REQUIRE DIFFERENT MECHANISMS.

878
00:28:34,040 --> 00:28:35,920
IT'S REALLY ANALOGOUS ON HOW WE

879
00:28:35,920 --> 00:28:37,000
SHOULD CONCEPTUALIZE BURN OUT.

880
00:28:37,000 --> 00:28:39,640
BURN OUT IS THE SYMPTOM OF

881
00:28:39,640 --> 00:28:42,080
ANOTHER UNDERLYING PROCESS.

882
00:28:42,080 --> 00:28:43,400
NEXT SLIDE.

883
00:28:43,400 --> 00:28:45,040
SO DR. LORNA GREEN HEROES FOWBD

884
00:28:45,040 --> 00:28:48,240
AIGDZ WHO JUST PARTNERED UP WITH

885
00:28:48,240 --> 00:28:49,120
INTERESTINGLY WITH THE SCHWARTZ

886
00:28:49,120 --> 00:28:51,480
FOUNDATION AND THAT'S AT GROUP

887
00:28:51,480 --> 00:28:52,120
FOR UNDERWRIEDING SCHWARTZ ROUND

888
00:28:52,120 --> 00:28:53,520
WHICH I KNOW SOME OF HAVE YOU

889
00:28:53,520 --> 00:28:54,760
COME FROM OTHER OUTSIDE

890
00:28:54,760 --> 00:28:57,160
INSTITUTIONS THAT HAVE THESE.

891
00:28:57,160 --> 00:28:58,640
THEY IDENTIFY TOP 5 ACTIONS TO

892
00:28:58,640 --> 00:28:59,760
SUPPORT CARE TEAMS WELL BEING,

893
00:28:59,760 --> 00:29:05,000
WHAT THEY CALL THE WELL BEING 5

894
00:29:05,000 --> 00:29:06,760
AND THAT'S START WITH NONNORMAL

895
00:29:06,760 --> 00:29:09,000
TIMES SO IT'S JUST YOUR

896
00:29:09,000 --> 00:29:09,840
EXPECTATION, DOCTORS, NURSES AND

897
00:29:09,840 --> 00:29:12,400
OTHERS ON THE CLINICAL CARE TEAM

898
00:29:12,400 --> 00:29:16,680
SPENT A HUGE AMOUNT OF TIME ON

899
00:29:16,680 --> 00:29:17,160
ADMINISTRATIVE FUNCTION.

900
00:29:17,160 --> 00:29:18,920
SO THEIR SECOND RECOMMENDATION

901
00:29:18,920 --> 00:29:22,280
IS GET RID OF STUPID STUFF, THIS

902
00:29:22,280 --> 00:29:24,840
BEGS THE PROBLEM OF REFRAMING

903
00:29:24,840 --> 00:29:27,480
QUESTIONS MAYBE WE DON'T HAVE A

904
00:29:27,480 --> 00:29:28,160
HEALTHCARE WORKFORCE SHORTAGE,

905
00:29:28,160 --> 00:29:29,800
MAYBE WE ARE WORKING ON THE

906
00:29:29,800 --> 00:29:30,520
WRONG THING?

907
00:29:30,520 --> 00:29:32,360
THE OTHER RECOMMEND

908
00:29:32,360 --> 00:29:33,520
ANTICIPATIONS INCLUDE GETTING

909
00:29:33,520 --> 00:29:35,400
RADICAL AND SHORE UP ON

910
00:29:35,400 --> 00:29:37,160
STAFFING, DESIGNATE A WELL BEING

911
00:29:37,160 --> 00:29:38,320
EXECUTIVE AND EMPLOYEE

912
00:29:38,320 --> 00:29:39,240
ASSISTANCE PROGRAMS ARE NOT

913
00:29:39,240 --> 00:29:42,360
ENOUGH, DO MORE AND THIS LAST

914
00:29:42,360 --> 00:29:43,560
RECOMMENDATION MEANS 2 THINGS,

915
00:29:43,560 --> 00:29:45,320
WE NEED MORE AND THE RIGHT KIND

916
00:29:45,320 --> 00:29:48,040
OF MENTAL HEALTH SUPPORT,

917
00:29:48,040 --> 00:29:50,080
INTHINKING ABOUT COMPLIMENTARY

918
00:29:50,080 --> 00:29:52,360
MODELS FOR MANAGING STRESS LIKE

919
00:29:52,360 --> 00:29:53,920
COACHING INTRODUCTIONS WHICH ARE

920
00:29:53,920 --> 00:29:55,200
BEING EFFECTIVELY USED AROUND

921
00:29:55,200 --> 00:29:59,520
THE COUNTRY FOR PHYSICIAN

922
00:29:59,520 --> 00:30:03,360
FACULTY AND TRAINEES AS A MEANS

923
00:30:03,360 --> 00:30:03,800
FOR FULFILLMENT.

924
00:30:03,800 --> 00:30:05,880
WE ALSO NEED TO MOVE AWAY FROM

925
00:30:05,880 --> 00:30:08,000
FRAMING THIS 1 AS ERNETAL DRIVES

926
00:30:08,000 --> 00:30:09,280
OF BURN OUT ONLY.

927
00:30:09,280 --> 00:30:12,400
LET ME EXPLAIN.

928
00:30:12,400 --> 00:30:14,160
REJILLIENCE AND SELF-CARE HAVE

929
00:30:14,160 --> 00:30:20,440
BECOME TRIGGERS TERMS BECAUSE WE

930
00:30:20,440 --> 00:30:21,640
RECOUNT THEM, LESSONS ON

931
00:30:21,640 --> 00:30:24,160
PSYCHOLOGY WELL BEING, LESSONS

932
00:30:24,160 --> 00:30:25,360
ON RESILIENCE OF DOCTORS, THE

933
00:30:25,360 --> 00:30:26,200
PROBLEM OF PHYSICIAN BURN OUT

934
00:30:26,200 --> 00:30:28,720
AND YOU CAN GO NEXT RITA, THE

935
00:30:28,720 --> 00:30:32,600
PROBLEM OF PHYSICIAN BURN OUT IS

936
00:30:32,600 --> 00:30:34,120
GENERALLY NOT ORIGINALLY

937
00:30:34,120 --> 00:30:34,680
DOCUMENTED.

938
00:30:34,680 --> 00:30:38,440
RITA CAN YOU HIT NEXT.

939
00:30:38,440 --> 00:30:40,520
THERE WE GO, SO THE PROBLEM OF

940
00:30:40,520 --> 00:30:43,280
PHYSICIAN BURN OUT IS GENERALLY

941
00:30:43,280 --> 00:30:44,600
NOT A RESILIENT SYSTEM.

942
00:30:44,600 --> 00:30:47,000
AND BY THE WAY ON A DIFFERENT

943
00:30:47,000 --> 00:30:47,920
BUT RELATED NOTE, 1 OF THE

944
00:30:47,920 --> 00:30:49,240
REALLY IMPORTANT TAKE HOMES WE

945
00:30:49,240 --> 00:30:50,600
HEARD AT THE NRIERKS H OVER THE

946
00:30:50,600 --> 00:30:53,680
LAST SEVERAL YEARS IS THAT

947
00:30:53,680 --> 00:30:54,720
LEADERS PARTICULARLY PHYSICIAN

948
00:30:54,720 --> 00:30:56,520
LEADERS NEED TO MODEL

949
00:30:56,520 --> 00:30:57,120
VULNERABILITY BETTER INCLUDING

950
00:30:57,120 --> 00:30:59,640
THAT YOU DON'T HAVE TO BE

951
00:30:59,640 --> 00:31:02,360
RESILIENT 24/7 AND DR. GILMAN

952
00:31:02,360 --> 00:31:05,520
WAS AT THE HELM OF THAT WHEN HE

953
00:31:05,520 --> 00:31:08,480
SENT E-MAILS STARTING EARLY ON

954
00:31:08,480 --> 00:31:09,880
IN THE PANDEMIC THAT HELP SEEK

955
00:31:09,880 --> 00:31:11,960
SUGGEST A SIGN OF STRENGTH WHICH

956
00:31:11,960 --> 00:31:12,840
IS AN IMPORTANT MESSAGE.

957
00:31:12,840 --> 00:31:15,160
BURN OUT IS NOT A PROBLEM WHO

958
00:31:15,160 --> 00:31:24,200
DRIVERS LISTED SOLELY WITHIN THE

959
00:31:24,200 --> 00:31:25,760
CLINICIANS CHARACTERISTICS.

960
00:31:25,760 --> 00:31:28,120
PEOPLE ARE GREATER ON PHYSICIANS

961
00:31:28,120 --> 00:31:28,880
ON ADDRESSING CHARACTERISTICS

962
00:31:28,880 --> 00:31:30,520
WITH OF FACTORS AND EXTERNAL

963
00:31:30,520 --> 00:31:31,280
ENVIRONMENTS THAT CONTRIBUTE TO

964
00:31:31,280 --> 00:31:32,800
BURN OUT.  THIS IS HIGHLIGHTED

965
00:31:32,800 --> 00:31:34,920
FURTHER IN THE NATIONAL

966
00:31:34,920 --> 00:31:37,400
ACADEMY'S FRAMEWORK, A SYSTEMS

967
00:31:37,400 --> 00:31:39,840
MODEL OF CLINICIANAL WELL BEING.

968
00:31:39,840 --> 00:31:40,920
GO TO THE NEXT SLIDE.

969
00:31:40,920 --> 00:31:42,680
THIS IS A BUSY SLIDE SO YOU

970
00:31:42,680 --> 00:31:47,920
DON'T HAVE TO FOCUS ON THE

971
00:31:47,920 --> 00:31:48,720
DETAILS HERE.

972
00:31:48,720 --> 00:31:51,040
I'M GOING TO POINT OUT A FEW

973
00:31:51,040 --> 00:31:53,120
THINGS, THE NATIONAL ACADEMY

974
00:31:53,120 --> 00:31:54,640
COLLABORATATIVE IN TBENT FLEEN,

975
00:31:54,640 --> 00:31:56,200
SYSTEMS MODEL WHICH INCLUDED

976
00:31:56,200 --> 00:31:56,840
SYSTEMS ENGINEERING WHO WANTED

977
00:31:56,840 --> 00:31:58,640
TO POINT OUT HOW WORK SYSTEM

978
00:31:58,640 --> 00:32:02,240
FACTORS PLAY A MAJOR ROLE IN

979
00:32:02,240 --> 00:32:03,240
CLINICIAN BURN OUT.

980
00:32:03,240 --> 00:32:05,080
AND THOSE THAT IF YOU GO NEXT,

981
00:32:05,080 --> 00:32:07,160
RITA THIS IS WHAT I WANT TO

982
00:32:07,160 --> 00:32:08,880
FOCUS ON, THOSE ARE DISTINCT

983
00:32:08,880 --> 00:32:11,320
FROM THE INTERNAL MEDIATING

984
00:32:11,320 --> 00:32:13,000
INDIVIDUAL MEDIATING FACTORS,

985
00:32:13,000 --> 00:32:13,200
OKAY?

986
00:32:13,200 --> 00:32:16,960
RESEARCH SUGGESTS THAT FOR

987
00:32:16,960 --> 00:32:18,080
PHYSICIANS, EXTERBAL FACTORS

988
00:32:18,080 --> 00:32:19,680
CARRY MORE WEIGHT TO CONTRIBUTE

989
00:32:19,680 --> 00:32:22,840
TO BURN OUT THAN INTERNAL

990
00:32:22,840 --> 00:32:23,960
FACTORS.

