Children's Hospitals Today - Spring 2023 - 14

FEATURE / WORKFORCE
Sandhu's story is all
too familiar
up and down hospital halls across
America. Health care worker burnout
has hit record highs-and children's
hospitals are not immune to it. " There's
this fundamental disconnect between
what called people in the healing profession
to their work and the environment
they find themselves working
in today, " says Jessica Perlo, M.P.H.,
senior director and improvement advisor
at the Institute for Healthcare
Improvement (IHI). " We're seeing this
with high staff turnover, absenteeism,
burnout, poor mental health, and in
some cases, suicide. It's not new, but it
has been exacerbated by the pandemic. "
And it has snatched the joy out of
work for so many in health care-an
industry where joy is not just a nice-tohave.
According to Donald M. Berwick,
M.D., president emeritus and senior
fellow at IHI, joy in work is an essential
resource for the enterprise of healing.
" The gifts of hope, confidence and
safety that health care should offer
patients and families can only come
from a workforce that feels hopeful,
confident and safe, " he says.
To help hospitals and health systems
in this effort, IHI designed and tested
the IHI Framework for Improving
Joy in Work. Informed by experts and
organizations both in and outside of
health care, the Joy in Work Framework
outlines nine critical components of a
system for ensuring a joyful, engaged
workforce and the steps leaders and
teams can take to get there. It also provides
ideas to test and assessment tools
to set hospitals up for success. Here's
how children's hospitals are leveraging
the framework.
The Joy in Work Framework
According to Perlo, who leads IHI's
workforce well-being portfolio, the
most joyful, productive and engaged
staff feel physically and psychologically
safe; appreciate the meaning and
purpose of
their work; have
some
choice and control over their time; and
experience camaraderie with others at
work. Of the nine components, those
are the most important, followed by
the other five: recognition and rewards;
participative management; daily improvement;
wellness and resilience;
and real-time measurement. Essential
to all the components is fair and equitable
treatment of all employees.
There are many ways to implement
the components-from simple,
immediate initiatives to long-term,
system-wide projects-and what that
looks like will vary depending on the
organization and, especially, the leaders.
Senior leaders are accountable for
modeling and developing a culture,
structure and vision that fosters
trust, improvement and joy. Managers
and core leaders have a pivotal role in
everyday work by identifying what
matters and developing practical strategies.
All leaders can follow IHI's four
steps to implementing the framework
(see sidebar on page 16).
Although leadership is crucial, IHI
stresses that leaders are not solely
responsible for improving joy and
well-being in work. According to Perlo,
everyone plays an important role in
nurturing joy in the workplace by contributing
to local improvement efforts
to improve staff experience and working
to support a more equitable work or
learning environment.
Lastly, achieving joy in work requires
measuring results. " It's important for
joy to be a key organizational metric on
the same level as other organizational
priorities and measures, " Perlo says. IHI
provides a list of potential methods, but
Perlo says the most practical approach
is to leverage existing measurement
data-such as satisfaction, engagement,
burnout, turnover, retention and
absenteeism-and to supplement with
local measures where improvements
are being implemented. Regardless of
what is measured, leaders must track
and share data regularly during the
improvement process and make the
results transparent.
GETTING STARTED
One fun measurement tool
IHI provides a detailed list of tools children's
hospitals can use to measure and assess joy in
the workplace, but here's a simple idea you can
try right away: a jar into which staff drop a colored
marble at the end of each day. Blue for a good day,
tan for bad day. With a glance at the jar, staff can
gauge the daily mood of the organization and also
assess levels of joy in work over time.
Source: IHI Joy in Work White Paper
Getting started
with Joy in Work
As part of CHOC's broader organizational
strategy to take good care of
its people, Sandhu and her team have
been implementing IHI's Joy in Work
Framework since November 2021. They
selected three areas to pilot the framework-one
in each of their hospitals
and one in a primary care office-and
started right where IHI suggests: by
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CHILDREN'S HOSPITALS TODAY Spring 2023
Children's Hospitals Today - Spring 2023

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