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Acad Med. 2019 Feb;94(2):156-161. doi: 10.1097/ACM.0000000000002415.

Building a Program on Well-Being: Key Design Considerations to Meet the Unique Needs of Each Organization.

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T. Shanafelt is Jeanie and Stewart Ritchie Professor of Medicine, chief wellness officer, Stanford Medicine, director, Stanford WellMD Center, and associate dean, Stanford School of Medicine, Stanford, California. M. Trockel is associate professor of psychiatry, Stanford School of Medicine, and associate director, Stanford WellMD Center, Stanford, California. J. Ripp is professor of medicine, medical education, geriatrics, and palliative medicine; senior associate dean for well-being and resilience; and chief wellness officer, Icahn School of Medicine at Mount Sinai, New York, New York. M.L. Murphy is past administrative director, Stanford WellMD Center, Stanford, California. C. Sandborg is professor of pediatrics, Stanford School of Medicine, and vice president of medical affairs, Lucile Salter Packard Children's Hospital, Stanford, California. B. Bohman is clinical professor of anesthesiology, Stanford University School of Medicine, chief medical officer, University Healthcare Alliance, and senior advisor, Stanford WellMD Center, Stanford, California.


The current health care practice environment has resulted in a crescendo of burnout among physicians, nurses, and advanced practice providers. Burnout among health care professionals is primarily caused by organizational factors rather than problems with personal resilience. Four major drivers motivate health care leaders to build well-being programs: the moral-ethical case (caring for their people), the business case (cost of turnover and lower quality), the tragic case (a physician suicide), and the regulatory case (accreditation requirements). Ultimately, health care provider burnout harms patients. The authors discuss the purpose; scope; structure and resources; metrics of success; and a framework for action for organizational well-being programs. The purpose of such a program is to oversee organizational efforts to reduce the occupational risk for burnout, cultivate professional well-being among health care professionals, and, in turn, optimize the function of health care systems. The program should measure, benchmark, and longitudinally assess these domains. The successful program will develop deep expertise regarding the drivers of professional fulfillment among health care professionals; an approach to evaluate system flaws and relevant dimensions of organizational culture; and knowledge and experience with specific tactics to foster improvement. Different professional disciplines have both shared challenges and unique needs. Effective programs acknowledge and address these differences rather than ignore them. Ultimately, a professional workforce with low burnout and high professional fulfillment is vital to providing the best care to patients. Vanguard institutions have embraced this understanding and are pursuing health care provider well-being as a core organizational strategy.

[Indexed for MEDLINE]

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