991
00:32:23,960 --> 00:32:26,040
AGAIN, WHAT'S BROKEN?

992
00:32:26,040 --> 00:32:26,760
THE SYSTEM.

993
00:32:26,760 --> 00:32:29,200
AGAIN THEY'VE FOCUSED ON

994
00:32:29,200 --> 00:32:30,880
INDIVIDUAL MEDIATING FACTORS

995
00:32:30,880 --> 00:32:32,800
LIKE WORK, YOGA, MINDFULNESS

996
00:32:32,800 --> 00:32:33,640
PRACTICE AND REALLY IMPORTANT

997
00:32:33,640 --> 00:32:36,680
PROGRAMS LIKE PEER TO PEER

998
00:32:36,680 --> 00:32:37,400
INTERVENTIONS.

999
00:32:37,400 --> 00:32:38,920
AND DON'T GETNY WRONG, EACH THE

1000
00:32:38,920 --> 00:32:40,800
BEST EMPLOYEES ARE GOALS ARE TO

1001
00:32:40,800 --> 00:32:44,200
SUPPORT THEM AND RECOGNIZE THE

1002
00:32:44,200 --> 00:32:45,160
EMOTIONAL TOLL OF THE WORK AND

1003
00:32:45,160 --> 00:32:46,480
OFFER WAYS TO HELP AND THAT'S

1004
00:32:46,480 --> 00:32:49,120
BEEN GOOD AT RAMPING UP AND

1005
00:32:49,120 --> 00:32:50,440
HIGHLIGHTING ON HOW THESE THEMES

1006
00:32:50,440 --> 00:32:51,640
IMPACT BURN OUT BUT THESE ARE

1007
00:32:51,640 --> 00:32:51,960
NOT ENOUGH.

1008
00:32:51,960 --> 00:32:56,840
GO TO THE NEXT SLIDE.

1009
00:32:56,840 --> 00:32:58,600
SO THERE ARE 7 MAIN DRIVERS AND

1010
00:32:58,600 --> 00:33:00,440
OF BURN OUT DRIVEN BY THE

1011
00:33:00,440 --> 00:33:02,240
LITERATURE, EACH DRIVEN BY

1012
00:33:02,240 --> 00:33:05,520
NATIONAL ORGANIZATION AND THESE

1013
00:33:05,520 --> 00:33:07,640
INCLUDE WORK LOADS,

1014
00:33:07,640 --> 00:33:09,480
EFFICIENCIES, FLEXIBILITY AND

1015
00:33:09,480 --> 00:33:10,840
CONTROL, WORK LIFE INTEGRATION,

1016
00:33:10,840 --> 00:33:13,040
COMMUNITY AT WORK AND MEANING AT

1017
00:33:13,040 --> 00:33:13,640
WORK.

1018
00:33:13,640 --> 00:33:13,840
NEXT.

1019
00:33:13,840 --> 00:33:17,480
AND WE NEED TO LOOK AT BOTH

1020
00:33:17,480 --> 00:33:18,720
INTERNAL FACTORS LIKE ANXIOUS

1021
00:33:18,720 --> 00:33:20,320
WITHOUT COMPETENCY AND LOSS OF

1022
00:33:20,320 --> 00:33:21,200
POSITIVE CONNECTION IN THE

1023
00:33:21,200 --> 00:33:22,840
WORKPLACE AND SO FORTH, BUT

1024
00:33:22,840 --> 00:33:25,640
NEXT, WE ALSO NEED TO LOOK AT

1025
00:33:25,640 --> 00:33:28,720
THE EXTERNAL FACTORS, THINGS

1026
00:33:28,720 --> 00:33:31,800
LIKE EMRs, ADMINISTRATIVE

1027
00:33:31,800 --> 00:33:32,440
INEFFICIENCIES, UNREALISTIC WORK

1028
00:33:32,440 --> 00:33:33,880
LOADS AND SO FORTH.

1029
00:33:33,880 --> 00:33:34,360
NEXT.

1030
00:33:34,360 --> 00:33:37,400
I COMPLETED A REALLY WONDERFUL

1031
00:33:37,400 --> 00:33:39,560
STANFORD MD-Ph.D. WELL BEING

1032
00:33:39,560 --> 00:33:42,280
DIRECTORS COURSE LAST FALL,

1033
00:33:42,280 --> 00:33:45,280
THERE MOTTO FOR PROFESSIONAL

1034
00:33:45,280 --> 00:33:46,800
FULFILLMENT IS REALLY AMAZING

1035
00:33:46,800 --> 00:33:49,960
AND THAT'S 3 DOMAINS, CULTURE OF

1036
00:33:49,960 --> 00:33:52,560
WELLNESS,ENTIOUS FICIENCY AND OF

1037
00:33:52,560 --> 00:33:53,880
PRACTICE AND PERSONAL

1038
00:33:53,880 --> 00:33:55,760
RESILIENCE, 2/3RDS IN RED AND

1039
00:33:55,760 --> 00:33:58,360
ONE-THIRD IN BLUE, THAT'S

1040
00:33:58,360 --> 00:34:00,080
PURPOSEFUL, THE EMPHASIZE THE

1041
00:34:00,080 --> 00:34:03,600
NEED TO FOCUS NOT ONLY ON

1042
00:34:03,600 --> 00:34:04,840
PERSONAL RESILIENCE BUT EXTERNAL

1043
00:34:04,840 --> 00:34:05,080
DRIVERS.

1044
00:34:05,080 --> 00:34:06,680
SO I WANT TO DEFINE THESE

1045
00:34:06,680 --> 00:34:07,600
DOMAINS FURTHER AND HIGHLIGHT

1046
00:34:07,600 --> 00:34:09,840
THE EFFORTS AT THE NIH THAT HAVE

1047
00:34:09,840 --> 00:34:10,680
KNOW IMPLEMENTED HERE, MOSTLY BY

1048
00:34:10,680 --> 00:34:13,080
THE CLINICAL CENTER AND THE

1049
00:34:13,080 --> 00:34:15,480
GRADUATE MEDICAL EDUCATION AND

1050
00:34:15,480 --> 00:34:17,000
BY MANY OTHERS IN THIS SPACE WHO

1051
00:34:17,000 --> 00:34:18,280
HAVE BEEN HARD AT WORK.

1052
00:34:18,280 --> 00:34:20,080
SO THE CULTURE OF WELLNESS IS

1053
00:34:20,080 --> 00:34:21,720
THE DIMENSION THAT DESCRIBES THE

1054
00:34:21,720 --> 00:34:22,880
ORGANIZATIONAL WORK ENVIRONMENT

1055
00:34:22,880 --> 00:34:25,440
AND VALUE AND BEHAVIORS THAT

1056
00:34:25,440 --> 00:34:28,160
MODELED TO PROMOTE SELF-CARE,

1057
00:34:28,160 --> 00:34:30,400
PERSONAL AND PROFESSIONAL GROWTH

1058
00:34:30,400 --> 00:34:32,000
AND COMPASSION, AND LEADERSHIP

1059
00:34:32,000 --> 00:34:33,160
ALIGNMENT AND VOICE OF INPUT, IF

1060
00:34:33,160 --> 00:34:34,480
YOU GO TO NEXT, I WANT TO POINT

1061
00:34:34,480 --> 00:34:36,480
OUT THIS IS A SHORT LIST AND NOT

1062
00:34:36,480 --> 00:34:37,800
INCLUDES THISEM BUT THESE ARE

1063
00:34:37,800 --> 00:34:39,480
EXAMPLES THAT NIH TERMS OF THE

1064
00:34:39,480 --> 00:34:41,000
KULTDURE OF WELLNESS, INCLUDE

1065
00:34:41,000 --> 00:34:42,040
THE STAFF SUPPORT TELEPHONE LINE

1066
00:34:42,040 --> 00:34:43,800
THAT WE'VE HAD TWICE, DOCK SIDE

1067
00:34:43,800 --> 00:34:45,200
WHICH HAD A GROUP I WILL TELL

1068
00:34:45,200 --> 00:34:50,320
YOU ABOUT FOR FELLOWS, PEER TO

1069
00:34:50,320 --> 00:34:51,720
PEER, CODE LAVENDAR AND THOSE

1070
00:34:51,720 --> 00:34:53,120
COME FROM THE PATIENT SAFETY AND

1071
00:34:53,120 --> 00:34:55,560
QUALITY HERE AS WELL AS NURSING,

1072
00:34:55,560 --> 00:34:57,000
FROM BEREAVEMENT GROUPS THAT ARE

1073
00:34:57,000 --> 00:34:58,920
RUN OUT OF THE SPIR YIT

1074
00:34:58,920 --> 00:34:59,960
ULTIMATELY MINISTRY AND

1075
00:34:59,960 --> 00:35:02,160
HOSPITALITY OF MEDICINE, WE'VE

1076
00:35:02,160 --> 00:35:03,440
GOT WELLNESS AMBASSADORS AT THE

1077
00:35:03,440 --> 00:35:05,880
IC LEVEL AND OF COURSE HELP SEEK

1078
00:35:05,880 --> 00:35:07,640
SUGGEST A SIGN OF STRENGTH OUT

1079
00:35:07,640 --> 00:35:09,880
OF DR. GILMAN'S NEXT.

1080
00:35:09,880 --> 00:35:11,280
NEXT, EFFICIENT OF PRACTICE AS I

1081
00:35:11,280 --> 00:35:12,760
MENTIONED DEPENDS ON WORKPLACE

1082
00:35:12,760 --> 00:35:13,960
SYSTEMS AND PROPHECIES AND

1083
00:35:13,960 --> 00:35:15,240
PRACTICE, AND PRACTICES THAT

1084
00:35:15,240 --> 00:35:17,520
PROMOTE SAFETY, QUALITY AND

1085
00:35:17,520 --> 00:35:18,600
EFFECTIVENESS, EXAMPLES INCLUDE

1086
00:35:18,600 --> 00:35:20,000
SCHEDULES AND WORK FLOW IN OUR

1087
00:35:20,000 --> 00:35:23,000
ENVIRONMENT, IF YOU HIT NEXT,

1088
00:35:23,000 --> 00:35:24,400
DR. --JOHN AND COLLEAGUES AT

1089
00:35:24,400 --> 00:35:26,760
CCRI HAVE DONE A REALLY NICE JOB

1090
00:35:26,760 --> 00:35:34,160
ROLLING OUT NEW FEATURES IN THIS

1091
00:35:34,160 --> 00:35:36,000
THE EDITORS, CRSP, ET CETERA AND

1092
00:35:36,000 --> 00:35:37,680
THESE ARE AGAIN A SHORT LIST OF

1093
00:35:37,680 --> 00:35:39,920
EXAMPLES AT THE NIH AND FINALLY

1094
00:35:39,920 --> 00:35:41,640
NEXT, RETIRED ATHE PERSONAL

1095
00:35:41,640 --> 00:35:42,600
RESILIENCE DOMAIN WHICH REFERS

1096
00:35:42,600 --> 00:35:46,400
TO THE INDIVIDUAL SKILLS AND

1097
00:35:46,400 --> 00:35:48,120
BEHAVIORS AND ATTITUDES THAT

1098
00:35:48,120 --> 00:35:49,840
CONTRIBUTE TO PHYSICAL, ERKSZ

1099
00:35:49,840 --> 00:35:50,480
MOTIONAL AND PERSONAL WELL

1100
00:35:50,480 --> 00:35:51,560
BEING, IF YOU GO TO NEXT, THERE

1101
00:35:51,560 --> 00:35:54,120
ARE A LOT OF PEOPLE THAT ARE

1102
00:35:54,120 --> 00:35:56,000
WORKING AND HAVE PROGRAMS ON THE

1103
00:35:56,000 --> 00:35:59,520
SAME GME SIDE, WE HAVE BUDDY

1104
00:35:59,520 --> 00:36:01,720
PROGRAMS, INTRAMURAL COURSE

1105
00:36:01,720 --> 00:36:03,480
OFFERINGS, DR. SHARON HAS A TON

1106
00:36:03,480 --> 00:36:05,280
OF OFFERINGS ON THE OFFICE OF

1107
00:36:05,280 --> 00:36:08,160
INTRAMURAL AND EDUCATION ON THE

1108
00:36:08,160 --> 00:36:09,760
ORS, AND EMPLOYEE ASSISTANCE

1109
00:36:09,760 --> 00:36:13,120
PROGRAM HAS PROGRAMS, ET CETERA.

