University of Utah Health Wellness Champion Poster Session 2019

INTRODUCTION
Within the Department of Pharmacotherapy (DoP) at
the University of Utah College of Pharmacy, 78% of
clinical faculty members are experiencing emotional
exhaustion and 0% reported that they have good
control of their workload according to the 2017
Wellness Survey.
Despite feeling job satisfaction and finding their work
meaningful, 56% felt a great deal of stress due to their
job. Based on these astonishing statistics, the newly
formed DoP Resiliency Committee felt the need to
impact the wellbeing of faculty members.
Problem Investigation
To better understand our baseline state, we analyzed
data from multiple wellness survey tools:
• Wellness Survey: The 2017 Wellness Survey showed:
− 78% of Clinical Faculty in the College of
Pharmacy are experiencing burnout
• Employee Engagement Poll: Waggl poll,
administered by the University of Utah Health
Sciences HR to gauge employee satisfaction and
provide an opportunity for employees to give
feedback for change initiatives showed:
− 46% of faculty had control over their workload
− 30% reported having a great deal of stress due
to their job
Reviewing the 2018 WAGGL results, one common
theme to improve wellbeing within the faculty was
flexible work and the ability to work from home. With
this in mind, the idea for "The White Space Project"
was born.
METHODS FOR IMPROVEMENT
The White Space Project promoted increased control
over individual workload by encouraging participants
to schedule white space time to complete projects.
work wherever they could be most productive at this
time, which could be at home, at a coffee shop, or in
their DoP office. This project encouraged better
control over workload and flexibility in each
individual's work environment.
To Support and Promote the White Space Project:
RESULTS
Survey Findings: A total of 11 clinical faculty, completed the post-
analysis survey. Of those respondents, 2 reported implementing
the "White Space Project".
Although we saw gains from the 2017 Wellness Survey in our
department burnout rate & improved control over individual
workload, faculty experiencing stress rose from 56% to 72%.
College of Pharmacy, Department of Pharmacotherapy
Hanna Raber; Alisyn May; Heather Nyman;, Jim Ruble; Dan Witt
PROGRESS
 Implemented project to add 4 hours of weekly protected time,
or white space, to participants schedule.
LIMITATIONS & BARRIERS
 Lack of faculty participation due to unawareness of project or
lack of control in their schedule/workload to block time.
 Resiliency Center Well-being survey put on hold required us to
create our own survey later than expected
VALUABLE LESSONS LEARNED
 Not a strong enough baseline understanding of the resiliency
concerns of the department
 Ensure leadership support behind departmental cultural
change to ensure a supportive environment
PROJECT INSIGHTS
Communication campaign: This
project was introduced at a clinical
faculty meeting via a presentation
from the Resiliency Center.
Sharing Successes: At each faculty
meeting, the vision of this project
was discussed and success stories
were shared.
To track progress and reflect: A
survey was sent (once) to assess
the impact of this project.
THE WHITE SPACE PROJECT
This project included a
Resiliency Center presentation
and encouraged DoP Faculty
to find "white space" on their
calendars for at least four
hours per week and devote
that time to themselves.
Faculty were encouraged to
MON TUE WED THU FRI
8
12
5
0%
20%
40%
60%
80%
2017 2018
Goal 33%
• Improved Burnout Rate from 78% to 45%1
78%
45%
0%
20%
40%
60%
80%
2017 2018
Goal 73%
• Improved Control Over Individual Workload to 54%2
0%
54%

INTRODUCTION
Due to the Williams Building's displaced location in Research Park, accessing
wellness resources is challenging. Our aim is to increase access to wellness
activities available on-site.
Our wellness initiatives intend to create an environment at the Williams Building
that meets the unique needs of staff through leveraging existing wellness offerings
and opportunities, as well as creating new opportunities.
Our Wellness Team conducted a baseline analyses to identify barriers that
prevented the Division of Critical Care staff at the Williams Building from engaging
in wellness activities.
 Voice of the Customer: interviews & surveys of the Division staff reported barriers
to participation including awareness and accessibility (located off campus,
shuttle availability to main campus, etc.).
Our goal is to create an environment that
meets the unique needs of staff at the
Department of Pediatrics Division of Critical
Care located in the Williams Building. These
needs are multifaceted and fluid.
Crowdsourcing Ideas: In order to crowdsource
potential ideas and activities, the Wellness
Team at the Division utilized a web-based idea
management software platform called
IdeaScale. Launched in late in October 2018,
the group developed a campaign to solicit
ideas from Division staff on the types of wellness
activities they would be interested in (figure 3).
The campaign was launched in conjunction
with a ‘Lunch & Learn’ presentation from the
Wellness & Integrative Health (WIH) team. One-
quarter of the Division staff attended the
presentation and many expressed surprise at
available resources which they had not heard
about prior to the presentation.
RESULTS & NEXT STEPS
The Division of Critical Care Wellness Team
has forged relationships with contacts from
the Wellness Center, the Resiliency Center,
RD-Approved, and PEAK. These
relationships and the identification of a
Wellness Ambassador will be important in
communicating available wellness offerings
and providing feedback on potential new
offerings.
WELLNESS AT THE WILLIAMS BUILDING
Department of Pediatrics, Division of Critical Care
Eduardo Zamora; Diane Hartford; Lisa Winter; Stephanie Busch; Maggie Mair
PROGRESS
 Developed key partnerships with wellness
resources.
 Implemented a crowd sourcing tool to
collect ideas for additional wellness
activities based on wellness wheel
categories.
 Wellness team members changed during
the project.
 Scheduling time with leadership to discuss
purpose and goals was challenging.
 Engage with your leadership early and
often.
 Clearly message goals and intentions of
project to gain inclusive support.
PROJECT INSIGHTS
Continue to moderate the IdeaScale
campaign to encourage ideas and
assess interest in wellness activities at
the Williams Building.
1
2
Identify a department Wellness
Ambassador and establish ongoing
relationship with WIH team to design
potential new offerings based on
IdeaScale suggestions.
ASK“WHY”5TIMES
What is the abnormal
condition?
Limited access of wellness activities in
the Williams Building
Why is there limited
access to wellness
activities?
Because there is limited coordination of
wellness activities at the Williams
Building
Why are wellness
activities not
coordinated?
Because wellness activities are
sponsored/organized by multiple
entities across the U of U campus
Why are wellness
activities are organized
across multiple entities
across the UU campus?
Because information is
shared/accessed based on your
network or the path you access it
Why is information
shared/accessed
differently?
Because wellness is valued differently
across groups and people
Why is wellness valued
differently?
Root Cause - Because wellness is
multifaceted, unique, and fluid to the
individual. The current environment
does not meet the needs of staff at the
Williams Building
Figure 2: 5 Why’s Root Cause Exercise
 Brainstorm Sessions: identified wellness
issues and organized using a
cause/effect diagram (aka fishbone).
Categories were: method, awareness,
transportation, environment, and
culture (Figure 1).
 Root Cause ‘5 Whys’ Analysis:
identified the complexity of wellness
and the need to diversify to meet the
needs of individual wellness
perceptions (Figure 2).
Based on our investigation findings, the
team will focus on the following:
1. Improving access to activities to
Division employees in the Williams
Building
2. Increasing awareness of ongoing U
Health official and unofficial wellness
activities available
Figure 1: Cause/Effect Diagram
Figure 3: IdeaScale Promotion

INTRODUCTION
The 2017 University of Utah Health Burnout survey showed improvement in
burnout (emotional exhaustion 44% in 2016 to 33% in 2017), however
decrease in satisfaction in role (89% in 2016 to 67% in 2017) and decrease in
control over workload. A follow-up survey was administered to further clarify
areas for improvement. Key findings included: isolation between providers,
poor communication, lack of awareness of colleagues’ passion/projects,
and burden of activities and meetings outside of work hours.
With these in mind, the monthly PM&R faculty meeting was identified as an
opportunistic space to build connections/collegiality and establish a
culture of respect.
 Less: Financial updates; Minimally, relevant topics and outside speakers.
 To improve participation & collegiality: Create inclusive environment;
Elicit individual feedback; Optimize pertinence to practice of topics;
Agree upon and enforce a code of respect and professional standards;
Include updates on others’ professional interests and practices, personal
spotlights, and IRB’s and opportunities for collaboration; Consider team
building activities.
Targeting faculty meeting with the goal to optimize
content, collegiality, cohesiveness, and respect, we have:
 Reviewed survey findings with new (Oct 2018) division
chair
 Established culture and communication group to
analyze initial survey findings and target areas for
change.
Initial changes implemented with chair transition at first
new chair faculty meeting: Environment/ambience
change (soft lights, new table setup), food/nutrition
improvements, personalized introduction by chair (family,
extracurricular interests, work interests), introduction of
tricycle model for division (large clinical front wheel,
research and academic/teaching back wheels),
optimization of inclusiveness and feedback elicited from
different specialties, thanks/respect given to all members
present, suggestions elicited on a variety of topics, humor
integrated.
1. Defined 3 deliverables for faculty meets: make
decisions, educate, and relate (build connections)
2. Asked for individual feedback: "Who are you?", "Why
medicine?", "Why academic medicine at the UofU?",
"Why are you here?"
3. Introduced potential to explore/reformat faculty
meeting: Value-added purpose/content, ground rules
for communication/respect, frequency of meeting,
location of meeting (SOM, UUOC, restaurant, rotating
location), time of meeting.
Changes implemented at 2nd new chair faculty meeting:
1. Staff/faculty recognition with Starbucks card reward
for exception recent work.
2. Mindfulness speaker and group practice; UofU
mindfulness resources (for patients and staff/faculty)
introduced.
FUTURE CONSIDERATIONS
• Content / Structure
− Condense and rotate updates
(finance, sites, new hospital)
− Transparency from policy
committees
− Strategic planning session to develop
PM&R Vision Statement
− Agenda prior to meeting
− Limit outside speakers
− Optimize relevance
• Professionalism & Respect
− Utah Leadership Training Office
professionalism session or
reinforcement of SOM
professionalism standards to optimize
respect
• Collegiality & Culture
− Employee recognition and faculty
spotlights, personal and professional
− Updates on IRB’s & collaborations
− Team building activities
− Wellness interventions at start of
meeting (i.e. mindfulness practice,
movement, etc.)
• Logistics
− Frequency, time, & location of
meeting
FACULTY MEETING REDESIGN
Division of Physical Medicine & Rehabilitation
Alan Davis, MD (co-lead) and Rebecca Wilson Zingg, DO (co-lead); Candace Floyd, PhD; Richard Kendall, DO; Abbie Paxman; David Steinberg,
MD
PROGRESS
 Assessed faculty to determine what
needed to change and got buy in
from new chair.
 In progress with target deadline of
April 1, 2019
 Change of chair in October 2018,
impacted time of implementation but
ultimately acted as great transition
point for change
 How much culture of respect and
limited collegiality are affecting our
division
PROJECT INSIGHTS
1
2
3
4
Figure 2: Fishbone diagram
PM&R
FACULTY
MEETING
P E O P L E
S T R U C T U R E
C U L T U R E
L O G I S T I C S / O T H E R
F I S H B O N E D I A G R A M
Problem Statement: Why is faculty meeting the way that it is? How can we
engender a culture of respect, collegiality, and value?
food
Time of day
Day of week
Frequency
Historical structure
Topics/interests represented
Required content
Elective content/speakers
Place
Faculty present
Leadership/facilitation
Personalities
Diverse specialties/interests
Multiple institutions
Participation
Tone of meeting
Cohesiveness/Collegiality
Efficiency, 5.78
Transparency of Information, 5.59
Culture of Respect, 5.44
Topic Relevance, 5.39
Collegiality, 5.28
Professional Interests, 5.24
Openness, 5.22
Ease of Participation, 4.89
Faculty Meeting Survey
Figure 1. Faculty were asked to rank meeting components in a
survey on a scale of 1 to 10 with 10 being best.
The PM&R faculty meeting has grown
organically under multiple, different
active and interim chairs.
Faculty were asked to rank meeting
components in a survey on a scale of 1 to
10 with 10 being best (figure 1).
Results from Survey:
All categories ranked between 4.89-5.78
with efficiency of meeting ranking highest
and ease of participation ranking lowest.
60% of faculty felt disrespect at meeting.
Open Ended Survey Responses:
 Add/More: Hospital, research, and
faculty updates; Site updates; Vision
plan; Multi-disciplinary, relevant topics;
Transparency in policy and policy
committees; Agenda sent in advance.

