UCLH ED-CREW Compassion Resilience Engagement Wellbeing

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UCLH ED-CREW Compassion Resilience Engagement Wellbeing by Mind Map: UCLH ED-CREW  Compassion Resilience Engagement Wellbeing

1. Compassion Compassion for self, patients, carers & colleagues. Mindfulness as a means of developing compassion.

1.1. Sources to inform approach

1.1.1. Intelligent kindness: reforming the culture of healthcare | John Ballatt; Penelope Campling | London RCPsych Publications 2011

1.1.2. Medicine & Compassion: A Tibetan Lama's Guidance for Caregivers (Medicine and Compassion) (eBook, 2006) [WorldCat.org]

1.1.3. Mindful medical practice : clinical narratives and therapeutic insights (eBook, 2015) [WorldCat.org]

1.1.4. Attending : medicine, mindfulness, and humanity (eBook, 2017) [WorldCat.org]

1.1.5. Compassion, empathy and sympathy – what do they truly mean? - To Medicine with Love

1.1.6. Barriers to the delivery of compassionate care in emergency departments https://journals.rcni.com/emergency-nurse/evidence-and-practice/compassion-in-emergency-departments-part-2-barriers-to-the-provision-of-compassionate-care-en.2018.e1775/full

1.1.7. Empathy, sympathy and compassion in healthcare: Is there a problem? Is there a difference? Does it matter?

1.1.8. Enabling and supporting delivery of compassionate care in emergency departments https://journals.rcni.com/emergency-nurse/evidence-and-practice/compassion-in-emergency-departments-part-3-enabling-and-supporting-delivery-of-compassionate-care-en.2018.e1776/full

1.2. Issues & initiatives

1.2.1. Facilitated discussion in teaching time about what is compassion, what are the barriers, how can we practise it?

1.2.2. Mindfulness, empathy and compassion

2. Resilience Organisational resilience vs. personal resilience: a resilient organisation absorbs shocks so staff don't have to; this should be our chief concern. But some stresses are inevitable in medicine, so stress management is important for individuals, too.

2.1. Sources to inform approach

2.1.1. Sign Up to Safety |

2.1.2. Greater resilience, better care

2.1.3. The Resilient Physician : a Pocket Guide to Stress Management (eBook, 2018) [WorldCat.org]

2.1.4. Real happiness at work : meditations for accomplishment, achievement, and peace (eBook, 2014) [WorldCat.org]

2.1.5. Every Doctor : Healthier Doctors = Healthier Patients. (eBook, 2018) [WorldCat.org]

2.1.6. Incivility Bad manners in the Emergency Department: Incivility among doctors Mastering civility An Antidote to Incivility Overlooked but not untouched: How rudeness reduces onlookers’ performance on routine and creative tasks Assessing and attacking workplace incivility Assessing and attacking workplace incivility

2.1.7. Health Education England - Mental Wellbeing Report

2.1.8. Health Education England - Enhancing Juniors Doctors' working lives

2.1.9. Conceptual Model of Factors Affecting Clinician Wellbeing and Resilience - National Academy of Medicine

2.1.10. Wellness book for emergency physicians https://medicine.umich.edu/sites/default/files/content/downloads/Wellness_Book_for_Emergency_Physicians.pdf

2.1.11. Educational innovations to foster resilience in the health professions

2.2. Issues & initiatives

2.2.1. Workplace incivility Incivility between colleagues Appoint civility champions within ED? Referrals to inpatient specialties Abuse from patients Can we be clearer about refusing treatment to abusive patients?

2.2.2. Staff facilities Relaxation / quiet space Catering Toilets Lockers & changing facilities

2.2.3. What else causes avoidable stress during a typical shift in the emergency department? Staff feedback exercise

2.2.4. Moral injury and the second victim syndrome Mental processing of challenging events Incorporate critically reflective review of difficult cases / shifts into ED education programme Promote the use of reflective journals and adopt a structured model for criticalreflection

2.2.5. Providing clear signposting to professional support services Notice board Website Twitter

2.2.6. Managing distractions and interruptions

3. Engagement Can be viewed as the opposite of burnout: an engaged employee exhibits vigor, dedication, and absorption in their work.