1110
00:36:13,120 --> 00:36:13,400
NEXT SLIDE.

1111
00:36:13,400 --> 00:36:16,200
SO I WANT TO SHIFT HERE NOW AND

1112
00:36:16,200 --> 00:36:17,600
FOCUS ON THIS QUALITY

1113
00:36:17,600 --> 00:36:18,800
IMPROVEMENT PROJECT AS WE

1114
00:36:18,800 --> 00:36:20,240
UNDERTOOK ON OUR SUBCOMMITTEE OF

1115
00:36:20,240 --> 00:36:22,720
WELLNESS, IT'S BEEN A LONG

1116
00:36:22,720 --> 00:36:24,960
UNWINDING ROAD AND A PLEASURE TO

1117
00:36:24,960 --> 00:36:27,600
PARTICIPATE ON, DR. BOB WAS AT

1118
00:36:27,600 --> 00:36:28,880
THE HELM EMPHASIZING THE NEED TO

1119
00:36:28,880 --> 00:36:30,880
ACT AND DR. JENNIFER CHANG WHOO

1120
00:36:30,880 --> 00:36:32,200
IS THE CHAIR OF THIS COMMITTEE

1121
00:36:32,200 --> 00:36:35,640
HAS BEEN A WONDERFUL PARTNER AS

1122
00:36:35,640 --> 00:36:38,440
WELL AS DR. LIPSCLRKS ITZ TO DO

1123
00:36:38,440 --> 00:36:39,320
THE WORK AS WELL.

1124
00:36:39,320 --> 00:36:40,440
LET'S GO TO THE NEXT SLIDE.

1125
00:36:40,440 --> 00:36:49,320
I HAVE TO THANK MY COLLEAGUE

1126
00:36:49,320 --> 00:36:51,040
DR. HOROWITZ, DON'T LET

1127
00:36:51,040 --> 00:36:52,120
STRESSORS BE THE ENEMY OF THE

1128
00:36:52,120 --> 00:36:52,560
GOOD.

1129
00:36:52,560 --> 00:36:55,160
SO WE'VE TAKEN THIS AS AN

1130
00:36:55,160 --> 00:36:56,240
UNDERLYING ON MOTTO BUT THIS IS

1131
00:36:56,240 --> 00:36:59,120
A TIMELINE THAT I WILL ROLL IN,

1132
00:36:59,120 --> 00:37:01,560
THERE RITA IF YOU CAN GO NEXT,

1133
00:37:01,560 --> 00:37:04,600
IN 2017 THEY PUBLISHED THE

1134
00:37:04,600 --> 00:37:06,360
REQUIREMENT, NEXT, IN 2018,

1135
00:37:06,360 --> 00:37:08,200
CLEAR VISITSA THE CLINICAL

1136
00:37:08,200 --> 00:37:10,120
CENTER FOR THE FIRST TIME, NEXT

1137
00:37:10,120 --> 00:37:11,880
IN 2019 THE GRADUATE MEDICAL

1138
00:37:11,880 --> 00:37:14,080
EDUCATION SUBCOMMITTEE ON

1139
00:37:14,080 --> 00:37:15,520
WELLNESS WAS ESTABLISHED, AND WE

1140
00:37:15,520 --> 00:37:17,760
TRY TO ENGAGE STAKEHOLDERS AND

1141
00:37:17,760 --> 00:37:19,560
CHAMPIONS, AND STARTED THIS QIP

1142
00:37:19,560 --> 00:37:24,760
IN 2020, YOU SEE WE INITIATED A

1143
00:37:24,760 --> 00:37:26,600
SURVEY AND IN 2021 NEXT, NEXT

1144
00:37:26,600 --> 00:37:27,800
THE CLEAR CAME BACK TO VISIT US

1145
00:37:27,800 --> 00:37:31,440
AGAIN AND WE ROLLED OUT SURVEY

1146
00:37:31,440 --> 00:37:32,200
NUMBER 2.0.

1147
00:37:32,200 --> 00:37:32,640
NEXT SLIDE.

1148
00:37:32,640 --> 00:37:34,960
I WANT TO START WITH AND LET YOU

1149
00:37:34,960 --> 00:37:37,920
KNOW THAT WE LOOKED AT FELLOW

1150
00:37:37,920 --> 00:37:40,120
SURVEYS, THE ACGME HAS WELL

1151
00:37:40,120 --> 00:37:41,080
BEING QUESTIONS BAKED IN SO WE

1152
00:37:41,080 --> 00:37:44,200
CAN GET A PULSE ON HOW RESIDENTS

1153
00:37:44,200 --> 00:37:45,120
AND FACULTY WERE DOING AT THE

1154
00:37:45,120 --> 00:37:47,200
START OF THIS PROJECT.

1155
00:37:47,200 --> 00:37:47,440
NEXT.

1156
00:37:47,440 --> 00:37:49,000
OUR FIRST STEP AGAIN WAS TO

1157
00:37:49,000 --> 00:37:49,960
FIGURE OUT MEASUREMENTS, WHAT

1158
00:37:49,960 --> 00:37:51,960
TOOLS YOU CAN GO NEXT THERE

1159
00:37:51,960 --> 00:37:53,160
RITA, WHAT TOOLS WE WERE GOING

1160
00:37:53,160 --> 00:37:55,160
TO NEED, WE WANT TO PICK

1161
00:37:55,160 --> 00:37:56,200
VALIDATED TOOLS, WE CAN MEASURE

1162
00:37:56,200 --> 00:37:58,040
THE PROBLEM TO GET THE ACCURATE

1163
00:37:58,040 --> 00:38:00,360
READ AND THERE ARE MANY TOOLS AS

1164
00:38:00,360 --> 00:38:06,600
YOU CAN SEE IDENTIFIED HERE IN

1165
00:38:06,600 --> 00:38:07,280
THE ARLBY [INDISCERNIBLE], WE

1166
00:38:07,280 --> 00:38:09,520
WANT TO GET AN APPROACH FOR

1167
00:38:09,520 --> 00:38:12,560
WHERE WE HAVE A MINNAL BURDEN

1168
00:38:12,560 --> 00:38:13,600
AND SOMETHING THAT'S ACTIONABLE

1169
00:38:13,600 --> 00:38:15,080
AND WE HEARD LOUD AND CLEAR THAT

1170
00:38:15,080 --> 00:38:17,400
FOLKS DID NOT WANT TO DEAL WITH

1171
00:38:17,400 --> 00:38:21,040
LONG SURVEYS AND MASLOW'S BURN

1172
00:38:21,040 --> 00:38:23,160
OUT WAS IESHES DENTIFIED AS WAY

1173
00:38:23,160 --> 00:38:25,200
TOO LONG AND BURDENSOME, SO IF

1174
00:38:25,200 --> 00:38:27,120
YOU GO AND NEXT AGAIN, PHYSICIAN

1175
00:38:27,120 --> 00:38:29,360
WORK LIFE SURVEY WHICH IS THE

1176
00:38:29,360 --> 00:38:32,320
MINIZ AND A 1 ITEM AND SIMPLE TO

1177
00:38:32,320 --> 00:38:33,840
ANALYZE TOOL AND WAS FREE WHICH

1178
00:38:33,840 --> 00:38:36,600
WAS GOOD BECAUSE WE DIDN'T HAVE

1179
00:38:36,600 --> 00:38:37,440
ANY FUNDING, NEXT.

1180
00:38:37,440 --> 00:38:39,760
WHAT IS THAT QUESTION, WELL HERE

1181
00:38:39,760 --> 00:38:41,400
IT IS:  OVER ALL BASED ON YOUR

1182
00:38:41,400 --> 00:38:42,800
LEVEL OF BURN OUT HOW WOULD YOU

1183
00:38:42,800 --> 00:38:44,560
RATE YOUR LEVEL OF BURN OUT SO

1184
00:38:44,560 --> 00:38:45,960
THIS IS I 5-POINT SCALE.

1185
00:38:45,960 --> 00:38:48,640
NO SYMPTOMS TO HAVE I HAVE A

1186
00:38:48,640 --> 00:38:48,800
LOT.

1187
00:38:48,800 --> 00:38:51,800
NEXT SLIDE SMGHT AGAIN, WE

1188
00:38:51,800 --> 00:38:52,480
MENTIONED IDENTIFYING DRIVES

1189
00:38:52,480 --> 00:38:53,720
FROM THE BURN OUT LITERATURE AND

1190
00:38:53,720 --> 00:38:55,480
THESE ARE THE DRIVERS I SHOWED

1191
00:38:55,480 --> 00:38:57,600
YOU EARLIER, WE ADDED

1192
00:38:57,600 --> 00:38:58,280
PROFESSIONAL DEVELOPMENT BECAUSE

1193
00:38:58,280 --> 00:38:59,200
WE THOUGHT THAT WAS IMPORTANT IN

1194
00:38:59,200 --> 00:39:01,440
THE SETTINGS AND IN OUR FEEDBACK

1195
00:39:01,440 --> 00:39:03,200
AFTER THE FIRST, THE SURVEY THAT

1196
00:39:03,200 --> 00:39:06,120
WENT OUT FOR 2 PBT 0, WE ADDED

1197
00:39:06,120 --> 00:39:07,080
DIVERSITY, EQUITY AND INCLUSION,

1198
00:39:07,080 --> 00:39:08,480
THIS IS AN IMPORTANT AREA AS

1199
00:39:08,480 --> 00:39:19,040
WELL AS OTHER FOR FEEDBACK GOING

1200
00:39:19,040 --> 00:39:19,480
FORWARD, NEXT SLIDE.

1201
00:39:19,480 --> 00:39:21,280
AND I WANT TO LET YOU KNOW THAT

1202
00:39:21,280 --> 00:39:22,680
WE TAKE THESE CATEGORIES AND

1203
00:39:22,680 --> 00:39:23,520
GIVE EXAMPLES THAT ARE SPECIFIC

1204
00:39:23,520 --> 00:39:24,920
IN OUR SETTINGS SO YOU WILL SEE

1205
00:39:24,920 --> 00:39:28,040
THIS IS WHAT OUR FELLOW SOFTWARE

1206
00:39:28,040 --> 00:39:30,240
SUPPORT TAKE, TAKE A READ ON

1207
00:39:30,240 --> 00:39:32,160
INCLUDING PRESSURES THAT YOU CAN

1208
00:39:32,160 --> 00:39:33,120
SEE AS AN EXAMPLE.