INTRODUCTION
The UU College of Nursing (CON) has the highest faculty
burnout rates across the health science colleges and
schools with 51% of faculty and 34% of staff reporting
emotional exhaustion + depersonalization.
As CON Wellness Champions, we aim to foster and facilitate
a culture of wellness, to make it a place that people are
energized and passionate about coming to work.
To better understand our baseline state, we analyzed data
from multiple wellness survey tools:
 Wellness Survey: Resiliency Center October 2017 survey:
− 51% faculty/34% of staff report emotional exhaustion +
depersonalization
− 80% of faculty and 34% of staff report feeling a great
deal of stress because of their job
− Only 22% faculty/49% staff report feeling a sense of
control over workload
 Employee Engagement Poll: The Waggl poll, administered
in May 2018 by the University of Utah Health Sciences
Human Resources to gauge employee satisfaction and
provide an opportunity for employees to give feedback
for change initiatives, showed:
− 53% of faculty and 38% staff feel they cannot express
opinions for fear of retribution or retaliation
− 76% faculty and 50% staff reported no perceived
control over their workload.
 Faculty & Staff Feedback: College Spring Retreat on
4/27/18 showed areas to address:
− Being able to communicate without repercussions
− Dedicated support for wellness opportunities and
activities
− Flex time and telecommuting options for staff
Based on the consistent themes regarding wellness among these
three evaluations, we focused our initial improvements on building
an infrastructure to foster a culture of wellness in our College for staff
and faculty.
Our Wellness Champion project is to increase visibility of wellness in
the College of Nursing with the goal of facilitating a culture of
wellness. The improvements satisfaction/evaluation surveys will be
conducted as needed with faculty and staff to track progress and
reflect on effectiveness.
RESULTS
Faculty and Staff responses in our
November 2018 College wide survey:
• 73% stated the visibility of wellness in the
College has increased in the past 6
months
• 95% stated that the six presentations in
College Council and Quarterly Staff
Meeting increased wellness visibility
• 92% stated that the presence of a
Wellness Committee has helped
increase wellness visibility
•
• 78% stated that a wellness tile in Pulse
would increase access to wellness
materials
Promoting a Culture of Wellness & Resilience in the College of Nursing
College of Nursing, University of Utah
Katarina Friberg Felsted, PhD; Jennifer Clifton, DNP, FNP-BC, CNE, CCHP; Sue Chase-Cantarini, DNP, RN, CHSE; Jenneth B. Doria, DNP, MS, RN;
Hollie J. Fuhrmann, MA; Erin Meyer, PhD, C-IAYT, E-RYT; Patrick Murphy; Lisa J. Taylor-Swanson, PhD, MAcOM, EAMP; Sunnavy Thomson, MPH
PROGRESS
 Identified wellness as a major concern in
three significant evaluations in the past
year, through both quantitative and
qualitative sources.
 Built foundation for a culture of wellness
through awareness, resources, and a
dedicated committee to evaluate needs
and implement changes.
 An erroneous yet wide-spread belief that
resilience is merely a personal not a
systemic problem.
 Overcoming the perception that wellness
is ‘fluffy’ rather than an integral part of a
healthy workplace culture and crucial for
employee productivity.
 The necessity of persistence and multi-
pronged approaches in creating cultural
change
 The strength of the data captured and
incorporated in our initiatives
PROJECT INSIGHTS
1
2
3
1. Establish CON Wellness Committee
Explore and implement ideas to promote wellness.
After meetings with interested faculty and staff, the
Dean, Interim Dean, and the Executive Committee
(EC), the establishment of a permanent Wellness
Committee was approved as a subcommittee
directly reporting to the EC. All committee members
volunteered and this trend continues.
2. Promote Wellness
Regularly engage faculty and staff in evidence-
based wellness activities.
The Wellness Committee plan and implement
wellness presentations at each College Council
and Quarterly Staff Meeting on topics raised at the
College Spring Retreat such as email etiquette,
mindfulness practice, and the RD approved
program
3. Wellness Resources
Share resources for wellness through a central
location, the College of Nursing Pulse site.
The Wellness Pulse tile has recently been created as
a repository for articles, web links, meeting minutes,
and Quarterly Staff Meeting and College Council
presentations.
4

INTRODUCTION
The Sorenson Legacy Foundation Center for Student Success seeks
to create culture of wellness among our team members in order to
put into practice and role model the values of the College of Health
on a weekly basis. We implemented a multi-pronged wellness
initiative in order to address key concerns and needs. Key needs for
our team members in order to improve wellness, reduce the chance
of burnout, and improve the work environment were identified as: 1)
Increased time flexibility and 2) The opportunity for out of office
interaction that includes activity and/or stress relief during work
hours.
PROBLEM INVESTIGATION
Baseline state was examined by the following:
A GEMBA WALK which showed a lack of any natural light in the
center for student success office, no suitable outside seating area in
close proximity to the HPR building for lunch breaks, etc.., a lack of
shade around the HPR building for staff members to sit outside
comfortably in warmer/sunnier weather.
ASSESMENT among Center for Student Success faculty/staff which
elicited feedback in person and by email from all staff/faculty in the
center about needs, barriers, and opportunities surrounding wellness
(physical activity, health, mindfulness, stress management).
To analyze the baseline state data we used:
FISHBONE DIAGRAM to assess causes of challenges (lack of natural
light, lack of access to outdoor environment, lack of physical
activity, lack of consistent interactions with colleagues, a lack of
control over work schedules and work loads at certain times in the
academic year.
We analyzed feedback from needs, barriers, and opportunities
assessment and several key themes surfaced:
- A desire for time during the work day for physical activity and
mindfulness
- A desire to connect with other co-workers and encourage each
other to keep up with wellness behaviors
- Barriers surrounding lack of opportunity for fitness/physical activity
time during the day
- Barriers surrounding access to fitness facilities and/or cost of
facility membership
- Busy/stressful times of the year for staffers that affect their
wellness.
An obtainable goal for the Wellness Champion
team was to address barriers to physical fitness.
We created a schedule and streamlined
access to workout facilities in our HPR building
complex for Center for Student Success
staff/faculty.
To support the communications and access
process we implemented the following:
Paper Flyer/Schedule to assure faculty/staff
were aware of offerings and that access was
available weekly
Email Reminders describing access and
offerings for staff/faculty to assure staff/faculty
were aware of offerings and were consistently
reminded about the benefits
Physical Activity/Wellness Log to remind team
members to track progress
To track progress and reflect on effectiveness
of the improvement the team used:
Quarterly Scorecard self report by staff of
usage of facilities, PEAK classes, and wellness
behaviors
GOALS
1) Improve quality outcome by increasing
amount of positive staff interaction in
faulty/staff members in the Center for
Student Success of interactions by
10/1/2018.
2) Improve quality outcome by increasing
perceptions of wellness in faculty/staff
members in the Center for Student Success
from 0 self reported increase in wellness
activities to 1 self reported increase in
wellness by 11/15/2018.
3) Assess resiliency and level of burnout
among Center for Student Success
faculty/staff members
4) Improve quality outcome by decreasing
level of perceived stress among
faculty/staff members in the Center for
Student Success
RESULTS
2018 WELLNESS COLLABORATIVE
College of Health, Center for Student Success
Gardner, E [L]; Belt, D [M]; Beyene, Y [M]; Brown, L [M]; Lindsey, S [M]; Paisley, K [M]; Park, B [M]
Goal 1: “The best part of the Wellness Champion
initiative was talking supportively about taking
better care of ourselves and encouraging each
other to stick to health goals” Team Member 2
PROGRESS
 Completed
 Lack of funding, not receiving a Wellness Grant for
outdoor seating area, initial barrier of a nearby and
affordable access to physical activity facility, and lack of
control over workload for staff during busy times of the
academic year.
 The majority of team members reported utilizing the
physical activity room in HPR East after we secured
consistent weekly access times.
 Team members reported that they enjoyed the time
allotted during the workday for physical/wellness
activities and wanted to continue the program.
 Most members reported that they had engaged in
physical activity/wellness offerings together with another
colleague (walking in Huntsman Arena, working out in
the HPR East room together and setting goals as a
group).
PROJECT INSIGHTS
1
2
3
Goal 2: “The Best part of wellness champion
initiative for me was getting access to HPR East
Workout room, and while I was there, I found a
peak class that worked for me and signed up and
that have been helping me a lot with my Workouts
and Nutrition plans. I really feel like I am getting
closer and closer to my goal of being fit and
healthy.” Team Member 1
Goal 3: Our small team of 7 faculty/staff reported
no signs of burnout and all agreed or strongly
agreed that they were “satisfied with their job”
according to the burnout survey conducted by the
Resiliency Center in November 2018.

