Creating Joy in Work – Critical issues

Last week I discussed IHI Framework for Improving Joy in Work and it’s relevance to the veterinary profession.   The purpose of the study was identify concrete ways healthcare leaders can  initiate change from a culture of burnout to a culture of joy and engagement. Four steps were recommended in starting the process:

• Ask staff, “what matters to you?”
• Ask staff, “what impedes your ability to do your best?”
• Use a systems approach to tackle improvement projects
• Measure and celebrate what you do

Five Critical Issues

Through the four step approach, five critical issues were identified that must be addressed with the greatest attention if you really want to decrease burnout and increase joy. All of these directly apply to veterinary medicine. The five critical issues include:

• Physical and psychological safety
• Purpose and meaning of work is appreciated
• Some choice and control over the way time is spent at work
• Camaraderie with colleagues
• Work life is considered to be fair and equitable

Let’s talk about ways that veterinary leaders can address and improve each of these 5 critical needs.

Joy in Work Critical Issues – #1: Physical and psychological safety

It is incredibly difficult to be happy at work if you are worried about getting hurt and don’t feel like others care.  Do you know how many bites happen in your hospital each year?  Do you provide needed equipment for preventing bites?  What is your training program for new employees?  Do you have ergonomic chairs, workstations, and equipment to help move large dogs? Are your staff safe from dangers from clients, especially if working at night?  Do you have a panic button?  Protocols for calming irate customers?  A fast management/doctor response when front line client care is worried or scared? You can’t change these things all at once.  ASK your staff, “what worries you most?” and start there.

Psychological safety is one of the most important aspects of a joyful culture.  Psychological safety means that people trust that they will get a positive response when they ask a question, seek feedback, admit a mistake, or propose an idea.  Studies in human medicine have shown that patients are safer in hospital cultures where all staff members are comfortable speaking up. In fact, it is very hard to have a conversation about what matters unless people feel safe to tell you.

A recent study of adverse events during spay/neuter surgeries demonstrated this importance in veterinary medicine.  The study looked at how veterinarians recovered after a patient death or adverse event.  The study found that veterinarians who had an opportunity to have open conversations and learn from these adverse events were more resilient and able to recover that those that did not.  Creating psychological safety is hugely important in preventing burnout, especially when unexpected things happen.

Joy in Work Critical Issues – #2: Purpose and meaning of work is appreciated

Do you have a mission statement for your hospital?  Do you know what it is?  Does your staff?  Does it really drive and inform decisions?  More importantly, is your mission statement really WHY you do what you do? I love this TED talk by Simon Sinek on the importance of finding your personal “why” when running your business.

I think we often underestimate the importance of feeling connected to a bigger purpose in satisfaction at work.  A study by Bentley’s University’s Center for Women and Business reported that 84% of millennials believe that making a difference is more important than professional recognition .  In a study of millennials by Deloitte, 2/3 state they chose their job based on the organization’s purpose.

Joy in Work Critical Issues – #3: Choice and control over the way time is spent at work

While there are some things that must be done a certain way at a certain time, providing some autonomy and choice, greatly improves people’s enjoyment at work.  For example, you can comfort a mom coming back from maternity leave if you grant her the freedom to adjust the appointment schedule if needed to allow her to pump.   If someone suggests a change to the medical record format to fix a work flow issue, implement it! These changes will likely gain you both appreciation and efficiency.  Give your client care staff  the freedom to provide a gift card or small discount if a client is upset.  This both empowers your team to address issues quickly and decreases demands on your time.

Joy in Work Critical Issues – #4: Camaraderie with colleagues

The creation of a shared vision of success is one of the most important things that a hospital owner and manager can do to build a cohesive team.  You should aim to create a culture in which appreciation and gratitude is expressed daily as this is incredibly important for a joyful work environment.  How are people treated when they ask a question?  Is the culture one in which all questions and feedback are valued and answered?  How often do people say, “thank you,” or ask you how your day is going?  These things matter.

Creating a team environment also means hiring for attitude and value alignment not just skill. “Plays well with others,” is crucial for the team based care we need in our veterinary hospitals.

Joy in Work Critical Issues – #5: Work life is considered fair and equitable

When workplaces play favorites, team morale suffers.  I have seen several situations where on call was not split equally among clinicians in a certain specialty.  That unfairness by itself created a workplace that could not become cohesive.  Transparency around decisions and being willing to explain “why” helps in demonstrating fairness and equity.

No one said change is easy

Change is hard.  For some, any change brings stress.  For others, moving too slowly on a route of change is even more stressful.  However, if burnout and turnover are occurring in your hospital and you don’t ASK these questions and take action, you won’t make a difference.

Bright spots

The Oregon Medical Group provides a bright spot of what can happen when an organization sets out to improve.  This physician led group started measuring burnout in its staff and clinicians in 2013.   At that time, the prevalence of emotional exhaustion was 38%.  When measured in 2017, it had decreased to 8%.  What changed?

First of all, the simple choice to measure burnout means that it is being taken seriously.  You can’t fix what you don’t understand.  Second, as discussed last week, you have to ASK the right questions of the right people to really know what is causing them stress.  Third, you have to understand the underlying causes of burnout and work to address them.  The cultural changes the organization was willing to make has transformed it from a tired staff to one that is engaged.

I challenge you to start the journey today to improve joy in your hospital.