1209
00:39:33,120 --> 00:39:34,560
SO GO TO THE NEXT SLIDE SO WHAT

1210
00:39:34,560 --> 00:39:36,120
DID THE SURVEY LOOK LIKE WHEN

1211
00:39:36,120 --> 00:39:37,720
THEY WENT OUT, WELL THEY WENT

1212
00:39:37,720 --> 00:39:41,080
OUT TO THE ELECTRONIC PLATFORM,

1213
00:39:41,080 --> 00:39:42,880
LINE OF QUESTIONS, THAT BURN OUT

1214
00:39:42,880 --> 00:39:49,520
QUESTION AND THEN IDENTIFYING

1215
00:39:49,520 --> 00:39:51,160
THE TOP DRIVERS OF BURN OUT.

1216
00:39:51,160 --> 00:39:51,480
NEXT SLIDE.

1217
00:39:51,480 --> 00:39:54,680
SO IN TERMS OF THE PROJECT, IT

1218
00:39:54,680 --> 00:39:56,680
WAS A SIMPLE DESIGN, CREATED 2

1219
00:39:56,680 --> 00:39:58,400
QUESTION SURVEY TOOLS AND THEN

1220
00:39:58,400 --> 00:39:59,720
TALK WITH PRESENTLY DIRECTORS

1221
00:39:59,720 --> 00:40:01,000
ABOUT HOW TO ADMINISTER THE

1222
00:40:01,000 --> 00:40:02,880
TOOL, HOW OFTEN AND 1 OR 2 TIMES

1223
00:40:02,880 --> 00:40:04,560
A YEAR AND WHEN TO MEET WITH

1224
00:40:04,560 --> 00:40:06,360
TRAINEES AND WHY INCLUDING

1225
00:40:06,360 --> 00:40:07,360
NORMALIZING THE CONVERSATION,

1226
00:40:07,360 --> 00:40:09,400
OFFERING A FRAMEWORK IN A MODEL

1227
00:40:09,400 --> 00:40:12,720
AND DISCUSSING TOP DRIVERS SO

1228
00:40:12,720 --> 00:40:13,840
THAT, INTERVENTIONS COULD BE

1229
00:40:13,840 --> 00:40:15,120
SPECIFICALLY TARGETED TO THE

1230
00:40:15,120 --> 00:40:16,520
INDIVIDUAL TRAINEES COMING TO

1231
00:40:16,520 --> 00:40:18,640
THEIR OFFICES, SO OBVIOUSLY IT'S

1232
00:40:18,640 --> 00:40:20,840
NOT ANONYMOUS, WE DID THIS SO WE

1233
00:40:20,840 --> 00:40:22,080
COULD INTERVENE AT THE

1234
00:40:22,080 --> 00:40:23,880
INDIVIDUAL LEVEL NEXT SLIDE.

1235
00:40:23,880 --> 00:40:26,120
IN ADDITION WE CREATED AN

1236
00:40:26,120 --> 00:40:27,520
ALGORITHM AND CAN YOU GO NEXT,

1237
00:40:27,520 --> 00:40:29,080
FOR ACTIONS SO THAT ALL PROGRAMS

1238
00:40:29,080 --> 00:40:31,120
ACROSS THE BOARD WOULD HAVE

1239
00:40:31,120 --> 00:40:33,600
CONSISTENCY ABOUT HOW THEY

1240
00:40:33,600 --> 00:40:34,720
MANAGED THE DRIVERS OF BURN OUT

1241
00:40:34,720 --> 00:40:37,000
AND THE IMPACT THEY SEE, NO

1242
00:40:37,000 --> 00:40:39,760
INTERVENTION ON THE GREEN,

1243
00:40:39,760 --> 00:40:40,840
SCHEDULE FREQUENT CHECK-IN

1244
00:40:40,840 --> 00:40:42,440
SESSIONS, AND SO FORTH, CAN YOU

1245
00:40:42,440 --> 00:40:44,320
GO NEXT AND NEXT THERE, RITA.

1246
00:40:44,320 --> 00:40:48,760
SO THAT WHEN WE GOOT, IF THERE

1247
00:40:48,760 --> 00:40:49,840
WAS SOMEONE THEY WERE CONCERNED

1248
00:40:49,840 --> 00:40:52,160
ABOUT THEY COULD GET A CRITICAL

1249
00:40:52,160 --> 00:40:54,800
VALUE SEBT TO THEM IMMEDIATELY

1250
00:40:54,800 --> 00:40:56,280
AND YOU CAN ACT AS NEEDED.

1251
00:40:56,280 --> 00:40:58,080
SO OVER ALL WHRA ARE THE

1252
00:40:58,080 --> 00:40:58,320
RESULTS?

1253
00:40:58,320 --> 00:41:01,040
WELL OVER ALL WE HAD ABOUT 10

1254
00:41:01,040 --> 00:41:01,960
PROGRAMS, 10 PROGRAMS

1255
00:41:01,960 --> 00:41:03,320
PARTICIPATED IN OUR INITIATIVE

1256
00:41:03,320 --> 00:41:07,080
IN YEAR 1, THAT'S IN 2020, AND

1257
00:41:07,080 --> 00:41:09,560
2021 AND 9 ADDITIONAL PROGRAMS

1258
00:41:09,560 --> 00:41:11,360
JOINED FOR THE SECOND YEAR SO WE

1259
00:41:11,360 --> 00:41:14,960
ALMOST DOUBLED OUR ENROLLMENT

1260
00:41:14,960 --> 00:41:15,840
THERE, WE HAVE--IT'S THE

1261
00:41:15,840 --> 00:41:17,880
COUNTING ON OUR NUMBER OF ACGME

1262
00:41:17,880 --> 00:41:20,840
PROGRAMS HERE IS DIFFICULT, BUT

1263
00:41:20,840 --> 00:41:24,400
WE HAVE OVER 27 ACGME CREDIT

1264
00:41:24,400 --> 00:41:26,440
PROGRAMS AND ABOUT 31

1265
00:41:26,440 --> 00:41:27,040
NONACCREDITED FELLOWSHIP

1266
00:41:27,040 --> 00:41:29,520
PROGRAMS FOR A TOTE OF OF 260 OR

1267
00:41:29,520 --> 00:41:33,480
70 MEDICAL AND DENTAL FELLOWSA

1268
00:41:33,480 --> 00:41:35,720
THE TIME AND TO GO TO THE NEXT

1269
00:41:35,720 --> 00:41:37,880
SLIDE, WE HAD 7 OUT OF THE 10

1270
00:41:37,880 --> 00:41:41,960
PROGRAMS SO 70% RESPONSE RATE IN

1271
00:41:41,960 --> 00:41:43,840
THE INITIATIVE AND THIS IS WHAT

1272
00:41:43,840 --> 00:41:45,480
THEY IDENTIFIED AND THEY

1273
00:41:45,480 --> 00:41:47,160
IDENTIFIED AS TD TOP DRIVERS OF

1274
00:41:47,160 --> 00:41:49,480
BURN OUT, THOSE HAD TO DO WITH

1275
00:41:49,480 --> 00:41:51,640
WORK LOAD, JOB DEMAND,

1276
00:41:51,640 --> 00:41:52,760
PROFESSIONAL DEVELOPMENT, SOCIAL

1277
00:41:52,760 --> 00:41:53,640
SUPPORT AND WORK LIFE

1278
00:41:53,640 --> 00:41:54,920
INTEGRATION, I DON'T HAVE THE

1279
00:41:54,920 --> 00:41:55,760
NUMBERS OF INDIVIDUALS BECAUSE

1280
00:41:55,760 --> 00:41:57,640
AGAIN THESE ARE THE PROGRAMS

1281
00:41:57,640 --> 00:41:59,440
THAT SENT US INFORMATION ABOUT

1282
00:41:59,440 --> 00:42:02,480
THIS, AT THE INDIVIDUAL LEVEL.

1283
00:42:02,480 --> 00:42:05,440
IF YOU GO TO THE NEXT SLIDE, WE

1284
00:42:05,440 --> 00:42:06,200
INTEGRATED INTERVENTIONS

1285
00:42:06,200 --> 00:42:07,880
ACCORDING TO THE DRIVERS AND TO

1286
00:42:07,880 --> 00:42:09,080
EITHER EXISTING PROGRAMS OR WE

1287
00:42:09,080 --> 00:42:14,360
CO CREATED AND BUILT NEW 1S.

1288
00:42:14,360 --> 00:42:17,240
SO I WILL JUST POINT OUT A FEW

1289
00:42:17,240 --> 00:42:18,960
IN THE CLINICAL PROFESSIONAL

1290
00:42:18,960 --> 00:42:22,000
DEVELOPMENT AREA, THE YOMAN'S

1291
00:42:22,000 --> 00:42:23,000
JOB UPDATING THE 2021 HAND BOOK

1292
00:42:23,000 --> 00:42:24,800
WHICH OFFERS A LOT OF GREAT

1293
00:42:24,800 --> 00:42:26,000
INFORMATION, ON SOCIAL SUPPORT,

1294
00:42:26,000 --> 00:42:30,960
IN TERMS OF OUR WELL BEING

1295
00:42:30,960 --> 00:42:32,480
SUBCOMMITTEE WE STARLIGHTED AN

1296
00:42:32,480 --> 00:42:35,480
INTRAMURAL SUPPORT GROUP AND

1297
00:42:35,480 --> 00:42:37,240
INITIATIVE CALLED DOC SIDE FOR A

1298
00:42:37,240 --> 00:42:38,160
GROUP THAT STARTED OF FELLOW

1299
00:42:38,160 --> 00:42:40,160
THIS IS YEAR, TO GET TOGETHER IN

1300
00:42:40,160 --> 00:42:43,120
A HYBRID MODEL MONTHLY TO HAVE

1301
00:42:43,120 --> 00:42:45,000
DISCUSSIONS ABOUT THEMES AND

1302
00:42:45,000 --> 00:42:46,600
WORK LIFE INTEGRATION, WE

1303
00:42:46,600 --> 00:42:48,400
LAUNCHED SEVERAL BUDDY PROGRAMS,

1304
00:42:48,400 --> 00:42:50,480
AND RESIDENCY PROGRAM AS WELL AS

1305
00:42:50,480 --> 00:42:53,760
A PROACTIVE EAPP PROGRAM OUT OF

1306
00:42:53,760 --> 00:42:55,240
OUR GROUP.

1307
00:42:55,240 --> 00:42:55,960
NEXT SLIDE.

1308
00:42:55,960 --> 00:42:59,280
I WILL GIVE A SHOUT OUT TO

1309
00:42:59,280 --> 00:43:01,200
DR. [INDISCERNIBLE] AND

1310
00:43:01,200 --> 00:43:01,840
DR. [INDISCERNIBLE] FELLOW

1311
00:43:01,840 --> 00:43:03,160
SHARES FOR THE LAST YEAR, THEY

1312
00:43:03,160 --> 00:43:05,440
DID A TERRIFIC JOB IN TERMS OF

1313
00:43:05,440 --> 00:43:08,560
PROFESSIONAL DEVELOPMENT AND

1314
00:43:08,560 --> 00:43:09,840
CREATING AN UNDATED

1315
00:43:09,840 --> 00:43:12,040
INFRASTRUCTURE THAT IS AN

1316
00:43:12,040 --> 00:43:13,520
EXECUTIVE COMMITTEE FOR

1317
00:43:13,520 --> 00:43:14,840
ENHANCING PROFESSIONAL

1318
00:43:14,840 --> 00:43:16,320
DEVELOPMENT AND LEADERSHIP FOR

1319
00:43:16,320 --> 00:43:18,120
THEMSELVES WITHIN THE LARGER NIH

1320
00:43:18,120 --> 00:43:20,080
STRUCTURE AND THAT'S JUST A GOOD

1321
00:43:20,080 --> 00:43:21,760
EXAMPLE'VE HOW THIS IS ANOTHER

1322
00:43:21,760 --> 00:43:24,440
EXAMPLE OF HOW WE RAMP UP AND

1323
00:43:24,440 --> 00:43:25,960
ADVANCE PROFESSIONAL DEVELOPMENT

1324
00:43:25,960 --> 00:43:27,800
OPPORTUNITIES FOR OUR RESIDENTS

1325
00:43:27,800 --> 00:43:29,080
AND FELLOWS, NEXT SLIDE.