INTRODUCTION
As Wellness Champions, we received feedback from providers that the food
provided by their centers for meetings was often not healthy. As part of overall
University of Utah Wellness Center goals, we feel that improving the
healthfulness of meals brought in for staff meetings demonstrates concern for
provider wellness, helps providers return to work after meetings feeling healthy
and energized, and is part of an organizational commitment to health.
Community Clinics administrative staff order provider lunches from a variety of
locations, and use factors such as cost, convenience (ie delivery, speed of
obtaining food) to determine food choices. Variable degrees of attention to
the healthfulness of this food have been paid.
A survey of community clinics providers showed:
 Assessment of the food quality in terms of healthy choice/nourishment, 26%
rated poorly [score 1-4] and 45% rated satisfactory [score 5-7] (figure 1).
 Assessment of energy levels after eating at meetings showed 13% rated low
energy [score 1-4] and 56% rated moderate energy [score 5-7] (figure 2).
 Comments showed a variability of opinions in current selection (figure 3).
1. We began by collecting data from each
center about who ordered lunches, where
they ordered from and what their budgets
and any other constraints were.
1. We then worked with Registered Dietitians
(RD) from the Wellness Center who
analyzed menus and offered healthier
choices on those menus, as well as general
suggestions for healthy food choices.
1. These were then shared with center
administrators.
Catering Guidelines
Catering Menu / Suggestions
NEXT STEPS
We have surveyed providers pre
implementation of these changes, and plan to
repeat the survey in several months to see if
there has been change.
We will continue to encourage an
improvement in healthful options for catered
lunches.
IMPROVING THE QUALITY OF CENTER LUNCHES
Community Physicians Group
Margaret Solomon, MD; Carolyn Sanchez, MD; Ann Lokuta; Anne Taylor
PROGRESS
 Gathered information from centers about
who orders lunch and where they order from.
 Working with a registered dietician, we
developed recommendations on healthier
options and a list of healthy food suggestions.
 Initial survey sent to providers about food
choices at meetings. Will re-survey in 3
months.
 Time to work on project.
 Some lack of responsiveness from center
managers ordering food
 Variability among providers: some really care
about healthier food choices while others
either don't think it is an important issue or
don’t have an opinion.
 Identify someone in each center to work
directly with the person in their center who
orders food, and help them select a more
appealing and healthier menu.
PROJECT INSIGHTS
10%
4%
8%
4%
12%
14%
20% 20%
8%
2%
1 2 3 4 5 6 7 8 9 10
0%
5%
10%
15%
20%
25%
8%
2% 2% 2%
21%
12%
23%
27%
2% 2%
1 2 3 4 5 6 7 8 9 10
0%
5%
10%
15%
20%
25%
30%
1
2
 General tips
 Meal-specific tips
 Meal-specific examples
 Nutritional guidelines to
meet Registered
Dietician approval
requirements.
 Frequently used
companies from survey
 Specific healthy
complete meals from
each caterer
 Listed price per person
3
Figure 1. Using a scale of 1-10 with 1 being very poor and 10 being
excellent, how would you rate the quality (in terms of healthy
choices, nourishment) of the food at your monthly provider
meetings?
Figure 2. On a scale of 1-10, with 1 being exhausted/no energy, 5
being okay/some energy, and 10 being great/energetic, how
would you describe your energy level for clinic after provider
meetings
Energy lever for clinic after provider meetingsQuality of food (healthy choice and nourishment)
− More vegetarian, vegan or seafood options. Less carbs
− Usually it's pastries and carbs , not what any of us needs. Finally coffee is available. Plain
yogurt, real fruit is nice.
− Needs to taste good, more than just healthy. Not everyone likes kale and lawn clippings.
− I think the choices have been fine and see no need to change. There are some healthy
options for those who want as well as less healthy options for those who are less
concerned
“ “
Figure 3. Variety in Provider Comments

INTRODUCTION
Message handling is a crucial issue which
affects patient care and satisfaction, and
also provider wellness. There has been
little standardization of in-basket
management in the Community Clinics.
Medical Assistants who are the first to
handle messages in the in-basket have
little formal training on how to address
them, resulting in many calls and my chart
messages being forwarded directly to the
provider without being triaged or having
work done before routing messages.
 Data review: Volume of weekly in-
basket messages ranged by provider
(figure 1).
 Process Analysis: Showed many
messages were being routed to
provider before any MA action taken
Our improved design creates standardized in-basket flows for common calls,
provides guidance to MAs on how to effectively manage these calls with
minimal provider work, and embeds this process into Epic to make sure it is
sustainable and easy to use.
 Message Type Analysis: Over serval weeks, providers flagged in-basket
messages that they felt would benefit from a standardized process. These
were then reviewed with the group and a list of fifteen (15) common
message types were determined for intervention:
− WIC Form Request
− DMV Form Request
− Physical Form Request
− Work/School Excuse Request
− FMLA/Disability Form Request
− Logisticare Form Request
− Other Forms
− Forms Received Ahead of Visit
 Standardized Workflows: Providers worked with the lead MA, who also has
experience with Epic optimization, to develop standardized workflows that
encouraging MAs to work at the top of their licenses, improving
responsiveness to messages, and facilitating more rapid complete
responses to patients. (figure 2)
− Dot phrases were created to support the improved processes within
the MA’s usual workflow.
 Implementing & Training: Our lead MA met individually with each MA on
our team to review these tools and how to use them. Reminder signs on
computers listed available dot phrases.
GOALS
We aim to decrease the number of messages
providers receive daily, decreasing in-basket volume
and work, and allowing providers to complete their
daily work more efficiently; by February 1, 2019:
Goals will be monitored in a monthly scorecard.
IN-BASKET FLOW
Departments of Internal Medicine and Pediatrics – Redwood Health Center
Margaret Solomon, MD; Tyler Nelson; Brian Head; Mitchell Cannon, MBA
PROGRESS
 Identified message types to standardize practices,
designed workflows, created "dot phrases" in Epic,
and trained medical assistants in new workflows.
 Time constraints to work on this
 Changes in team members caused delays
 If you have an idea, even if it seems
overwhelming to make it work, and even if it is
only a small step or small piece of the bigger pie,
it is worth trying it and then going back to see if it
worked.
 Tap into institutional resources (Value Engineers,
lead MAs, Epic support, Wellness staff) to help
make the project happen. These people are
great at what they do.
PROJECT INSIGHTS
• Reduce the total volume of weekly phone
and MyChart messages received by providers
from 174 messages to 157 messages.
• Reduce the median time messages sit in a
provider’s in-basket from 14.07 hours to 12.5
hours.
• Reduce the median time messages sit in the
MA message pool from 1.63 hours to 1.55
hours.
1
2
3
Figure 1: Baseline weekly in-basket volume by provider,
averaged by month.
0
10
20
30
40
50
60
70
80
90
100
Provider1
Provider2
Provider3
Provider4
Provider1
Provider2
Provider3
Provider4
Provider1
Provider2
Provider3
Provider4
Provider1
Provider2
Provider3
Provider4
July August September October
Average Weekly In-Basket
Volume
Calls Messages
− Citizenship Forms
− Home Health Orders
− Appointment Request
− Pharmacy Calls
− Lab Request
− Referral Request
− Overdue Results
Figures 2: Sample workflows created for a few of the identified message types.

INTRODUCTION
The motto of the Cystic Fibrosis
Foundation is "Adding
Tomorrows." Caring for patients
with a terminal disease can
negatively affect work/life
balance and can contribute to
compassion fatigue and
burnout.
Our goal is to reduce burnout
and improve the work/life
balance of the University of
Utah Cystic Fibrosis care team
through a challenge geared
toward healthy lifestyle choices
and team building.
In a group brainstorming
session, the Wellness Champion
team discussed options on how
to engage team members to
improve work life balance.
Our pre-challenge survey
surprised us with only 13% of the
team experiencing emotional
exhaustion, about 20% below
the University of Utah Health
average. Additionally, 73% of
the team rated their work/life
balance a 7 or higher on a
scale from 1 to 10.
The Wellness Champion team designed a 12-week challenge to reinforce or
create new, easy, and healthy habits. Weekly challenges were decided upon
by researching other worksite wellness programs and from past conferences
where self care and wellness were discussed.
A team luau was hosted at the end of the 12-week challenge to celebrate
everyone's success.
RESULTS
Our original goal of increasing level of work/life balance in
the cystic fibrosis team from 7.2 on a scale of 1 to 10 to 8 did
not come to fruition.
Many participants have expressed interest in another
challenge or continuing parts of this challenge, especially the
weekly walks.
NEXT STEPS
• Design a spring 2019 Wellness Challenge
• Start a walking group that continues outside of challenge
weeks
Daily Challenges, One Each Week
‘ADDING HEALTHY TOMORROWS’ WELLNESS CHALLENGE
Division of Pulmonology – Cystic Fibrosis Team
Jessica Francis, CCRC; Alice Moe, MA ; Lynda Roe, CPhT; Gretchen Anderson, DNP, FNP-C; Mary Andolsek, LCSW
PROGRESS
 Designed and completed a 12-week challenge
 Lacked buy in or participation from some team members.
However, many others wholly embraced the challenge.
 Our teams burnout rate was significantly lower than the
average UUH employees.
 The teams biggest 'complaint’ was their clinic environment,
which is not an area where we could affect change.
 Try to understand the barriers that keep team members
from participating.
PROJECT INSIGHTS
Great to have non
work things to do
with coworkers“
“
- Do a hobby for 30 minutes
- Drink 1 litre of water
- Get 7 hours of sleep
- Walk 30 minutes
- Mediate for 10 min a day
- Floss daily
- Eat one home cooked meal
- Use the stairs
- List 3 things you are grateful for
- Use a reusable water bottle
- Compliment someone
- Eat five servings of fruits veggies daily
Figure 2: Wellness Challenge Score Card
Figure 1: Ex. Weekly Response Sheet
1
2
Those that participated received weekly emails
with reminders about the current week's
challenge and reported back with their
involvement at the end of each week (figure 1)
through a survey. Bonus challenges were
spread throughout the 12 weeks.
Individuals’ participation was tracked in a score
board (figure 2). By displaying the challenge
board in the hallway, team members were
reminded of the challenge daily and hopefully
inspired to participate.
However, the post-survey
results showed that many
participants continued
activities after the overall
challenge was completed.
Favorite challenges were
30 minute hobby, drink
water, sleep, and 30
minute walk (figure 3).
0 2 4 6
Try a New Activity
Eat five servings of…
Compliment a…
Use a Reusable…
List 3 things you are…
Use the stairs at work
Visit a New Place
Meditate for 10…
Floss daily
Walk 30 Minutes
Get 7 hours of sleep
Drink 1 litre of water
Do a hobby for 30…
Favorite Challenge
Figure 3. Top 3 favorite challenges from 15 participants