3.1. Sources to inform approach

3.1.1. Bakker & Demerouti's job demands & resources model of work engagement

3.1.2. Ryan & Deci's self-determination theory of motivation and wellbeing

3.1.3. Johnson & Johnson's cooperative learning model

3.1.4. Engaging for success: enhancing performance through employee engagement, a report to Government - Digital Education Resource Archive (DERA)

3.2. Issues & initiatives

3.2.1. Promote clinicians' autonomy Develop proposal for annualised self-rostering for ST4+ grades Support ST4+ autonomy on the shop floor

3.2.2. Enhance team members' relatedness Establish an ED social committee Online networking & discussion Increase use of cooperative learning / team-based learning in ED education programme

3.2.3. Support clinicians' sense of competence Develop a system to regularise giving positive feedback to colleagues, e.g. by consultant in charge

4. Wellbeing Strategies to help staff maintain their health as an holistic concept incorporating physical, psychological, emotional, relational, and spiritual wellness.

4.1. Sources to inform approach

4.1.1. The Wellness Inventory (John Travis)

4.1.2. HM Government report - Mental capital and wellbeing (five ways to wellbeing)

4.1.3. Action for Happiness - 10 Keys to Happier Living

4.1.4. PERMA at University of Pennsylvania - Positive Psychology Initiatives | Authentic Happiness

4.1.5. The Wellness Wheel

4.1.6. Wellness for helping professionals : creating compassionate cultures (Book, 1990) [WorldCat.org]

4.2. Issues & initiatives

4.2.1. Deliver an holistic wellbeing session as part of the ED induction programme Each attendee will complete a personal wellbeing plan

4.2.2. "Passive programming" - providing information about healthy habits and practices Notice board Website Twitter

4.2.3. Embedding the concept of wellbeing into our everyday practice Make wellbeing an explicit part of all educational supervision meetings

4.2.4. Increase availability of information about the 52 Club and SPSS to junior doctors in the ED

4.2.5. Healthy snacks in the department

4.2.6. Link up with UCL's iWARDS programme (https://drive.google.com/open?id=1iBtC3SNkSz7LcjdSjm_MZTqDPMSSfNJU)

4.2.7. What is the place of mindfulness in the practice of medicine?

5. Why this? Why now?

5.1. Health Education England - Mental Wellbeing Report

5.2. Health Education England - Enhancing Juniors Doctors' working lives

5.3. GMC - Supporting medical students and doctors' wellbeing

5.4. UK Doctors' Burnout & Lifestyle Survey

5.5. We Need to Talk More about Physician Burnout

5.6. Burnout among doctors

5.7. Burnout, depression and anxiety – why the NHS has a problem with staff health

5.8. NHS health and well-being review : Department of Health - Publications

5.9. Panic, chronic anxiety and burnout: doctors at breaking point

5.10. Also human : the inner lives of doctors (eBook, 2018) [WorldCat.org]

6. Resources

6.1. Online (accessible from outside of work)

6.1.1. Padlet board - UCLH ED-CREW

6.1.2. Twitter profile - UCLH ED-CREW (@uclhedcrew)

6.1.3. Shared reading list

6.1.4. Pinterest board - UCLH ED-CREW

6.1.5. WordPress blog - UCLH ED-CREW

6.2. Noticeboard in ED staff area

6.3. Licence to use Maslach Burnout Inventory? Maslach Burnout Inventory (MBI) - Assessments, Tests | Mind Garden - Mind Garden

6.3.1. Would UCL Partners fund this, if part of a research proposal?

6.3.2. Alternatives exist, and some are free Valid and Reliable Survey Instruments to Measure Burnout, Well-Being, and Other Work-Related Dimensions - National Academy of Medicine See also A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being - National Academy of Medicine

6.4. Occasional healthy snacks for staff

6.4.1. Would UCLH Charity support this financially?

6.5. Time allocated in teaching rotas & induction programme

7. Aspirational projects (long-term)

7.1. ‘Listening ear’ service helps A&E staff at Leeds Teaching Hospitals

7.2. Well MD

7.3. The ED Spa. Wellness and Support in #Virchester. St.Emlyn's. • St Emlyn's

8. Connection with UCLH values

8.1. Safety

8.1.1. Workplace incivility impairs medical staff performance and decision-making

8.1.2. More resilient, engaged healthcare workers provide better care

8.2. Kindness

8.2.1. Creating a focus on the role of compassion and how to cultivate it

8.2.2. Interventions to reduce burnout (burnout reduces empathy and compassion)

8.3. Teamwork

8.3.1. Addressing incivility between colleagues

8.3.2. Enhancing networking between colleagues and promoting social events

8.3.3. Increasing team member relatedness through team-based learning

8.4. Improving

9. Measuring the efficacy of the UCLH ED-CREW programme

9.1. Sickness absence rates

9.2. Regular administration of a burnout scale

9.3. End-of-placement feedback from trainees

9.4. Patient complaints relating to empathy, compassion, communication

9.5. Safety incidents

9.6. Direct feedback from clinicians about the utility of the programme

9.7. Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)