1326
00:43:29,080 --> 00:43:32,880
THIS IS REALLY THE FOCUS OF

1327
00:43:32,880 --> 00:43:34,520
WHERE THINGS NEED TO BE IN TERMS

1328
00:43:34,520 --> 00:43:36,320
OF MAKING CHANGE IN HEALTHCARE

1329
00:43:36,320 --> 00:43:38,160
SYSTEMS AROUND THE COUNTRY.

1330
00:43:38,160 --> 00:43:39,680
THESE ARE GENERIC EXAMPLES OF

1331
00:43:39,680 --> 00:43:40,960
THE KINDS OF INTERVENTIONS THAT

1332
00:43:40,960 --> 00:43:42,360
WILL HELP US THROUGH AUTONOMY

1333
00:43:42,360 --> 00:43:44,440
AND THROUGH PUT AND REDUCING

1334
00:43:44,440 --> 00:43:46,240
INEFFICIENCIES, THESE ARE

1335
00:43:46,240 --> 00:43:47,880
EXAMPLES LIKE AGAIN, THE

1336
00:43:47,880 --> 00:43:49,040
DOCUMENTATION PROTOCOL, I WANT

1337
00:43:49,040 --> 00:43:53,480
TO POINT OUT MAXIMIZING PRIVACY

1338
00:43:53,480 --> 00:43:55,880
AROUND LICENSURE AND

1339
00:43:55,880 --> 00:43:57,520
CREDENTIALING, IT'S AN IMPORTANT

1340
00:43:57,520 --> 00:43:59,760
TOPIC AND AS YOU KNOW PHYSICIANS

1341
00:43:59,760 --> 00:44:01,840
ARE ENGAGED AS TO WHETHER THEY

1342
00:44:01,840 --> 00:44:02,840
HAVE HAD MENTAL TREATMENT IN THE

1343
00:44:02,840 --> 00:44:04,800
PAST AND THERE ARE VARYING

1344
00:44:04,800 --> 00:44:06,400
APPROXIMATELY SEES IN EACH STATE

1345
00:44:06,400 --> 00:44:07,720
AND PEOPLE ARE WORKING ACTIVELY

1346
00:44:07,720 --> 00:44:08,640
AT TRYING TO REDUCE THE

1347
00:44:08,640 --> 00:44:10,480
SIGNATURES STATE REGULATOR AND

1348
00:44:10,480 --> 00:44:12,240
WHAT EXTENT THIS NEEDS TO BE

1349
00:44:12,240 --> 00:44:17,480
CHANGED SO THESE ARE JUST

1350
00:44:17,480 --> 00:44:18,680
SUGGESTIONS FOR AREAS OF

1351
00:44:18,680 --> 00:44:22,280
CONTINUED WORK. 

1352
00:44:22,280 --> 00:44:25,840
SO NEXT SLIDE, WAFTER IN HIS

1353
00:44:25,840 --> 00:44:27,600
2018 JAMA ARTICLE, OOPS I WAS 1

1354
00:44:27,600 --> 00:44:30,840
BEHIND IN HIS ARTICLE RESOLVING

1355
00:44:30,840 --> 00:44:33,920
THE PRODUCTIVITY PARADOX OF

1356
00:44:33,920 --> 00:44:35,240
HEALTH INFORMATION TECHNOLOGY,

1357
00:44:35,240 --> 00:44:37,160
SAID THAT ALTHOUGH EVIDENCE OF

1358
00:44:37,160 --> 00:44:38,000
HEALTHCARE DIGITIDESSATION HAS

1359
00:44:38,000 --> 00:44:39,400
LED TO IMPROVEMENTS IN QUALITY

1360
00:44:39,400 --> 00:44:41,600
AND SAFETY IS GENERALLY

1361
00:44:41,600 --> 00:44:43,560
POSITIVE, UNIVERSALLY, THESE

1362
00:44:43,560 --> 00:44:45,160
HAVE BEEN CONTACT DEPENDENT

1363
00:44:45,160 --> 00:44:49,480
RECRUITMENT AND HAVE BEEN

1364
00:44:49,480 --> 00:44:51,480
RELATIVELY SMALL, SO, THE BOTTOM

1365
00:44:51,480 --> 00:44:54,320
LINE HERE IS A COMPLAINT THAT

1366
00:44:54,320 --> 00:44:55,320
LITTLE USEFUL INTELLIGENCE IS

1367
00:44:55,320 --> 00:44:56,280
BEING DELIVERED BACK TO

1368
00:44:56,280 --> 00:44:58,000
CLINICIANS IN TERMS OF THINK

1369
00:44:58,000 --> 00:44:59,520
BEING THE PRESENCE OF THAT

1370
00:44:59,520 --> 00:45:01,400
COMPUTER AS A SEPARATION BETWEEN

1371
00:45:01,400 --> 00:45:02,200
CLINICIANS AND PATIENTS AND

1372
00:45:02,200 --> 00:45:06,520
OTHERS AND AS A WAY TO ENHANCE

1373
00:45:06,520 --> 00:45:07,960
COMMUNICATION,S BUT WHAT IT DOES

1374
00:45:07,960 --> 00:45:12,520
SAY IS JUST THE FLIP SIDE ON

1375
00:45:12,520 --> 00:45:14,480
SORT OF PRODUCTIVITY NEAR

1376
00:45:14,480 --> 00:45:16,120
INFORMATION TECHNOLOGY IS THAT

1377
00:45:16,120 --> 00:45:17,000
PRODUCTIVITY DOES NOT

1378
00:45:17,000 --> 00:45:18,680
IMMEDIATELY IPT GREATER CREASE

1379
00:45:18,680 --> 00:45:21,400
WITH THE INVESTMENT IN I.T. BUT

1380
00:45:21,400 --> 00:45:24,640
IT TAKES TIME SO IT TAKES 15-20

1381
00:45:24,640 --> 00:45:26,000
YEARS TO SEE THE FRUITS OF THAT

1382
00:45:26,000 --> 00:45:28,080
LABOR, IF YOU LOOK AT OTHER

1383
00:45:28,080 --> 00:45:29,720
INDUSTRIES LIKE IN THE LAB AND

1384
00:45:29,720 --> 00:45:31,000
THE CREATION OF THE MODERN

1385
00:45:31,000 --> 00:45:32,920
TELEPHONE, IT LOOK A LONG TIME

1386
00:45:32,920 --> 00:45:34,920
FOR PRODUCTIVITY TO IMPROVE AND

1387
00:45:34,920 --> 00:45:36,400
IMPROVEMENT OCCURRED AFTER THE

1388
00:45:36,400 --> 00:45:38,560
REDESIGN OF THE WORK ITSELF AND

1389
00:45:38,560 --> 00:45:41,000
THAT'S REALLY IMPORTANT BECAUSE

1390
00:45:41,000 --> 00:45:42,760
WHAT WAFTER SAYS IS THAT WE'RE

1391
00:45:42,760 --> 00:45:44,040
AT THE SWEET SPOT, THE RIGHT

1392
00:45:44,040 --> 00:45:47,400
SPOT IN TIME WHEN THESE AI, ML

1393
00:45:47,400 --> 00:45:48,280
TECHNOLOGIES ARE RAPIDLY

1394
00:45:48,280 --> 00:45:49,160
ACCELERATING SO THE GOOD NEWS IS

1395
00:45:49,160 --> 00:45:50,840
THAT I THINK WE HAVE MUCH TO BE

1396
00:45:50,840 --> 00:45:51,640
HOPEFUL ABOUT WHERE THIS IS

1397
00:45:51,640 --> 00:45:54,880
GOING IN THE FUTURE.

1398
00:45:54,880 --> 00:45:55,280
NEXT SLIDE.

1399
00:45:55,280 --> 00:45:56,920
SO IN TERMS OF OUR WELL BEING

1400
00:45:56,920 --> 00:45:59,000
COMMITTEE IT'S BEEN A LITTLE BIT

1401
00:45:59,000 --> 00:46:01,080
LIKE FEELING LIKE WE'RE THROWING

1402
00:46:01,080 --> 00:46:02,600
SPAGHETTI AT THE WALL IN TERMS

1403
00:46:02,600 --> 00:46:04,040
OF COMING UP WITH INTERVENTIONS

1404
00:46:04,040 --> 00:46:06,240
THAT MIGHT STICK BUT WE

1405
00:46:06,240 --> 00:46:07,960
REALLY--I THINK HAD QUITE A BIT

1406
00:46:07,960 --> 00:46:10,000
OF SUCCESS IN TRYING TO

1407
00:46:10,000 --> 00:46:11,800
UNDERSTAND BE SPECIFIC ABOUT

1408
00:46:11,800 --> 00:46:13,120
IDENTIFYING DRIVERS OF BURN OUT

1409
00:46:13,120 --> 00:46:15,160
AND CO CREATING SOLUTIONS WITH

1410
00:46:15,160 --> 00:46:15,400
OUR TEAM.

1411
00:46:15,400 --> 00:46:16,720
GO TO THE NEXT SLIDE, THIS IS

1412
00:46:16,720 --> 00:46:19,960
OUR WAY OF MEASURING KIND OF HOW

1413
00:46:19,960 --> 00:46:21,720
WE'RE DOING OUT OF THE ARTICLE

1414
00:46:21,720 --> 00:46:23,600
IN 2017, LOOKING AT THE TYPICAL

1415
00:46:23,600 --> 00:46:26,480
STEPS IN AN ORGANIZATION JOURNEY

1416
00:46:26,480 --> 00:46:27,760
TOWARDS EXPERTISE POSITION WELL

1417
00:46:27,760 --> 00:46:29,720
BEING AND AGAIN, WE COULD--WE

1418
00:46:29,720 --> 00:46:31,680
CAN PUT THE WORD PHYSICIAN AND

1419
00:46:31,680 --> 00:46:34,280
PUT IN CLINICIAN, ON THE Y-AXIS

1420
00:46:34,280 --> 00:46:37,360
IS THE IMPACT, SO, MINOR,

1421
00:46:37,360 --> 00:46:38,120
MODERATE, MAJOR TO

1422
00:46:38,120 --> 00:46:41,520
TRANSFORMATIVE AND ON THE X-AX

1423
00:46:41,520 --> 00:46:43,760
SIS STAGE FROM NOVICE TO

1424
00:46:43,760 --> 00:46:45,200
BEGINNING TO COMPETENT TO

1425
00:46:45,200 --> 00:46:47,120
BEGINNING TO EXPERT, SO WHEN OUR

1426
00:46:47,120 --> 00:46:48,160
SUBCOMMITTEE TOOK A LOOK AT THE

1427
00:46:48,160 --> 00:46:49,920
START OF OUR WORK TO WHERE WE

1428
00:46:49,920 --> 00:46:51,560
WERE, YOU SEE ON THE BOTTOM HOW

1429
00:46:51,560 --> 00:46:53,080
AND WHERE WE WERE AWARE OF THE

1430
00:46:53,080 --> 00:46:54,480
ISSUE, WE HAD THIS WELLNESS

1431
00:46:54,480 --> 00:46:56,400
COMMITTEE BUT WE WEREN'T--IT

1432
00:46:56,400 --> 00:46:57,760
TOOK USA IA WHILE TO GET FURTHER

1433
00:46:57,760 --> 00:46:58,840
ALONG, IF YOU GO TO THE NEXT

1434
00:46:58,840 --> 00:47:00,600
SLIDE, BY THE END OF 2021, HERE

1435
00:47:00,600 --> 00:47:01,880
WE ARE IN TERMS OF WHERE WE

1436
00:47:01,880 --> 00:47:06,040
THINK WE ARE NOW ON OUR JOURNEY

1437
00:47:06,040 --> 00:47:07,800
TOWARDS THAT PHYSICIAN WELL

1438
00:47:07,800 --> 00:47:08,120
BEING.