INTRODUCTION
It is well understood that burnout is a contributor
to faculty attrition, stress for individuals and teams,
can lead to increased rate of errors, lack of
enthusiasm for work, and even depression,
suicidality and substance abuse. In the long term,
burnout can contribute to the development of
chronic diseases like coronary artery disease and
type 2 diabetes. Burnout can be understood as
both an individual and organizational problem
and both have been shown to help improve
wellness and decrease burnout.
In a 2017 baseline study across departments in the
School of Medicine at the University of Utah, the
Physician Assistant Faculty, reported baseline high
job satisfaction along with higher than institutional
average for signs of burnout. In response to this,
the PA division wellness champions facilitated
staff and faculty development of simple cultural
changes that the team believed could improve
wellness culture and decrease individual burnout
and measured the impact of these two
interventions 3 months after implementation.
2017 University of Utah Wellness Survey: showed
high job satisfaction of 89% of faculty who are
overall satisfied with their jobs, however 44%
demonstrate signs of burnout (n=9). There was a
correlation between hours worked and burnout
(Pearson correlation = .587). Additionally, the 2016
University of Wellness Survey found 57% of faculty
to show signs of burnout, though a limited sample
size of 7.
Design Improve Wellness by enacting office hours policy and restrictions on
sending and receiving emails to staff and faculty by 15% as measured by
standardized wellness scoring after 3 months.
To communicate we used an internal ranked survey given to faculty and staff
in which they ranked top choices, generated from the group, for cultural
changes. These changes were brought back to the group at a division
meeting and implementation was agreed on and a technological support
tool for scheduling office hours was also developed.
To support the improved process: google calendar for posting office hours,
POST IMPLEMENTATION SURVEY FINDINGS
RESULTS
CULTURE CHANGE TO PROMOTE WELLNESS AMONG PA FACULTY
Department of Family and Preventive Medicine, PA Division
Joanne Rolls, MPAS, PA-C; Amanda Moloney-Johns, MPAS, PA-C
PROGRESS
 In progress. Interventions were decided
upon, implemented and short-term data
(3-month impact) has been collected.
 Culture change, in general, is difficult. A 3
month follow up interval may not show
actual change.
 Engage all stakeholders from the onset of
developing sustainable cultural change.
PROJECT INSIGHTS
62% of PA faculty implemented
office hours in the last 3 months.
1
2 62% of PA faculty modified specifically
sending/receiving emails only between
7am and 6pm.
1 Review survey feedback regarding
barriers to implement, attempt to
remove barriers and reassess in three
months.
I really like this… If I do find
myself working on email after
hours- this initiative actually helps
me to think about how urgent it
is that I send something and I am
more mindful about this.
“ “
including location and virtual access, was created, access
give to faculty and students could view this calendar.
To track progress we are checking in at division meetings,
every 1-2 months.
62%
38%
Implemented office hours and/or
modified email behavior in last 3
months
Yes
No
Barriers to Implementations
Office Hours
- Other meetings
- Students not attending
- Location of office hours
Email Culture
- Urgent responses required
- No time to catch up on email during
standard work hours
- Stress that comes from not checking
NEXT STEP
3 Post intervention survey results
demonstrated a burnout rate of 33% with
a sample size of 21, a decrease from 44%
in 2017.

Use of a Provider Feedback Survey Tool to improve Wellbeing
Department of Family and Preventive Medicine, Division of Family Medicine
INTRODUCTION
Engagement and resilience in physicians is impacted by
multiple factors (Figure 1), emphasizing the need for
personalized interventions. The Division of Family
Medicine Wellness Champions (WC) in partnership with
leadership developed and implemented a quarterly
anonymous provider survey in 2016 to facilitate an
ongoing improvement process for provider wellness
(Figure 1). Articulated concerns and constructive
solutions resulted in a number of systematic changes
that increased communication, reduced burnout and
increased a sense of control. This project examines the
ongoing impact during the second year.
Amy Locke MD, Katie Fortenberry PhD, Erika Sullivan MD, Sonja Van Hala MD
We used 2016 - 2018 survey data to assess the following:
burnout, control over work, satisfaction with work, meaning in
work. Division data was benchmarked to national and local
data among school of medicine faculty. Quarterly surveys
assess issues of most concern to providers in supporting
wellbeing in the following areas: administration, clinic,
personnel, division, scholarship, teaching, wellness, service,
responsiveness to concerns. Issues were brought up in each
of the key drivers of engagement and resilience (Figure 2
and Table 1). Each quarter we asked participants about
responsiveness to concerns. The second year of the project
resulted in modifications of how data was reviewed and
reported. At the two year mark, we looked at usefulness of
the tool, value to leadership and providers, as well as impact
on work wellbeing.
RESULTS
PROGRESS
 The quarterly survey continued to identify issues
impacting faculty wellness over the second year.
 Several difficult to address issues came up repeatedly,
leading to a sense of inaction and frustration.
 This model, which has been exported to other groups at
the University of Utah, has the potential to reduce
burnout in health care in a variety of settings.
 This project requires a close ongoing working relationship
and open communication with leadership to be
successful.
 Our next step is to implement workgroups to address
challenging issues with regular reporting expected.
Burnout decreased dramatically between year 1
and year 2 (Figure 3), related to a number of high
level changes. However, burnout increased in year
3, corresponding with a decrease in sense of
control over workload (Figure 3). Possible
explanations include frustration with changes not
yet made, and perceptions of decreasing
leadership involvement.
Figure 2
Figure 3
Figure 4
Table 1 Action Plans Implemented in the Division to Improve Provider Wellbeing
Issues Identified Quotes Changes Taken Category
Long hours of
operation;
inconsistent
workload
“Close the clinics at 7 pm. It is rare to
find a provider or a patient who would
rather see or be seen after 7. We are
only open then out of convenience for
scheduling and room access.."
Condensed hours of clinic
operation improved individual
flexibility
Templated scheduling to reduce
variation
Workload;
Work-life
Integration
Faculty frequently
bumped out of
clinic to
accommodate
residents
“If you want providers that are going to
be here for a long time and continue
doing a quality job, there needs to be
better scheduling practices.”
Schedule faculty first and then
residents to reduce faculty bumps
out of clinic
Control
Some faculty
overburdened by
covering
attending
“The number of resident clinics to cover is
too many and it is too challenging to
cover the additional slots when people
go on vacation.”
Adjusted payment to faculty for
attending residents to encourage
more consistent staffing
Workload
Frequent charting
after hours
“need more staff support to answer
endless Mychart requests/ labs”
“Keep moving on optimizing the team-
based approach to inbox management.
We've made great progress so far.”
Expansion of Dragon
Medical secretary role
In-basket management work
group Clinic flow and efficiency
work group
Efficiency;
Workload
Faculty struggle
with academic
work
“no time, support, mentorship or structure
to do any research / scholarly work other
than CQI and even then that is
fragmented”
Mentorship of junior faculty writing
Support for faculty scholarship and
career development
Culture
and Values
Desire to
schedule
vacations into the
future
“It was pretty stressful to not know about
time off for summer being ok'd until quite
late this year.”
Process for advance scheduling to
allow time away planning
Work-life
Integration
Poor
communication
“Need more time as a group to discuss
how to manage issues whether it is
scheduling, clinic flow, team function,
etc. Too much being told how things will
go and what will happen and too little
on deciding together what makes the
most sense.”
Recommend time set away to
discuss quarterly
Work groups to address tough
issues.
Culture
and
Values;
Social
Support
and
Community
PROJECT INSIGHTS
PROCESS OF QUARTERLY SURVEY ADMINSTRATION TO FAMILY
MEDICINE PROVIDERS
Figure 1

INTRODUCTION
Results from the 2017 University of Utah Health
Wellness survey indicated faculty and staff at
the Eccles Health Sciences Library (EHSL)
lacked good morale and a unifying team
mindset. Workplace studies show that adding
a social context to work through employee
clubs can be an effective way to increase
moral, reduce stress levels, boost overall
health and well-being, and foster team
bonding.1,2
The Club Eccles (CE) project was inspired by
the 2018 U.S. Women's Olympic Cross-Country
Skiing Team’s mantra3:
CE enables employees with similar interests to
spend 30 minutes or more per week together,
participating in activities they enjoy, while
developing collegiality and camaraderie.
Baseline:
• Feedback from Fall 2017 University of Utah
Health Wellness Survey
• Ideas generated by an EHSL follow-up
meeting with the Resiliency Center
The most significant needs identified: morale
and team building
To develop collegiality and comraderies, Club Eccles was developed and provided a
variety of employee-suggested, extracurricular clubs that had “something for
everyone.” Employees could choose an
Timeline
RESULTS
EHSL monthly employee survey (Y/N):
 Has participating in CE this month
improved your morale at work?
 Has participating in CE made you feel
like you were part of a team?
CLUB ECCLES
Spencer S. Eccles Health Sciences Library
Sarah Dickey, Erica Lake, MLS, AHIP; Melissa Rethlefsen, MLS, AHIP; Catherine Soehner, BSN, MLS
• 50% of employees answered “Yes”
to one of the two questions on
improved moral and team building.
• Scores from the 2018 survey show a
25% increase in wellbeing scores
from the 2017 baseline survey.
• 5 of the 8 clubs voted to continue
even after project ended in Sept.
PROGRESS
 Completed
 None, happily reported
 Sometimes the simplest approaches
are best
PROJECT INSIGHTS
2
3
Do what’s right for me in a
way that’s right for we
“
“ Mar Apr May Jun Jul Aug Sep Oct Nov
Project
Development
8 Clubs
Employee Signup ≥ 1
Club Eccles
Launch
Evaluate
Data
Wrap Up & Celebrate!
Library-wide Picnic
activity they enjoyed, and that best fit
into their work schedule, family
obligations, and other time
commitments, thus relieving potential
stress.
1. Lunch Club
2. Hiking Club
3. Craft Club
4. Tea Time
5. Nap Club
6. Walking Club
7. Book Club
8. Yoga Club
Club Eccles Offerings
4
13.15% 11.10%
86.85% 88.90%
JUNE/JULY AUGUST
No Yes
• Nearly 90% of
participants
reported CE
improved morale
& team inclusion.
1
REFERENCES: 1. Shevory, Kristina. “The Workplace as Clubhouse.” New York Times, February 16, 2008, https://www.nytimes.com/2008/02/16/business/yourmoney/16money.html. Accessed April 10, 2018; 2. Barton, Tynan. “The motivational impact of sports and social clubs.” Employee Benefits, October 24, 2013,
https://www.employeebenefits.co.uk/issues/motivation-and-recognition-supplement-2013/the-motivational-impact-of-sports-and-social-clubs/. Accessed April 10, 2018; 3. Pokorny, Annie. “How the U.S. team completely rebuilt the culture of women's cross-country skiing -- then won the first Olympic gold ever.” ESPN W, March 16, 2018,
http://www.espn.com/espnw/life-style/article/22780439/how-us-team-rebuilt-culture-women-cross-country-skiing-won-first-olympic-gold-ever. Accessed April 10, 2018
CLUB
ECCLES

