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El Rio Santa Cruz Neighborhood Health Center; Tucson, AZ
Douglas Spegman, Chief Clinical Officer
- Five-year effort of cultural transformation including defining six cultural principles.
- Developing transformative leadership with skill development supported by consultant.
- Focus on optimizing EHR and health information technology (HIT) and hired Clinician Leader in Informatics.
- Optimizing multidisciplinary teams and workflows.
- Provides one to four hours per week to staff to focus on areas of interest (e.g. teaching, advocacy, quality improvement).
- Senior leadership is lead for workforce engagement and well-being: commits to cultural principles, provides resources, and holds meetings and committees to engage staff.
- Well-Being and Health Builder Team arranges well-being activities for all employees.
- Quarterly staff satisfaction surveys; staff turnover rate: <6%, decreased from under 20% four years ago; increased primary care provider workforce by 72% in last five years.
- Able to move from a “counting widget mentality” due to increasing proportion of value-based revenue. Recognizes downstream return on investment.
RiverStone Health; Billings, MT
Megan Littlefield, Chief Medical Officer
- Using AMA framework, implementing a three-pronged approach to promoting workforce wellness and resilience: organizational changes, workflow efficiencies, individual staff, and team support.
- Workforce wellness a strategic focus; resources made available; organizational structure for wellness and resilience; led by Executive Leadership Group with CMO as champion, advised by interdisciplinary Wellness and Resilience Steering group.
- Two medical assistants (MAs) per provider—one for rooming and second for in-room support, which is a promotion and career track for MAs; charting efficiency.
- Enhanced onboarding and mentoring; provider-focused employee assistance program; meaningful administrative time to foster leadership roles (e.g., teaching, program development); team wellness-projects; structured debriefs of complex cases.
- Yearly assessments of burnout and work life with follow-up data on annual assessments pending; staff turnover rate is 10%.
- Return on investment in reduced recruitment costs and preventing consequences of staff turnover and burnout.
Westside Family Healthcare; Wilmington, DE
Megan Werner, Associate Medical Director of Population Health and Quality
- Optimizing workflows and minimizing care team stressors; focusing on having appropriate staffing levels, doing meaningful work, and removing inefficiencies.
- Six-month mentoring process for new providers: slow ramp up of patient panels, structured approach to EHR training, routine check-ins with Associate Medical Director, case-based mentoring.
- Spreading work across the care team members; expanded role of MAs, which required protocols, competency training, and buy-in of providers.
- Providing career advancement opportunities for staff (e.g., supervisor position for MAs, nurse care manager positions for chronic disease and prenatal care management).
- CEO is champion, supported by clinical leadership team, which drives the interventions.
- Prioritize wants and needs; be ready to respond to funding opportunities to finance priorities.
Valid and reliable assessment tools can help health centers accurately measure and understand workforce engagement and well-being and identify solutions. Assessment tools to consider include:
Organizational assessments:
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