1439
00:47:08,120 --> 00:47:08,320
NEXT.

1440
00:47:08,320 --> 00:47:10,320
AND I WANT TO SAY THAT THE

1441
00:47:10,320 --> 00:47:11,520
NATIONAL ACADEMY OF MEDICINE

1442
00:47:11,520 --> 00:47:13,240
AGAIN AND THE SURGEON GENERAL

1443
00:47:13,240 --> 00:47:15,000
ARE TRYING TO IDENTIFY THESE

1444
00:47:15,000 --> 00:47:16,760
PRIORITY AREAS, THAT IS CREATING

1445
00:47:16,760 --> 00:47:20,360
AND SUSTAINING POSITIVE WORK AND

1446
00:47:20,360 --> 00:47:22,520
LEARNING ENVIRONMENTS, INVESTING

1447
00:47:22,520 --> 00:47:24,360
IN MEASUREMENTS, REDUCING

1448
00:47:24,360 --> 00:47:25,760
ADMINISTRATIVE BURDENS, ENGAGE

1449
00:47:25,760 --> 00:47:26,800
NOTHING EFFECTIVE TECHNOLOGY

1450
00:47:26,800 --> 00:47:28,200
TOOLS AND PROTECTING THE HEALTH

1451
00:47:28,200 --> 00:47:31,240
AND WELL BEING OF ALL HEALTHCARE

1452
00:47:31,240 --> 00:47:32,000
WORKERS, PRIORITIZING SOCIAL

1453
00:47:32,000 --> 00:47:34,400
CONNECTION AND COMMUNITY AS A

1454
00:47:34,400 --> 00:47:36,280
CORE VALUE, REPORTING MENTAL

1455
00:47:36,280 --> 00:47:38,160
HEALTH AND STIGMA, AADDRESSING

1456
00:47:38,160 --> 00:47:39,920
COMPLIANCE AND REGULATORY

1457
00:47:39,920 --> 00:47:40,600
BARRIER AND INSTITUTIONALIZING

1458
00:47:40,600 --> 00:47:43,960
WELL BEING AS A LONG-TERM VALUE

1459
00:47:43,960 --> 00:47:46,280
WITH MANY HOSPITALLING EMPLOYING

1460
00:47:46,280 --> 00:47:48,760
CLEAVE WELLNESS OFFICERS AS PART

1461
00:47:48,760 --> 00:47:51,440
OF THE CTC TEAM AND INCLUDIVE

1462
00:47:51,440 --> 00:47:52,520
WORKFORCES SO I WILL JUST WRAP

1463
00:47:52,520 --> 00:47:54,960
UP HERE IF YOU GO TO THE NEXT

1464
00:47:54,960 --> 00:47:56,720
SLIDE, ANYBODY WORKING IN

1465
00:47:56,720 --> 00:47:59,600
HOSPITALS IS THE 90S WILL

1466
00:47:59,600 --> 00:48:00,720
REMEMBER THE GREAT KD--SALLY

1467
00:48:00,720 --> 00:48:02,320
WHRA, WAS A METHODOLOGY THAT WAS

1468
00:48:02,320 --> 00:48:04,000
BROUGHT TO HEALTHCARE FROM THE

1469
00:48:04,000 --> 00:48:05,440
AUTOMOTIVE INDUSTRY AND THAT'S

1470
00:48:05,440 --> 00:48:07,640
HOW SORT OF PATIENT SAFETY AND

1471
00:48:07,640 --> 00:48:11,280
QUALITY PROGRAMS IN HOSPITALS

1472
00:48:11,280 --> 00:48:15,280
WERE LAUNCHED TO ERR IS HUMAN

1473
00:48:15,280 --> 00:48:19,160
AND CROSSING THE QUALITY CHASM

1474
00:48:19,160 --> 00:48:21,080
AND EVERYONE KNOWS WHAT YOU

1475
00:48:21,080 --> 00:48:23,560
CHECK IN TERMS OF QUALITY

1476
00:48:23,560 --> 00:48:24,560
IMPROVEMENT METHODOLOGY, WE HAD

1477
00:48:24,560 --> 00:48:26,560
PARTNERS ALL OVER THE COUNTRY,

1478
00:48:26,560 --> 00:48:28,000
CHIEF OFFICERS AND PATIENT

1479
00:48:28,000 --> 00:48:30,680
SAFETY IN CARE AND QUALITY AND I

1480
00:48:30,680 --> 00:48:32,280
THINK WHAT'S PATIENT AND SAFETY

1481
00:48:32,280 --> 00:48:34,600
QUALITY WAS IN THE 90S, IS

1482
00:48:34,600 --> 00:48:36,000
CLEARLY WHAT WELL BEING IS NOW

1483
00:48:36,000 --> 00:48:38,040
AND IS GOING TO BE GOING

1484
00:48:38,040 --> 00:48:38,240
FORWARD.

1485
00:48:38,240 --> 00:48:38,560
NEXT SLIDE.

1486
00:48:38,560 --> 00:48:41,920
SO I JUST WANT TO MAKE A PUBLIC

1487
00:48:41,920 --> 00:48:43,280
SERVICE ANNOUNCEMENT, DOCK SIDE

1488
00:48:43,280 --> 00:48:45,240
WILL BE LAUNCHED AGAIN AND OUR

1489
00:48:45,240 --> 00:48:47,480
SECOND FORM WHICH IS A DIFFERENT

1490
00:48:47,480 --> 00:48:48,680
INITIATIVE AND AGAIN, TELL BE

1491
00:48:48,680 --> 00:48:50,400
FOR PRESIDENTS AND FELLOWS IF

1492
00:48:50,400 --> 00:48:53,080
YOU'RE NEW HERE, TAKE A LOOK AT

1493
00:48:53,080 --> 00:48:54,560
YOUR INBOXES IN AUGUST OR

1494
00:48:54,560 --> 00:48:55,920
SEPTEMBER TO HEAR ANNOUNCEMENTS

1495
00:48:55,920 --> 00:48:56,760
ABOUT THEM, WE REALLY WELCOME

1496
00:48:56,760 --> 00:49:00,360
YOU TO JOIN THIS INITIATIVE

1497
00:49:00,360 --> 00:49:01,480
AGAIN, MONTHLY GROUP

1498
00:49:01,480 --> 00:49:02,640
SPECIFICALLY GEARED TOWARDS OUR

1499
00:49:02,640 --> 00:49:04,000
REZONING DEBTS AND FELLOWS AND

1500
00:49:04,000 --> 00:49:05,400
NEXT SLIDE, I JUST WANT TO

1501
00:49:05,400 --> 00:49:08,360
ENVIED THOSE THAT WOULD BE

1502
00:49:08,360 --> 00:49:10,640
INTERESTED TO JOIN OUR GRADUATE

1503
00:49:10,640 --> 00:49:12,040
MEDICAL EDUCATION WELLNESS

1504
00:49:12,040 --> 00:49:13,240
SUBCOMMITTEE, IT'S A WONDERFUL

1505
00:49:13,240 --> 00:49:13,440
GROUP.

1506
00:49:13,440 --> 00:49:15,240
WE HAVE A LOT OF CURRENT

1507
00:49:15,240 --> 00:49:17,280
PROJECTS WE COULD USE NEW IDEAS

1508
00:49:17,280 --> 00:49:19,440
ON AND WE'RE ALWAYS WILLING TO

1509
00:49:19,440 --> 00:49:21,040
START NEW PROJECTS.

1510
00:49:21,040 --> 00:49:21,960
OUR DOOR IS OPEN.

1511
00:49:21,960 --> 00:49:25,520
NEXT SLIDE, SO TO SUM IT UP,

1512
00:49:25,520 --> 00:49:27,920
UPSTART CLINICIANS ARE COMPETING

1513
00:49:27,920 --> 00:49:28,880
IN OPERATIONAL MODELS,

1514
00:49:28,880 --> 00:49:30,240
PHYSICIANS ARE CERTAINLY AT

1515
00:49:30,240 --> 00:49:31,960
INHERENT RISK CONDITIONALLING TO

1516
00:49:31,960 --> 00:49:34,600
THIS CALLING THAT'S OFTEN

1517
00:49:34,600 --> 00:49:37,800
ENORMOUS DRIVES TO SEE AND I

1518
00:49:37,800 --> 00:49:39,800
MEAN TO HEAL AND SECURE AND

1519
00:49:39,800 --> 00:49:42,600
CAUSE THE ADVANCE OF HELT IN ALL

1520
00:49:42,600 --> 00:49:44,680
SETTINGS AND WORKING

1521
00:49:44,680 --> 00:49:45,400
ALTRUISTICALLY AND OUR

1522
00:49:45,400 --> 00:49:46,760
RESPONSIBILITY ARE BAKED INTO

1523
00:49:46,760 --> 00:49:48,840
WHAT IT MEANS NOT ONLY FOR

1524
00:49:48,840 --> 00:49:51,400
SUCCESSFUL DOCTORING BUT ALSO

1525
00:49:51,400 --> 00:49:53,280
FOR SUCCESSFUL CLINICIANING

1526
00:49:53,280 --> 00:49:56,200
REALRY TO BE BROADER AND MAKE UP

1527
00:49:56,200 --> 00:49:57,880
A WORD, I MEAN EVERYBODY HERE IS

1528
00:49:57,880 --> 00:49:59,720
REALLY FOCUSED ON DOING THE SAME

1529
00:49:59,720 --> 00:50:03,240
THING THERE, BUT WE HAVE TO

1530
00:50:03,240 --> 00:50:05,360
UNDERSTAND THIS IS GOING TO

1531
00:50:05,360 --> 00:50:07,280
IMPROVE CERTAIN INHERENT RISK

1532
00:50:07,280 --> 00:50:08,760
GIVEN THE CURRENT CLIMATE, RISKS

1533
00:50:08,760 --> 00:50:10,480
AROUND THE THINGS WE ALL CARRY.

1534
00:50:10,480 --> 00:50:11,680
OVER THE LAST 2 YEARS IN

1535
00:50:11,680 --> 00:50:13,400
PARTICULAR, EVERYONE HERE NOT

1536
00:50:13,400 --> 00:50:14,760
JUST CLINICIANS BUT EVERYONE'S

1537
00:50:14,760 --> 00:50:17,600
WENT ABOVE AND BEYOND THEIR

1538
00:50:17,600 --> 00:50:18,480
ORDINARY OBLIGATIONS TO RESPHOND

1539
00:50:18,480 --> 00:50:23,280
THIS NATIONAL AND GLOBAL LET TO

1540
00:50:23,280 --> 00:50:24,360
THEIR WELL BEING, AND WE'RE

1541
00:50:24,360 --> 00:50:25,520
WAITING IN THE BALANCE THAT

1542
00:50:25,520 --> 00:50:27,720
PEOPLE RELY ON ALL OF YOU TO

1543
00:50:27,720 --> 00:50:29,600
CURE, TO HEAL, TO ADVANCE

1544
00:50:29,600 --> 00:50:31,360
SCIENCE, IT'S AN ENORMOUS JOB

1545
00:50:31,360 --> 00:50:33,880
AND WE NEED TO MAKE SURE WE TAKE

1546
00:50:33,880 --> 00:50:34,960
CARE OF OURSELVES.