INTRODUCTION
The Clinical Staff Education (CSE) department at Huntsman
Cancer Institute (HCI) is a group of nurse educators that
function in a unique capacity while facing role-specific
challenges. Educators are expected to perform in a leadership
role; however, trainings afforded to other organizational leaders
are not always available. They also hold responsibility for all
employee education and competency verification but have
no authority to hold employees accountable. Their workload
and expectations are consistently high. Many of the challenges
faced are the same throughout the department. When
challenges are not addressed, nurse educators may
experience increased compassion fatigue and burnout.
The 2017 Engagement Survey asked employees to rate the
statement, "My organization helps me deal with stress and
burnout." The HCI CSE department's survey results were low at
36.4%, compared to a benchmark of 41.3% throughout the
organization.
The goal of this project was to identify departmental stressors
and implement appropriate interventions to address them.
To understand our baseline state burnout we examined:
 Burnout Survey: The department was below average (36.4%)
compared to the organizational average of 41.3%) for engagement.
 Professional Quality of Life (ProQOL) scale: A standardized tool
used to measure compassion fatigue, with a sub-scale that includes
burnout, was administered in May 2018 and results showed
compassion fatigue and employee burnout within the department.
 Engagement survey: The HCI CSE department was significantly
below the benchmark in several areas, specifically job satisfaction
and employee engagement.
 Qualitative survey: Educators were asked to specify what
contributed to burnout, and responses were compiled with the
following themes extracted:
1. Perceived lack of support / growth
2. Intradepartmental negativity
3. High workload
Our problem investigation showed a clear need to address
burnout to provide an optimal work environment with specific
themes in improving professional support and team culture.
1. Professional Support
To address the perceived lack of continued professional
growth, several group classes and team building activities
were implemented.
2. Team Culture
To promote a positive work environment and improve
collaboration the nurse educators took ownership for planning
and implementing team building activities, including service
projects and intradepartmental celebrations.
 Weekly huddle with whiteboard to display significant team events
for the week
 Recognition board: Publicly display peer appreciation and
recognition
 Monthly highlighted behavioral standard: Theme of the month
displayed in department office
 Team building through service project & team retreat
RESULTS
NEXT STEPS
Team suggestions to promote an optimal work
environment included:
 Celebrating success
 Increase support and advocacy for the
department
 Continued trainings and team building
DECREASING BURNOUT IN NURSE EDUCATORS
Huntsman Cancer Institute (HCI) - Clinical Staff Education Department
Cassidy Kotobalavu BSN, RN, OCN; Mary-Jean Austria MS, RN, OCN; Amanda Keddington MSN, RN, CCRN, OCN
 Scores related to all ProQOL scales improved
between May 2018 & November 2018.
Changes in burnout scores were the most
significant.
 Nurse educators reported team building and
educational trainings were most valuable.
 Frequency of comments related to negativity
and workload decreased.
PROGRESS
 Identified two opportunities for improvement:
(1) professional support and (2) team culture
 Successfully implemented several
interventions with 6 months of data
 Adding Wellness Champion project
responsibilities on top of required daily work
 Sponsorship and support from management
helps to remove barriers
 The Value Summary can be a useful tool to
organize and communicate your work
 Involving team in planning and implementing
activities contributed to ownership and buy-in
PROJECT INSIGHTS
1
2
3
Professional Growth & Support Class Topics
Leadership Personal
Resilience
Effective
Communication
15
20
25
30
35
40
45
Baseline (May 2018) 6 Months (November 2018)
ProQOL Results
Compassion Satisfaction Burnout Seconday Traumatic Stress
SCORE LEVEL
22 or
less
Low
23 - 41 Avg
42 or
more
High
21%
23%
42%
39%
35%
24%

INTRODUCTION
Recently, there has been
increased awareness of burnout
and poor mental health amongst
healthcare providers. Studies
show it begins in medical school
and can peak in residency where
the greatest contributing factor is
lack of control of one’s schedule
and available personal time.
Evidence suggests that residents
have higher rates of burnout and
depression compared with
population controls. Studies show
this trend continues into practice.
Two consecutive University of Utah
GME Resident Wellness surveys
found the Ophthalmology
residents to have an 80% burnout,
significantly higher than the
University of Utah Resident
average of 59%. The first survey set
the record for highest level-of-
burnout amongst any University of
Utah residency program but had
56% program response rate. The
second survey, though no longer
the highest level of burnout across
university residency programs,
had a 100% response rate and
demonstrated the same degree of
burnout - 80%.
Design
To improve sense of control and ultimately burnout, a proposal to provide residents with
residents a predetermined administrative half day once a month, was presented to
faculty. Upon approval, residents could choose what activity they did during their
administrative hours. Results of how time was spent is described in figure 1.
Summary Per the internal anonymous resident surveys, we found the administrative time
was used for:
GME Resident Wellness Survey Results
Rate of burnout decreased from 80% in 2017 to 30% in 2018! This was likely
multifactorial, but there was a consensus amongst residents that the administrative time
was the most impactful change.
RESULTS
NEXT STEPS
• Announcing the favorable survey results at
faculty meetings and house staff meetings to
reinforce to all the success of this program.
• A quarterly reminder to faculty and check-in
with residents to ensure the administrative time
continues to be protected.
• Internal resident surveys/reports were issued
(biannually) regarding the use of their
administrative time and perceived impact on
wellness using a Likert-type scale.
RESIDENT ADMINISTRATIVE TIME TO REDUCE BURNOUT
Moran Eye Center
Christopher J. Ricks, MD; Michael K. Burrow, MD; Jeff H. Pettey, MD; Griffin J. Jardine, MD
PROGRESS
 Implemented administrative half days for
ophthalmology residents.
 Getting Faculty buy-in
 A key component of burnout is the perception
that we in health care “lack control: over our
schedules and lives that makes us feel enslaved
to our responsibilities and work. Any effort to
restore control has significant impact on well-
being.
 Give residents administrative time, they love it!
PROJECT INSIGHTS
Spring 2017 Summer 2017 Fall 2017 Summer 2018
All participants indicated
administrative half-days are
extremely beneficial to
personal wellness and that
compared to other wellness
activities offered by the
University, academic half-days
are much more beneficial.
1
2
3
Exceeded goal to reduce burnout in the
Ophthalmology Residency Program.
0%
20%
40%
60%
80%
Oct 2015 Jan 2017 Apr 2018
Goal 40%
1
80%
30%
Faculty
agreement to
implement
First
implementation
attempt, 25%
success rate
Adoption at 50%
with reiteration at
each meeting
100% fully
implemented
29%
28%
13%
13%
18%
Administrative Activity
Study
Wellness Activities
Research
Technical/Surgical Skills
Practice
Other (presentations, patient
care, paperwork)
Figure 1. Results from survey on residents chosen activity
during admin hours.
80%

A Compassionate Workplace Starts With YOU
Sue Childress MN, RN, OCN; Melissa Banner MSN, RN, OCN
Huntsman Cancer Institute at the University of Utah Health
BACKGROUND
Huntsman Cancer Institute (HCI) is an NCI designated cancer hospital.
During a three year period this organization addressed concerns related to moral
distress, workload, and environment to create a more “Compassionate
Workplace.” Although metrics from the ProQOL V survey instrument showed a
modest improvement, comments revealed the need to continue work related to
civil communication. Senior leaders and front line managers all agreed that
holding staff accountable to the behavior standards was going to start with THEM.
INTERVENTIONS
• All managers were expected to take two of the hospital’s iLead classes:
Leading at the Speed of Trust and Crucial Conversations
• Staff were encouraged to use the incident reporting system (RL6) for any
type of incivility displayed by providers, staff, and/or patients/visitors
• The HR department collaborated with training and processes to address
employee issues
• A Civility task force was created including front line staff, managers,
directors and Organizational Development representation.
HCI Executive Leadership recognized that support of a
Compassionate Workplace through civil communication
began at the top, with a commitment to address behavior at
all levels.
OUTCOMES
• Managers and Directors completed iLead classes
• Behavior related reporting increased significantly
• HR provided managers with clear guidelines and support to hold
employees accountable for their behavior.
• Physician leadership established a clear guideline for MD/APC
behavior standards and follow-up
• University leadership, Customer Service and Risk management
provided strong support for patient/visitor expectations
PURPOSE
The purpose of this initiative was to improve communication across the
organization and create a civil environment that supports productive
patient care and employee satisfaction.
Training and Education
Reporting Events
Accountability
A Compassionate Workplace that emphasizes civil
communication can lead to improvements in:
• Quality
• Patient Satisfaction
• Financial bottom line
We have many people to thank for participation in this multi year project but it would not have been
possible without our senior leaders – Ben Tanner, HCI Executive Director and John Sweetenham MD, HCI
Senior Director, Clinical Affairs
NEXT STEPS
• The Civility Task Force, composed of front line staff, are developing
a program that will “hard wire” our PROMISE (Behavior) Standards
into every day work practices.
• Collaborating with the HR Organizational Department, the task
force is developing training for front line staff to reinforce civil
communication.

INTRODUCTION
Work-related chronic musculoskeletal pain and injury are common amongst surgeons. These injuries stem largely from poor operating
room ergonomics or a lack of surgeon understanding of how best to optimize the operating room environment to minimize injury. The
goal of this project is to define the prevalence of work-related pain and/or injury, assess knowledge of operating room ergonomics
and the role ergonomics play in causing injury, educate how to optimize ergonomics, and intervene on behalf of those with pain or
injury.
Voice of the customer analysis showed chronic pain and/or injury is common amongst surgeons at the University of Utah.
Surgeon Survey: The Department of Surgery Grand Rounds was used as a platform to discuss project and survey intent, we have
surveyed all surgeons at the University of Utah for prevalence of work related chronic pain and/or injury, surveyed their knowledge of
the role of operating room ergonomics in causing injury and their understanding of how to optimize ergonomics to prevent injury, and
implement an intervention on behalf of affected surgeons in partnership with Physical Therapy. The survey was developed by Mark
Savarise, MD, MBA (University of Utah) in partnership with Tatiana Catanzarie, MD (UCSD/Kaiser Permanente) with support of the
American College of Surgeons. Preliminary data from the initial survey of general surgery faculty are as follows:
Chronic pain and work-related injuries stemming from inadequate attention by surgeons to operating room ergonomics are common.
This is a significant detriment to the well-being of surgical faculty at the University of Utah. This issue is a consequence of inadequate
training of the importance of optimal operating room ergonomics and a failure of surgeons to recognize the importance of proper
ergonomics in preventing work-related pain and injury. To date, our faculty have not received formal training in work place
ergonomic optimization.
GOAL
MINIMIZING WORK PLACE INJURY BY OPTIMIZING OPERATING ROOM ERGONOMICS
Department of Surgery
David Ray, MBA; Robert Glasgow, MD; Yvonne Savarise, DPT; Mark Savarise, MD, MBA
PROGRESS
 Partnered with UCSD and the American
College of Surgeons to develop and
implement survey to gain a better
understanding of the current problem.
 In process of developing solutions based on
preliminary data findings.
 Finding time to work on project in addition to
team’s overall workload
 Pain and injuries are common in surgeons
 Wellness Champions should ask for help
earlier in their projects
PROJECT INSIGHTS
Reduce surgeon work-related injury
and/or chronic pain stemming from poor
optimization of operating room
ergonomics in all surgeons from 25% to
10% by 7/1/2019.
1
NEXT STEPS
Educate surgeons of the importance of
optimizing the above ergonomic variables
to minimize the chance of sustaining work
related pain and injury.
1
Resurvey following intervention to track
progress and reflect on effectiveness of
improvement
3
Work with Physical Therapy to evaluate and
treat affected surgeons
2
Ergonomics is the interface between the surgeon and the
operating room. Anything related to the operating room that
influences how a surgeon physically does an operation is included.
This includes physical layout of the OR, operating room table height
and angle, and surgeon related variables such as posture,
arm/shoulder/neck angles, etc.
ERGONOMICS er·go·nom·ics | noun
1 : an applied science concerned with designing and
arranging things people use so that the people and things
interact most efficiently and safely
— called also biotechnology, human engineering, human factors
2 : the design characteristics of an object resulting
especially from the application of the science of ergonomic
50-60% of respondents reported work-related
pain including chronic neck, back and
shoulder pain
15-20% had defined injuries
50% of surgeons noted gaps in their
understanding of proper operating room
ergonomics
1.5% of general surgery training programs in the
US have formal programs to address ergonomics

INTRODUCTION
As healers, we often forget to take care of ourselves. Our team identified social disengagement between providers and staff, as well as
different departments within primary care; Family Medicine, Internal Medicine, Pediatrics. A project working on social connectedness
would decrease absenteeism, improve staff health, mental acuity, reduce mistakes and errors, and improve patient care.
 Local Wellness Committee: First, a multidisciplinary committee was established with representation from internal medicine, family
medicine, and pediatrics. Also diversified in social traits (introvert/extrovert). The committee met regularly at beginning and then
moved to monthly once established.
 Scale of Workplace Social Connectedness: To understand our baseline workplace social connectedness, a survey adapted from the
Social Connectedness Scale (Lee, R. M., & Robbins, S. B., 1995). Wording of questions adjusted to accurately reflect community of
interest (i.e. workplace vs. general community). Questions were also added to assess for interpersonal preference (i.e.
extrovert/introvert) and willingness to participate in social activities during or after work hours.
RESULTS & REFLECTION
Attendance to the 1st potluck was high
and fell during the 2nd and 3rd. The social
connectedness survey was reapplied and
showed a mild decrease in connection,
with an average pre score of 31.81 and
post score of 32.28 with the lower number
indicating more connectedness.
CREATING A COMMUNITY OF SUPPORT
Primary Care – South Jordan Health Center
Michael Bouck, LCSW; Carolyn Sanchez, MD; Shane Gardner, RN; Linda Herrera, RN; Kelsee Wride, PharmD; Clint Christofferson, MA; Elizabeth
Starr, MA; Erica Styles, MA; Jennifer Bills, MA; Rebekah Johnson
PROGRESS
 Developed local wellness committee,
increased awareness of wellness in
department, developed measurement for
social connectedness, and hosted 3 events
 Barriers were both personal and systematic.
 Social event attendance barriers included
perceived expectation to contribute food
and having to use clinic or personal time
(clock-out) to attend.
 Providers and MA’s do not frequently use
email and Outlook calendars so those
channels did not work well for promotion
and reminders. Flyers were more effective
for promotion but are not effective at
reminding.
 Let attendees know the goal of the social
events to promote intermingling and
staying for the full event.
 For future social events, rotating with a
variety of activities could sustain
engagement and increase appeal to
different types of people.
 Work with leadership to increase incentives
to attendance and participation.
PROJECT INSIGHTS
Most significant response “I feel a sense
of community at work” decreased from
2.09 to 1.96.
1
 Figure 1 shows the pre-intervention social
connectedness survey results. Pre-test results
showed moderate feelings of connectedness
between employees. There was a fairly even
mix of introverts and extroverts in the survey
sample. Survey also showed a preference in
social activities during work hours (4.72) over
after work activities (4.06).
 Social Events: The committee determined a
lunch event would be most accessible and
respect the preference for activities during
work. We have successfully hosted 3 events:
− Monthly 1.5 hour open house style potluck.
− Two people from the committee were in
charge of theme, sign up sheet, plus setup
and cleanup.
− Word of mouth, flyers and emails were used
to promote the events.
It’s difficult for me to use my skills and talents without someone working close beside me, 3.75
My job is less satisfying without a close friend at work, 2.91
I don’t participate with anyone or any group at work, 4.09
Even among my closest colleagues, there is no sense of community, 4.34
I don’t feel a sense of connectedness with coworkers, 4.06
Even around people I know at work, I don’t feel I belong, 3.97
I participate in groups more for the friendship than the activity, 3.41
Working side by side with others is more gratifying than working alone, 4.28
I’m more productive when I work alone, 2.71
I have a close friend at work, 3.84
My thoughts and ideas are important to my coworkers, 3.84
I feel a sense of community at work, 3.78
I feel connected with people at work, 4.03
STRONGLY AGREE NEUTRAL STRONGLY DISAGREE
STRONGLY DISAGREE NEUTRAL STRONGLY AGREE
Scale of Social Connectedness
Figure 1: Scale of Social Connectedness Pre-Intervention Score out of 5.
1

INTRODUCTION
The Department of Surgery employs over 70 Nurse Practitioners (NP) and Physician Assistants (PA) in a variety of roles across it's 9
Divisions. Between Divisions, there lacks uniformity of annual evaluations or recognition of contributions by these Advanced
Practice Clinicians (APC). University-wide, APCs do not have a career advancement track and limited faculty roles available.
With over 500 APCs in University of Utah Health, this is a large number of individuals without a career advancement model.
Our turnover rate for APCs is higher than we would prefer, and while our average APC in the Department has been with us for
nearly 4 years, those who leave typically do so after just 2-3 years. Most APCs reach optimal proficiency at 18-24 months, so these
losses shortly thereafter increases the burden on the system in both lost productivity and strain on the remaining team members.
We are in an optimal position to look at retaining the talent we have and feel that providing recognition for professional
contributions and advancement opportunities will improve APC fulfillment in their current roles.
As one of many measures to address job
satisfaction and retention among NPs and PAs in
the Department of Surgery, we have looked into
creating a career progression model. This would
allow for consistent recognition of efforts by APCs in
a variety of areas such as clinical
standardization/optimization, research, education,
outreach, and mentorship.
We have developed a draft career ladder which
will now be evaluated for possible implementation.
GOAL
CAREER PROGRESSION OPPORTUNITIES FOR NPs & PAs
Department of Surgery – Advanced Practice Clinicians
Charity Coe, PA-C; Julie O’Brien, APRN; David Kendrick PA-C, Andrea Schindler APRN; Robert Glasgow, MD; David Ray, MBA
PROGRESS
 Learned more about the current state of the
Department of Surgery APCs and their
professional expectations and advancement.
 Draft of career progression model under review,
with collaboration with other Departments to
create a system that is as uniform as possible.
 Lack of senior leadership of the over 500 NPs and
APCs in the organization makes standardization
a challenge.
 Important changes take time and patience to
achieve a worthwhile result
 Collaboration and buy-in are key to a project’s
success.
PROJECT INSIGHTS
Increase NP and PA opportunities for
professional growth in The Department of
Surgery though implementing an evaluation
and professional progression model across
the Department, ideally within the next year.
1
Career Progression Model: The MA and RN career ladders show career
progression up to four levels with a focus on years of experience and
obtaining specific certifications (figure 1). The Physician (and other
clinical faculty)promotion criteria aligns with the School of Medicine
missions in four areas of accomplishment: clinical practice, education,
investigation, and administration (figure 2). Promotion is based on
demonstrating excellence in two areas and effectiveness in the other
two areas, as well as external involvement/dissemination (figure 1).
APC Roles & Responsibilities: Our APCs provide
high-quality clinical care and are involved in
optimizing processes to further streamline
patient care, including informatics. Academic
responsibilities include lecturing or precepting
students, as well as others who embrace a
more formal research role.
To encourage these type of highly engaged
individuals to thrive at the University of Utah,
we would propose an advancement model
that is more than time, certification and job-
based, such as the MA/RN models, to one that
encourages well rounded APCs to thrive in our
Department, similar to the physician model.
AREAS OF ACCOMPLISHMENT EXCELLENCE EFFECTIVE
C L I N I C A L P R A C T I C E
Direct patient care or oversight; develop algorithms, care process
models, protocols or templates; decision support tools to improve
patient care; participation in quality improvement projects or
programs;
− Service on clinical guidelines or
professional society committee
− Dissemination of QI projects
− Presentations on clinical topics.
− Improve care or clinical education.
− Deliver high quality care
− Participation in QI projects
− Ongoing commitment to
maintaining and improving
clinical skills.
E D U C A T I O N
Dissemination of knowledge, skills, and attitudes to trainees, faculty
members, clinicians, staff, colleagues, patients, and the public within or
external to the institution. Education includes teaching activities;
learner assessment; curriculum development; mentoring, advising, and
supervising; and educational leadership and administration.
− Service on curriculum committees
− Dissemination of curricula or teaching
methods
− Presentations on educational topics
− Curricular development
− Participation in at least one
area of education
− Ongoing commitment to
improving educational skills
− Positive assessments
I N V E S T I G A T I O N
Generate or advance creation or development of new knowledge.
These could include such activities as bench research, clinical trials,
quality improvement, and evaluation of educational efforts. Team
science, clinical care, collaboration, technology commercialization,
education, community engagement, advocacy, inclusion,
sustainability, web-based dissemination, administration / service, and
global health.
− Authorship on peer-reviewed original
articles
− Peer-reviewed, durable workshops
− Commercialized innovation that improves
patient care/outcomes
− Other metrics that demonstrate durable
dissemination and impact.
− Participation in investigation
projects that have impact.
− Substantial contributions to
enrolling patients in
published clinical trials
− Completion of QI projects.
A D M I N I S T R A T I O N
Leadership and work within and outside the institution on committees;
participation in organizational efforts to meet strategic goals; and
program or unit leadership. Service includes leadership and work as
part of inclusion, sustainability, outreach, and other service efforts. May
overlap with other areas of accomplishment.
− Service on admin/service related
committees
− Presentations related to admin/service
− Dissemination of admin/service
innovation
− Developmental, scholarly, or
investigational contributions
− Participation in
administrative / service roles
Figure 2. Clinical Track Areas of Accomplishment
LEVEL 1 LEVEL II LEVEL III LEVEL IV
MEDICAL
ASSISTANT
Experience < 6 mo 6 mo – 3 years 3+ years 3+ years
Certification MA by 6 mo MA MA MA
Leadership Role - - Operations responsibilities Lead MA
REGISTERED
NURSE
Experience < 1 year 1 – 5 years 5+
Being Developed
Certification RN Residency RN RN + Ntl. Nursing Cert.
Degree - - Nursing Bachelors (BSN)
Leadership Role - - Charge Nurse / Preceptor
INSTRUCTOR ASSISTANT PROF. ASSOCIATE PROFESSOR PROFESSOR
PHYSICIAN
Areas of
Accomplishment
Emerging
Commit 2 Areas
of Excellence
2 Areas of Excellence
2 Areas of Effectiveness
2 Areas of Excellence
2 Areas of Effectiveness
Involvement /
Dissemination
- -
Excellence outside of
division / department
Excellence outside of
the institution
Figure 1. Career advancement models for Medical Assistants, Nurses, and Clinical Physicians.