1547
00:50:34,960 --> 00:50:36,840
IF WE SAY THAT CARE IS IMPORTANT

1548
00:50:36,840 --> 00:50:40,560
BUT WE DON'T MONITOR BOUNDARIES,

1549
00:50:40,560 --> 00:50:42,600
WE DON'T OURSELVES GO TO OUR OWN

1550
00:50:42,600 --> 00:50:44,640
DOCTORS IF WE SAY WE ARE

1551
00:50:44,640 --> 00:50:45,600
SUPPORTIVE IN OUROIN COMMUNITY

1552
00:50:45,600 --> 00:50:47,800
BUT WE CAN'T OPEN OURSELVES UP

1553
00:50:47,800 --> 00:50:48,760
IF WE FOCUS ONLY ON THE BOTTOM

1554
00:50:48,760 --> 00:50:52,840
LINE, WITH THE  ASSOCIATED SPOT,

1555
00:50:52,840 --> 00:50:56,560
IF WE SAY TO ERR IS HUMAN, BUOY

1556
00:50:56,560 --> 00:50:58,760
THEN WE DON'T HAVE THE ALTRUISM,

1557
00:50:58,760 --> 00:50:59,880
THEN WE AREN'T WALKING THE

1558
00:50:59,880 --> 00:51:01,040
WALKER ENOUGH AND WE HAVE OUR

1559
00:51:01,040 --> 00:51:02,600
WORK OUT OUT FOR US IN THE WELL

1560
00:51:02,600 --> 00:51:02,920
BEING CASE.

1561
00:51:02,920 --> 00:51:04,720
I HOPE I MADE THE CASE ABOUT WHY

1562
00:51:04,720 --> 00:51:07,880
THIS IS IMPORTANT BUT HOW WE

1563
00:51:07,880 --> 00:51:08,920
MIGHT OPERATIONALIZE A NOVEL

1564
00:51:08,920 --> 00:51:10,240
PATH FORWARD AND THOSE WITH

1565
00:51:10,240 --> 00:51:11,560
OTHERS AND IF YOU GO TO THE NEXT

1566
00:51:11,560 --> 00:51:15,880
SLIDE, I WANT TO THANK SO MANY

1567
00:51:15,880 --> 00:51:16,400
PEOPLE.

1568
00:51:16,400 --> 00:51:17,640
IT TAKES A VILLAGE TO MAKE THIS

1569
00:51:17,640 --> 00:51:19,600
HAPPEN, THIS HAS BEEN A REAL

1570
00:51:19,600 --> 00:51:19,880
TEAM EFFORT.

1571
00:51:19,880 --> 00:51:21,720
I HAVE TO GIVE A SPECIAL SHOUT

1572
00:51:21,720 --> 00:51:27,960
OUT TO DR. MARILYN POWE SHE'S

1573
00:51:27,960 --> 00:51:29,600
BEEN AN INCREDIBLE SUPPORT HERE

1574
00:51:29,600 --> 00:51:31,320
AT THE NIMH AND ALONG THIS ROAD

1575
00:51:31,320 --> 00:51:38,200
AND AGAIN TO MY COLLEAGUES,

1576
00:51:38,200 --> 00:51:42,360
DR. JENNIFER CHANG AND

1577
00:51:42,360 --> 00:51:47,320
DR. [INDISCERNIBLE] AND MISS

1578
00:51:47,320 --> 00:51:49,400
EMILY GUINEE, AND DR. WEI AND

1579
00:51:49,400 --> 00:51:50,800
OUR MANY FELLOWS WHO HELPED IN

1580
00:51:50,800 --> 00:51:51,400
THIS SPACE.

1581
00:51:51,400 --> 00:51:55,600
THANK YOU.

1582
00:51:55,600 --> 00:51:55,920
DID EMPLOY.

1583
00:51:55,920 --> 00:51:57,040
>> THANK YOU SO MUCH FOR
THAT

1584
00:51:57,040 --> 00:51:58,120
INCREDIBLE VISION AND TALK.

1585
00:51:58,120 --> 00:51:59,520
I WANT TO REMIND PEOPLE THAT

1586
00:51:59,520 --> 00:52:02,880
THERE IS A LIVE FEEDBACK BUTTON

1587
00:52:02,880 --> 00:52:03,560
ON YOUR LIVE VIDEOCAST SCREEN

1588
00:52:03,560 --> 00:52:09,200
THAT YOU CAN USE TO SUBMIT

1589
00:52:09,200 --> 00:52:10,080
QUESTIONS BUT BARS THAT I WOULD

1590
00:52:10,080 --> 00:52:11,800
LIKE TO ASK THE FIRST QUESTION

1591
00:52:11,800 --> 00:52:15,200
WHICH IS:  ARE YOU AWARE OF ANY

1592
00:52:15,200 --> 00:52:19,760
STUDIES OR REPORTS ON THE COST

1593
00:52:19,760 --> 00:52:20,240
EFFECTIVENESS OF SUCH

1594
00:52:20,240 --> 00:52:21,760
INTERVENTIONS EITHER INDIVIDUAL

1595
00:52:21,760 --> 00:52:23,200
OR SYSTEMIC LEVEL?

1596
00:52:23,200 --> 00:52:24,320
BECAUSE SOME PEOPLE MIGHT SAY

1597
00:52:24,320 --> 00:52:26,320
WELL THIS IS EXPENSIVE TO OFFER

1598
00:52:26,320 --> 00:52:28,280
THESE SERVICES, IT'S EXPENSIVE

1599
00:52:28,280 --> 00:52:31,040
TO CHANGE OUR SYSTEMS OF HOW WE

1600
00:52:31,040 --> 00:52:34,440
PRACTICE, CAN YOU COMMENT ON

1601
00:52:34,440 --> 00:52:35,440
THAT AT ALL?

1602
00:52:35,440 --> 00:52:37,240
>> THIS IS A CHALLENGING

1603
00:52:37,240 --> 00:52:38,480
QUESTION BECAUSE IT'S REALLY

1604
00:52:38,480 --> 00:52:40,960
HARD TO MAKE A DIRECT STATEMENT

1605
00:52:40,960 --> 00:52:45,640
BETWEEN BURN OUT FOR EXAMPLE

1606
00:52:45,640 --> 00:52:46,480
TURNOVER RATE, WHY SOMEBODY'S

1607
00:52:46,480 --> 00:52:47,760
LEAVING TO MAKE THAT DIRECTLY TO

1608
00:52:47,760 --> 00:52:50,680
SAY THIS WAS THE SOLE CAUSE,

1609
00:52:50,680 --> 00:52:51,720
IT'S MULTIFACTORIAL AND IT'S

1610
00:52:51,720 --> 00:52:55,680
DIRTY SO IT'S VERY DIFFICULT TO

1611
00:52:55,680 --> 00:52:57,400
MAKE THOSE DIRECT LINKS.

1612
00:52:57,400 --> 00:52:59,400
I THINK THE COST IS TOO GREAT

1613
00:52:59,400 --> 00:53:02,200
NOT TO BEAR BUT THIS IS

1614
00:53:02,200 --> 00:53:03,000
SOMETHING THAT'S NATIONAL

1615
00:53:03,000 --> 00:53:05,040
LEADERS ARE TRYING TO GET THEIR

1616
00:53:05,040 --> 00:53:05,600
HANDS AROUND.

1617
00:53:05,600 --> 00:53:09,280
THERE IS A CONSORTIUM OF

1618
00:53:09,280 --> 00:53:10,280
ACADEMIC PROFESSIONALS, THAT

1619
00:53:10,280 --> 00:53:11,880
STARTED OUT AT STANFORD, THEY'RE

1620
00:53:11,880 --> 00:53:13,400
1 OF THE LEADERS IN WELL BEING

1621
00:53:13,400 --> 00:53:16,200
AS IS THE MAYO CLINIC AND WHAT

1622
00:53:16,200 --> 00:53:17,480
THEY'RE TRYING TO DO IS ENHANCE

1623
00:53:17,480 --> 00:53:19,720
THE RESEARCH IN THIS AREA,

1624
00:53:19,720 --> 00:53:20,520
COLLECTIVELY AND COLLABORATIVELY

1625
00:53:20,520 --> 00:53:22,960
TO LOOK AT EXACTLY THIS KIND OF

1626
00:53:22,960 --> 00:53:26,280
ISSUE TO MAKE THE ARGUMENTS FOR

1627
00:53:26,280 --> 00:53:29,800
WHY AND WHAT THE DATA AND

1628
00:53:29,800 --> 00:53:31,000
EVIDENCE IS ON THOSE FUNDS.

1629
00:53:31,000 --> 00:53:32,600
WE HAVE A WAYS TO GO ON THAT.

1630
00:53:32,600 --> 00:53:38,480
>> NOW A QUESTION FROM THE

1631
00:53:38,480 --> 00:53:38,760
FEEDBACK.

1632
00:53:38,760 --> 00:53:40,040
EXCELLENT TALK, THANK YOU VERY

1633
00:53:40,040 --> 00:53:41,840
MUCH, ANY UPDATE TO EXTENDING

1634
00:53:41,840 --> 00:53:44,800
THESE RESOURCES TO THE NIH STAFF

1635
00:53:44,800 --> 00:53:46,480
CLINICIANS OR MAYBE FACULTY IN

1636
00:53:46,480 --> 00:53:47,960
GENERAL, I KNOW NEXT WEEK WE

1637
00:53:47,960 --> 00:53:49,960
WILL HAVE A SPEAK TORE THAT BUT

1638
00:53:49,960 --> 00:53:52,440
YOU'VE BEEN FOCUSED MOSTLY ON

1639
00:53:52,440 --> 00:53:52,800
TRAINEES.

1640
00:53:52,800 --> 00:53:53,720
>> YES, THE FACULTY HAS
BEEN

1641
00:53:53,720 --> 00:53:55,560
ASKING US FOR SEVERAL YEARS NOW

1642
00:53:55,560 --> 00:53:58,040
TO WEIGH INTO THIS AREA AND WE

1643
00:53:58,040 --> 00:53:58,400
NEED CHAMPIONS.

1644
00:53:58,400 --> 00:53:59,600
SO IF YOU'RE OUT THERE AND

1645
00:53:59,600 --> 00:54:02,000
INTERESTED IN WORKING WITH US I

1646
00:54:02,000 --> 00:54:03,680
KNOW WE DON'T WANT TO ADD TO

1647
00:54:03,680 --> 00:54:05,040
YOUR BURN OUT, IS ASKING FOLKS

1648
00:54:05,040 --> 00:54:07,800
TO DO MORE WITH LESS, AND SO MY

1649
00:54:07,800 --> 00:54:09,400
CALL TO YOU WOULD BE TO SIT IN

1650
00:54:09,400 --> 00:54:11,440
ON A MEETING OR TALK TO US, IT

1651
00:54:11,440 --> 00:54:13,560
DOES NOT MEAN YOU'RE OBLIGATED.