INTRODUCTION
In 2017, Imagine Perfect Care awarded
the Redwood Health Center a grant to
build a community garden to improve
patient care. With the garden
construction completed in early 2018, the
garden manager and Redwood
stakeholders decided to use the garden
to engage patients in better self-care for
chronic illnesses, focusing on a clinic-wide
goal to improve diabetes control for their
patients with an A1C greater than 8%.
In 2017 only 66.5% of diabetic patients at
Redwood Health Center were considered
controlled with an A1C of ≤ 8%.
 Identified Barriers: psycho-social
barriers, medication costs, cultural
practices, inconsistent patient
outreach, lack of education, and
preexisting conditions.
 Voice of the Customer: Diabetes
impacts relationships in patients lives.
Health challenges interrupt activities of
daily living or other areas of functioning
(e.g. sleep, diet, food prep, energy
levels). More understanding about
diabetes management is desirable.
 Literature review findings: Greater self-
efficacy has been associated with
positive self-care behaviors in patients
with T2DM1. Studies focused on
improving patient access to produce
found improved health outcomes in
patients with diabetes2.
Our team developed an 8-month gardening program
that promotes healthy living and empowers skill
development through:
1. Educational Resources: A packet of available
diabetic and healthy living resources was
developed and given to each participant. We also
partnered with USU extension for class on using
garden produce for healthy meals.
2. Group Therapy: 8 group sessions were held to
address psycho-social barriers to change. Themes
for sessions came from Voice of Customer analysis.
3. Access to Healthy Food: A plot was
designated to each participant to
grow food of choice.
Promoting the Garden Program
 Internal Campaign: Project team presented at each
department staff meeting in Redwood Health
Center to provide details about the program with
written and verbal instructions to refer patients.
 Patient Promotion: Patients were given information
about the program via MyChart messages, in
person consultations, and referrals from providers or
staff. Interested individuals were given
appointments with the project team and were then
offered placement in the program depending on
interest.
 Patient Flyer: Provided information on the Diabetes
Care Team, Classes, and Other Resources for
support with managing diabetes.
 Dot Phrase in Epic: Inserted in diabetic patient
notes, provided information on the Diabetes Care
Team, Classes, and Other Resources for support with
managing diabetes.
RESULTS
Project evaluations and a focus group reported the program to be helpful.
At least half of the participants took part in all activities involved with the
program, with all participants utilizing appointments with specialists.
Additionally, most of the participants found the individual gardening and
living well classes helpful and all found appointments with specialists helpful.
• Participants with controlled A1c,
an indicator of diabetic wellness,
increased from 40% to 60%.
• Self-efficacy for diabetes, which
measures confidence in doing
certain activities on a scale of 1-
10, showed a positive increased
from 6.45 to 7.35.
ENGAGING PATIENTS IN HEALTHY LIVING
Redwood Health Center Garden Program
Megan Whitlock, LCSW; Michael Bouck, LCSW; Teresa Lopez, LCSW; Julia Ewanowski, LCSW; Hannah O’Neil, CSW; Shauna Chong Lee
PROGRESS
 Completed 8-month long healthy living garden program.
 Maintaining engagement over 8 months is challenging. Despite high
interest, patients were not always able to attend all the activities.
 Learning to grow food and maintain plot was a barrier for many first time
gardeners. Picking up produce in a timely fashion can be difficult.
 Staff participation is difficult without dedicated shift time to tend garden.
 Monetary incentives were provided for attendance to the therapy group
sessions. These were well-received but may not be sustainable.
 Partnering with community experts such as the Edible Campus Garden
and nearby agricultural schools as well as a dedicated garden manger
would help inform the best use of the garden space and ensure upkeep.
 Administrative support is needed to improve patient access to produce.
Next year we hope to implement a dedicated space in clinic for free
produce pick up for patients in need and promotion of available
produce from providers .
PROJECT INSIGHTS
1
2
References: 1. Aljasem LI, Peyrot M, Wissow L, & Rubin RR. (2001). The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Education, 27(3):393–404; 2. Weinstein, E., Galindo, R., Fried, M., Rucker, L., & Davis, N., (2013). Impact of a Focused Nutrition
Educational Intervention Coupled With Improved Access to Fresh Produce on Purchasing Behavior and Consumption of Fruits and Vegetables in Overweight Patients With Diabetes Mellitus. The Diabetes Educator, 40 (3), 100-106. doi/abs/10.1177/0145721713508823
Loved this program!
Participating in the gardening
program allowed me to use
more fresh vegetables in my
meals, being mindful of what
is a healthier option.
“ “

DEPARTMENT OF INTERNAL MEDICINE
WOMEN'S WORLD CAFÉ
Dori Knight; Mandy Skonhovd; Aaron Bell
RESILIENCY CENTER | DEPARTMENT OF INTERNAL MEDICINE
PROJECT VISION
BASELINE ANALYSIS
Participants in the Women's World Café educated
leaders on historical concerns and identified
several areas of immediate improvement or focus.
WORLD CAFÉ METHOD AND PROJECT OVERVIEW
A World Café helps to foster calm and deep conversations with less debate and more listening by using
five structured communication techniques:
1. Structuring Innovation: Invite participants to gather in small groups to discuss shared challenges
2. Arranging the Space: Tables with the advertised topic of conversation, with 5 to 7 seats at each, are
assigned a facilitator to keep the discussion on track and conversation flowing
3. Distributing Participation: Everyone is included in the conversations and provided with equal opportunity to
contribute
4. Configuring Groups: Table participants are unassigned and diversely comprised of any interested in the topic
5. Time Allocation: Facilitators host the dialogue, encouraging open-ended contributions from all participants
in five-minute rounds
PROGRESS TO DATE: Instituted faculty driven task forces to address diversity, equity, career
development, and mentoring, and launched a Women's World Café for staff.
ROADBLOCKS & BARRIERS: A World Café is a foreign format to most and getting enough
attendees proved difficult. Finding a convenient time that did not detract from work or family
was also a challenge, but holding an evening event was success.
VALUABLE LESSONS LEARNED: Addressing gender-related issues through a World Café can be
a unifying experience through opening conversations, increasing awareness, and in bringing
individuals of any gender together to identify productive solutions
ProjectInsights
WOMEN'S WORLD CAFÉ FOR STAFF
University of Utah Health Department of Internal Medicine
Over the last year, the Department of Internal Medicine chose to focus on gender related issues that directly impact resiliency and wellness of female faculty and
trainees. Historically, the State of Utah has struggled to break boundaries and address inequity issues for women, earning a rather poor report card with an F in Work &
Family, a D+ in Poverty & Opportunity, a B in Health & Well-Being, and a D in Employment & Earnings.
Though one of the largest departments in the School of Medicine, women are the overwhelming minority, representing only 36% of faculty in the Department of Internal
Medicine. To give these women a voice and safe space to come together, the Department of Internal Medicine chose to hold an event to address and learn about the
issues and concerns that directly impact this minority group.
1
2
Themes focused on:
• Workplace culture
• Bias
• Mentoring
• Enhanced communication
• Work-life balance
• Leadership development
• Career advancement
In true "café" style, we hosted a dinner which encouraged socializing and networking prior to discussions.
Chairs of other academic departments and senior women leaders from the School of Medicine
participated as facilitators. Over 50 faculty and trainees attended.
1. Status of Women in the States: https://statusofwomendata.org/wp-content/themes/witsfull/factsheets/economics/factsheet-utah.pdf
2. Liberating Structures Conversation Cafe: http://www.liberatingstructures.com/17-conversation-cafe/
Because of the event's success, we extended this
initiative to staff in the Department of Internal
Medicine.
Through the faculty event, we learned that certain
issues are not gender exclusive and that men
indicated a desire to know and understand issues
their women colleagues face.
Unlike the faculty event, invitations were sent to all
staff, regardless of gender, to be more inclusive.
The Women's World Café for Staff will be held
December 14, 2018. We look forward to learning
how we can further explore resiliency and wellness
issues for the entire Department of Internal
Medicine.
Women's World Café - March 14, 2018
As a result, Department leadership launched
multiple task forces to focus on mentoring, equity,
diversity, and career development. Additionally,
administrative initiative groups were formed to
tackle process improvement issues, brought up in
the discussions.

Team Building for Internal Medicine Interns: Part of a Comprehensive Wellness Program
Amy N. Cowan, MD, MS
Salt Lake City Veterans Administration Health Care System
University of Utah Graduate Medical Education, Department of Internal Medicine
Background Methods
Objectives
• Evaluate intern satisfaction through post-activity
survey and narrative comments
• Explore if these types of activities could lessen
burnout
• Use narrative comments to help guide future
activities
Design
• 55 Interns were divided into groups of 10-12
• Created a curriculum to relate rock climbing to
medicine – problem solving, emotion regulation, asking
for help, communication both verbal and non-verbal
Intervention
• Small groups each met once for 2.5 hours over 5 wks
• A climbing instructor taught the group belay skills
• Interns paired up with different partners throughout the
activity to practice as climber and belayer
• Scheduled pauses throughout the activity for
discussion, reflection, and stress relieving strategies
Results
Conclusions
Looking Ahead
• Change climbing activity from July
to February to target time of year
when interns are most at risk for
depression and burnout
• Focus activity to go beyond team
building and provide an opportunity
for debrief and to share support
strategies
• Include more Chief Medicine
Residents, residents and committed
faculty to participate
Survey Results
•Attending this activity was worth my time 96%
•I want more types of these activities sponsored by the
department 90%
•These activities are an important part of decreasing
burnout 85%
•I would highly recommend this activity to others 90%
Narrative Comments
“How quickly we could trust each other.”
“Surprised how others had similar feelings of being
overwhelmed at work.”
“How much I bonded in such a short time!”
“I feel valued.”
“Others are going through the same thing.”
i
• Interns and leadership see value in
this activity
• This program could serve as a
springboard for connection leading
to other wellness activities such as
meals together, beer making, hiking,
etc.
• Over time this activity, embedded
within a comprehensive wellness
program, may be protective against
workplace burnout
Medical residency has high rates of burnout
nationally. In October 2017 our program of 124 was
surveyed by GME. A response rate of 42% evaluated
the following:
• Symptoms of depression – program 33% vs all
programs in GME 35%
• Burnout – program 60% vs 59%
• Perceived appreciation from the program was
slightly below the mean for all programs.
Our wellness program includes a wellness lecture
series, social and athletic activities, snack baskets for
our inpatient teams and has named faculty and
residents as wellness champions. People identified as
peer or faculty support for residents in distress.
Since many interns have left behind an established
social support network we wanted to engage them
with each other and expose them to something our
community is famous for, rock climbing.

Restoring Balance Self-Care Retreats
DEPARTMENT OF PSYCHIATRY
Paul Thielking, MD University of Utah
Introduction
Burnout is a psychological syndrome that includes
emotional exhaustion, depersonalization, and a
reduced sense of personal accomplishment (1).
Physicians, nurses, and other health care
professionals are at high risk of burnout (2)(3).
Interventions with most evidence supporting their use
are mindfulness-based interventions. Mindfulness
interventions have been shown to decrease burnout,
increase empathy, decrease stress and anxiety, and
increase a sense of meaning/engagement with work
(4,5,6).
One barrier for professionals that might be interested
in mindfulness training is that mindfulness based
interventions often involve at 8 week commitment,
are time intensive.
In effort to create innovative ways of promoting self-
care and decreasing physician stress and burnout,
we have developed a one-day "Restoring Balance"
retreat. Starting in May, 2016 these retreats have
been offered on a monthly basis. The HCH retreats
have been attended by staff throughout the HCH
institution, including: nurses; social workers; chaplains,
advanced practice clinicians, clerical staff;
housekeeping personnel; pharmacy staff; food
service workers; and other HCH employees.
Results
A mixed model analysis found a significantly lower
Emotional Exhaustion (EE) score at post-survey than
at pre-survey (t = -2.30, p = .0257). At pre-survey, the
mean EE subscale raw score for all participants is
23.24. At post-survey, the mean EE subscale score for
all participants is 20.61
There were no significant differences in pre-survey
and post-survey scores for the Depersonalization and
Personal Accomplishment sub-scales.
Methods
Burnout was assessed using the Maslach Burnout
Inventory (MBI). The MBI measures three dimensions
of burnout: emotional exhaustion, depersonalization,
and personal accomplishment. (1) From December,
2016 through November, 2017, a total of 49 retreat
participants completed pre-retreat Maslach Burnout
Inventory (MBI) questionnaires and post-retreat
questionnaires 3 months following completion of the
retreat.
Discussion
Caring professionals are at high risk of burnout. The
oncology setting is particularly challenging for health care
professionals.
The Restoring Balance retreat offers a one-day intensive
that helps participants gain insights into sources of
burnout, and teaches tools that can be used to alleviate
stress and allow for balance between caring for others
and caring for the self. This one-day retreat was
associated with improvements in emotional exhaustion
that were present 3 months after the workshop.
Future plans will be to do a more rigorous assessment of
these workshops for nurses.
The Restoring Balance
retreats consist of several
components including:
Educational: Discussion of concepts including burnout,
compassion fatigue, wellness, mindfulness, and stages
of behavioral change.
Mindfulness Training: Guided mindfulness exercises are
taught at various times through the day, including
sitting meditation, walking meditation, and restorative
yoga. There is an emphasis on integrating brief
mindfulness practices in the midst of work activities.
Large group “Big Mind Process”: Facilitated exploration
of some of the core issues that contribute to provider
burnout, with a focus on internal resources and barriers
to good self-care.
Dyads: “Being Present” exercise with partner,
Closing Process: Integration of retreat experiences and
each participant developing a written self-care plan
Available on request.
References
Burnout Pre-Retreat Post -Retreat change p-value
Emotional Exhaustion 23.24 20.61 2.63- 0.0257
Depersonalization 6.39 5.17 1.22- 0.763
Personal Accomplishment 38.31 38.62 0.31+ n/a

0%
25%
50%
75%
100%
clinic lunch go relax respected
pre project post project
Look forward to
clinic lunches
Have somewhere
to go to relax
Feel respected &
appreciated by
management
Staff survey questionnaireRESULTS
NEXT STEPS
INTRODUCTION
We recognized a need to improve morale at our clinic. There
were no healthy options for buying snacks or lunch and no place
to decompress from clinic stress or connect with colleagues.
Monthly clinic meeting lunches and recognition rewards were
nutritionally poor and felt disrespectful.
This environment has led to staff not feeling valued, respected, or
connected. This was identified as a prominent issue on a pre
project survey and has resulted in high staff turnover.
Gemba Walk: showed inadequate, uncomfortable, break room
space with noise from GI suction closet and view of loading dock;
Staff eating separately in make-shift places -- at desk, in
conference room, in break room; Monthly lunch uninspiring,
processed, high-fat, nutritionally-poor food.
Voice Of Customer: Staff do not look forward to monthly lunches
and they do not have a place to go to decompress and relax.
Survey Results: On our survey of Redstone staff the majority
agreed that our coworkers are our best asset. They also agreed
that their main concerns are the negativity of the staff and the
lack of a supportive and respectful work environment.
• 83% feel connected to colleagues
• 79% of staff don’t look forward to clinic lunches
• 78% don’t have somewhere to decompress & relax at work
• 26% of staff have symptoms of burnout.
PROGRESS
▪ Ongoing
▪ Initial push-back from administration
▪ Delays in delivery of ordered products
▪ Delays in completion of work orders
▪ Difficulty coordinating efforts between off-site
departments
▪ Even with only partial project implementation, we
saw surprising improvements in staff attitudes
toward project goals.
▪ Staff burnout is multifactorial and continued
attention to wellness is needed to have a real
PROJECT INSIGHTS
We formed a Wellness Team with the goal of improving the
morale at our clinic. Our project focused on nourishing our
bodies and minds. We are creating a rejuvenating space for
employees and staff and we worked with administration and
registered dieticians to develop healthier options for snacks
and meals. Highlighted below are a few key initiatives:
Project 1: Breakroom Space
Project 2: Registered Dietitian Approved
Project 3: Wellness Team Suggestion Box
Working with the RD Approved team, we
were able to find healthier catering options
within budget for our monthly meetings.
Also, we have purchased a small fridge to
store healthy snacks and drinks for staff to
purchase in the breakroom. Profits from
snack sales will go towards future wellness
initiatives.
NOURISHING OUR BODIES & MINDS
Department of Family & Preventive Medicine – Redstone Clinic
Sandra Van Leuven, MD, PhD; Alessandra Zimmerman, PA-C; Mary Anderson, RN, BSN; Kristyne Showell, MA, EMT
The loading dock and breakroom were minimally furnished,
uninviting spaces for staff to relax. With the support of a
wellness grant, we are creating a welcoming, rejuvenating
environment where staff can connect.
A wellness suggestion box has been
created to generate future initiatives and is
posted prominently by the time clock.
• Implement the sale of healthy snacks and drinks in
break room by early 2019
• Complete loading dock remodel and break room
improvements by May 2019
• November 2018 survey results showed 23.5% of staff
have ANY symptoms of burnout vs. 14.4% in May.

IMPROVING CRITICAL TEST RESULT
MANAGEMENT IN RADIOLOGY
Megan K. Mills, Tony Jones, Richard Wiggins III, Taylor Conkey, Edward Quigley, Luca Boi and Satoshi Minoshima
Department of Radiology and Imaging Sciences, University of Utah
SUMMARY
One of the Joint Commission National Patient Safety
Goals is to “report critical results of tests and
diagnostic procedures on a timely basis”. Critical test
result management (CTRM) can be a frustrating task
for radiologists and support staff. This workflow
process is wrought with frequent interruption and
can require significant effort during an already busy,
high volume radiology practice. These stresses have
a negative impact on wellness in the work place.
The current CTRM process has numerous potential
targets for intervention and process improvement.
PLAN
We utilized a ‘go and see’ method of analysis to
identify specific areas for improvement in our critical
test result management (CTRM) workflow. The
current state is outlined by the flow chart in the
central panel. During clinical hours, radiologists
make use of a reading room assistant (RRA) to
perform steps of the workflow, while afterhours these
steps are performed by the interpreting radiologist.
We identified a bottleneck during a portion of the
workflow where the radiologist waits for a callback
from the responsible care provider (RCP). A call
back from the RCP took, on average, 7 minutes. We
decided to target this specific step for intervention.
Existing IT vendor products have been specifically
designed to improve the communication of critical
results. According to a report by AuntMinnie.com,
despite the availability of these products, fewer than
400 hospitals have implemented a CTRM product.
A solution assessment was undertaken for two
available CTRM products, an Epic-based
communication tool, as well as an external CTRM
product. The Epic solution addressed all of the
functional requirements of CTRM, including the
ability to establish direct communication, a ‘hands-
off’ solution for the radiologist, direct communication
with an RCP, and automated documentation that can
be audited. While the external CTRM product
provided many of these same abilities, barriers were
identified. These barriers included cost, introduction
of a new site-wide IT product, and the absence of
two-way communication.
We hypothesize that information technology
solutions can be used to improve the efficiency of
critical radiology results communication.
Implementation of an electronic critical test result
management tool can improve the radiologic
workflow, decrease stressors in the workplace, and
improve wellness.
The Epic CTRM tool is an existing feature that is
available, but not currently used at the University of
Utah. The Epic CTRM tool alerts an RCP via the
Epic Inbasket and provides the ability for
progressive alerts and flags within the electronic
medical record. Because this system is integrated
with the electronic medical record, it is auditable and
reportable through Epic Workbench. In addition to
the initial communication, the Epic CTRM also has
the ability to alert the RCP when a follow-up study is
due or provide a means to enter a future order.
DO
The next step in our process cycle to is implement
this initiative on a small scale. Participation of a few
radiologists and targeted clinicians will allow repeat
data collection on a small scale and further study of
our process change.
STUDY
We will gather data from our pilot and measure the
efficiency of CTRM delivery to evaluate the impact of
the change. We expect to see time savings after the
implementation of this tool. Compliance to JCAHO
National Patient Safety Goals and incidence of
critical result reporting is currently measured by our
department for a number of specific critical results
(ie. pulmonary embolism, acute intracranial
hemorrhage). Current compliance data could be
compared against reports utilizing CTRM software.
ACT
If our analysis demonstrates improved efficiency, we
can turn to system-wide implementation. CTRM
products have a varied history of success at other
institutions. A consistent barrier is the culture change
required for successful implementation. We continue
to seek ways to combat potential barriers, including
involvement of hospital administration senior staff
early in the implementation process. The current
process will continue to be refined, with the ultimate
goal of system-wide adoption and potential
expansion into other areas requiring critical
communication.
1. https://www.jointcommission.org/standards_information/npsgs.aspx
2. Critical Results Reporting Software Is Promising, Challenging
https://www.auntminnie.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=8
2463
3. SelectNuance Announces Veriphy 4.0, Critical Test Result Management For
Radiology, Pathology, Cardiology and Clinical Laboratories
https://www.businesswire.com/news/home/20091130005270/en/Nuance-
Announces-Veriphy-4.0-Critical-Test-Result
There is an opportunity to enhance wellness in the
radiology department by improving critical results
reporting at the University of Utah. The Epic critical
results management tool provides a way to increase
efficiency in the radiology workflow and, potentially,
other departments who manage critical results.
MOTIVATION
METHODS
CONCLUSION
METHODS CONT.
REFERENCES

University of Utah Health Wellness Champion Poster Session 2019

University of Utah Health Wellness Champion Poster Session 2019

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University of Utah Health Wellness Champion Poster Session 2019