1652
00:54:13,560 --> 00:54:16,760
I WILL SAY WE'VE SPOKE TONE

1653
00:54:16,760 --> 00:54:18,680
DR. PARKER RULE AND DR. CURRY

1654
00:54:18,680 --> 00:54:20,840
RECENTLY ON HOW WE CAN WORK WITH

1655
00:54:20,840 --> 00:54:22,000
STAFF CLINICIANS SPECIFICALLY

1656
00:54:22,000 --> 00:54:25,200
AND WE ARE CURRENTLY TRYING TO

1657
00:54:25,200 --> 00:54:26,360
WORK ON SPECIFICALLY FOR THAT

1658
00:54:26,360 --> 00:54:26,720
GROUP.

1659
00:54:26,720 --> 00:54:31,240
I HOPE WE WILL BE ABLE TO AS LHE

1660
00:54:31,240 --> 00:54:32,600
HAS BEEN--SHE'S ALREADY INVOLVED

1661
00:54:32,600 --> 00:54:35,040
A LOT WITH OUR FELLOWS HERE IN

1662
00:54:35,040 --> 00:54:36,480
THE HOSPITAL AND WE'VE SPOKEN TO

1663
00:54:36,480 --> 00:54:38,000
HER AND HAVE MEETINGS SET UP

1664
00:54:38,000 --> 00:54:39,320
ABOUT HOW WE CAN BRING SOME OF

1665
00:54:39,320 --> 00:54:43,720
HER PROGRAMS WHICH ARE FULLY

1666
00:54:43,720 --> 00:54:46,160
FUNDED AND HAVE BEEN REALLY

1667
00:54:46,160 --> 00:54:47,440
EFFECTIVE DURING COVID AND BRING

1668
00:54:47,440 --> 00:54:50,280
THEM SPECIFICALLY TO OUR STAFF

1669
00:54:50,280 --> 00:54:52,400
CLINICIANS, PART OF OUR

1670
00:54:52,400 --> 00:54:54,080
CHALLENGE IS MAKING SURE THESE

1671
00:54:54,080 --> 00:54:55,080
OFFERINGS ARE GEARED FORWARD

1672
00:54:55,080 --> 00:55:03,400
AUDIENCES AND THAT'S PART OF THE

1673
00:55:03,400 --> 00:55:03,840
CHALLENGE.

1674
00:55:03,840 --> 00:55:05,160
>> OKAY, I DON'T SEE ANY
OTHER

1675
00:55:05,160 --> 00:55:05,440
QUESTIONS.

1676
00:55:05,440 --> 00:55:06,960
DO YOU HAVE ANY OTHER CLOSING

1677
00:55:06,960 --> 00:55:10,400
STATEMENTS YOU WANT TO MAKE.

1678
00:55:10,400 --> 00:55:12,360
THERE WERE INCREDIBLE FINDINGS

1679
00:55:12,360 --> 00:55:13,400
YOU PRESENTED BI YOU I GUESS

1680
00:55:13,400 --> 00:55:15,000
WHAT I WOULD LIKE TO SAY IS

1681
00:55:15,000 --> 00:55:16,040
WHAT'S NEXT, YOU KNOW?

1682
00:55:16,040 --> 00:55:20,440
WHAT DO YOU HAVE ON THE HORIZON?

1683
00:55:20,440 --> 00:55:27,640
>> I THINK YOU HIT THE
NAIL ON

1684
00:55:27,640 --> 00:55:29,320
THE HEAD DOCTOR, I THINK FACULTY

1685
00:55:29,320 --> 00:55:31,520
IS STAFF, IN TERMS OF THE

1686
00:55:31,520 --> 00:55:34,160
GRADUATE MEDICAL EDUCATION

1687
00:55:34,160 --> 00:55:35,200
COMMITTEE ON WELLNESS BUT ALSO

1688
00:55:35,200 --> 00:55:36,640
MORE BROADLY TO CLINICIANS, YOU

1689
00:55:36,640 --> 00:55:38,960
KNOW BROADLY IN THE INSTITUTION,

1690
00:55:38,960 --> 00:55:43,760
MY HOPE WOULD BE THAT NIH CAN

1691
00:55:43,760 --> 00:55:46,240
CONTINUE TO WORK TOGETHER TO CO

1692
00:55:46,240 --> 00:55:48,640
CREATE SYSTEMATIC WELL BEING

1693
00:55:48,640 --> 00:55:50,440
PROGRAMS, I THINK THAT COMMENT

1694
00:55:50,440 --> 00:55:52,040
THAT WE'RE AN EMBARRASSMENT THE

1695
00:55:52,040 --> 00:55:54,240
OF RICHES BECAUSE WE ARE VERY

1696
00:55:54,240 --> 00:55:56,360
RESOURCE RICH IN IN SOME WAYS

1697
00:55:56,360 --> 00:55:58,280
AND IN OTHER WAYS WE HAVE TO GET

1698
00:55:58,280 --> 00:55:59,920
MORE TARGETED AND DO A BETTER

1699
00:55:59,920 --> 00:56:00,880
JOB OF COMMUNICATING WITH EACH

1700
00:56:00,880 --> 00:56:02,480
OTHER SO THAT WE'RE AWARE OF

1701
00:56:02,480 --> 00:56:03,720
WHAT'S OUT THERE AND AGAIN I

1702
00:56:03,720 --> 00:56:05,840
WANT TO FOCUS ON DRIVERS OF BURN

1703
00:56:05,840 --> 00:56:07,120
OUT, THAT'S THE FOCUS TO NOW

1704
00:56:07,120 --> 00:56:08,320
DRILL DOWN TO WHAT THE

1705
00:56:08,320 --> 00:56:10,840
INDIVIDUAL DRIVERS OF BURN OUT

1706
00:56:10,840 --> 00:56:13,960
ARE FOR INDIVIDUALS, FOR

1707
00:56:13,960 --> 00:56:14,560
SPECIFIC LABS FOR SPECIFIC

1708
00:56:14,560 --> 00:56:15,720
DEPARTMENTS SO THAT YOU CAN

1709
00:56:15,720 --> 00:56:17,000
BUILD INTERVENTIONS THAT ARE

1710
00:56:17,000 --> 00:56:18,760
MEANINGFUL TO PEOPLE LOCALLY, 1

1711
00:56:18,760 --> 00:56:23,640
SIZE IS NOT GOING TO FIT ALL AND

1712
00:56:23,640 --> 00:56:24,560
LOCAL BATTERS ARE VERY IMPORTANT

1713
00:56:24,560 --> 00:56:26,120
AT THE SAME TIME WE NEED IT TO

1714
00:56:26,120 --> 00:56:30,040
COME FROM THE TOP DOWN AS A MAIN

1715
00:56:30,040 --> 00:56:31,880
PRIORITY SO TO MAKE WELL BEING

1716
00:56:31,880 --> 00:56:32,960
BETTER INTEGRATED AND BAKED INTO

1717
00:56:32,960 --> 00:56:38,520
EVERYTHING WE DO HERE.

1718
00:56:38,520 --> 00:56:40,600
>> OKAY, WITH THAT, I
DON'T HAVE

1719
00:56:40,600 --> 00:56:42,520
ANYMORE QUESTIONS FROM THE

1720
00:56:42,520 --> 00:56:45,040
AUDIENCE--OH ACTUALLY MAYBE 1

1721
00:56:45,040 --> 00:56:45,600
MORE HERE.

1722
00:56:45,600 --> 00:56:48,360
HOW DO NATIONAL ISSUES THAT ARE

1723
00:56:48,360 --> 00:56:49,880
SO POLARIZING CONTRIBUTE TO THE

1724
00:56:49,880 --> 00:56:51,840
EROSION OF WELL BEING?

1725
00:56:51,840 --> 00:56:55,040
>> AS WE SAY IN
PSYCHIATRY, IT'S

1726
00:56:55,040 --> 00:56:57,240
LIKE THE QUESTION ASKED WITH 1

1727
00:56:57,240 --> 00:56:59,520
FOOT OUT THE DOOR.

1728
00:56:59,520 --> 00:57:01,760
SO IT'S A SERIOUS TOPIC AND

1729
00:57:01,760 --> 00:57:02,600
REALLY IMPORTANT, THE

1730
00:57:02,600 --> 00:57:03,560
POLARIZATION IN THIS COUNTRY AND

1731
00:57:03,560 --> 00:57:07,960
WHAT'S GONE ON IN THE LAST MANY

1732
00:57:07,960 --> 00:57:10,000
YEARS, ON TOP OF ALL THE

1733
00:57:10,000 --> 00:57:10,920
SOCIOLOGICAL POLITICAL ISSUES,

1734
00:57:10,920 --> 00:57:14,760
ABSOLUTELY CONTRIBUTE TO WELL

1735
00:57:14,760 --> 00:57:16,440
BEING, AND IMPACT KIND OF I

1736
00:57:16,440 --> 00:57:22,480
THINK ARE FUSES AND ARE DISTRESS

1737
00:57:22,480 --> 00:57:26,000
TOLERANCE AND OUR ABILITY TO

1738
00:57:26,000 --> 00:57:27,400
CO-PUT 1 ANOTHER IN WAYS AND

1739
00:57:27,400 --> 00:57:29,800
IT'S A HUGE PROBLEM AND I THINK

1740
00:57:29,800 --> 00:57:31,040
ALL--ALL I CAN SAY ABOUT THAT IS

1741
00:57:31,040 --> 00:57:33,080
WE ALL TAKE A MOMENT TO SORT OF

1742
00:57:33,080 --> 00:57:36,720
BREATHE BEFORE WE FIND OURSELVES

1743
00:57:36,720 --> 00:57:37,400
EMOTIONAL DISREGULATED AND

1744
00:57:37,400 --> 00:57:39,280
REACTING AND JUST TAKE A BREATH,

1745
00:57:39,280 --> 00:57:41,680
WE CAN LEARN FROM MINDFULNESS

1746
00:57:41,680 --> 00:57:43,000
BASE AND STRESS REDUCTION BEFORE

1747
00:57:43,000 --> 00:57:44,800
WE RESPOND AND TRY TO GROUND

1748
00:57:44,800 --> 00:57:45,840
OURSELVES IN ANCHOR OURSELVES

1749
00:57:45,840 --> 00:57:48,080
AND TRY TO WORK CIVILLY WITH 1

1750
00:57:48,080 --> 00:57:49,920
ANOTHER BUT THAT'S A HUGE

1751
00:57:49,920 --> 00:57:53,440
IMPORTANT POINT AND 1 I HOPE WE

1752
00:57:53,440 --> 00:58:03,840
CONTINUE TO TALK ABOUT.

1753
00:58:06,720 --> 00:58:07,360
>> SO MORE POSITIVE
COMMENTS

1754
00:58:07,360 --> 00:58:08,720
FROM THE AUDIENCE AND WITH THAT

1755
00:58:08,720 --> 00:58:10,920
I LIKE TO THANK OUR SPEAKER

1756
00:58:10,920 --> 00:58:12,640
DEBBIE SNYDER FOR A FABULOUS

1757
00:58:12,640 --> 00:58:15,080
TALK AND A SO TARGETED TOAUR

1758
00:58:15,080 --> 00:58:16,200
GRADUATE EDUCATION EFFORTS AND

1759
00:58:16,200 --> 00:58:16,520
BEYOND.

1760
00:58:16,520 --> 00:58:18,200
SO THANK YOU AGAIN.

1761
00:58:18,200 --> 00:00:00,000
AND GOOD DAY.