Resource Library

This assessment inventory is designed to help hospital and health system leaders, trustees, medical staff and employees think about how a hospital, department, or clinical area operationalizes patient- and family-centered care. It is designed for use with an interdisciplinary team that includes patients and families served by the hospital.

This resource is found in our Actionable Strategies for Health Organizations: Aligning Values (Invest/Advocate for Patients, Communities, & Workers).

UNISON is the largest trade union in the United Kingdom (UK) with 1.4 million members working in local government, health care, further and higher education, the water, gas, and electricity industries, transport and the voluntary sector. UNISON represents a wide range of professions and occupations, both manual and non-manual. Two-thirds of our members are women, many of whom provide caring services to the public.

This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Workplace Violence Prevention).

[This is an excerpt.] Twenty-one states have implemented "wage pass-through" programs with the stated expectation that doing so will help address the shortage of direct-care workers employed by long-term care providers in their states. A wage pass-through is an additional allocation of funds provided through Medicaid reimbursement for the express purpose of increasing compensation for direct-care workers. The purpose of this issue brief is to:

• Describe the structure of wage pass-through programs in selected states;
• Summarize what is known about the impact of these programs on the recruitment and retention of direct-care workers; and
• Identify key design elements that states should consider if they choose to implement a wage pass-through.

[To read more, click View Resource.]

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This resource is found in our Actionable Strategies for Government: Optimizing Workload & Workflows (Support & Ensure Safe Staffing).

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CONTEXT: Internship is a time of great transition, during which mood disturbances are common. However, variations in mood and empathy levels throughout the internship year have not been investigated. OBJECTIVE: To examine mood patterns and changes in empathy among internal medicine residents over the course of the internship year. DESIGN: Cohort study of interns involving completion of survey instruments at 4 points: time 1 (June 2000; Profile of Mood States [POMS] and Interpersonal Reactivity Index [IRI]), times 2 and 3 (November 2000 and February 2001; POMS), and time 4 (June 2001; POMS and IRI). SETTING: Internal medicine residency program at a university-based medical center. PARTICIPANTS: Sixty-one interns. MAIN OUTCOME MEASURES: Baseline scores of mood states and empathy; trends in mood states and empathy over the internship year. RESULTS: Response rates for time 1 were 98%; for time 2, 72%; for time 3, 79%; and for time 4, 79%. Results of the POMS revealed that physicians starting their internship exhibit less tension, depression, anger, fatigue, and confusion and have more vigor than general adult and college student populations (P<.001 for all). Results of the IRI showed better baseline scores for perspective taking (P<.001) and empathic concern (P = .007) and lower scores for personal distress (P<.001) among interns compared with norms. Five months into internship, however, POMS scores revealed significant increases in the depression-dejection (P<.001), anger-hostility (P<.001), and fatigue-inertia (P<.001) scales, as well as an increase in IRI personal distress level (P<.001). These increases corresponded with decreases in the POMS vigor-activity scores (P<.001) and IRI empathic concern measures (P = .005). Changes persisted throughout the internship period. CONCLUSIONS: We found that, in this sample, enthusiasm at the beginning of internship soon gave way to depression, anger, and fatigue. Future research should be aimed at determining whether these changes persist beyond internship.

Health and well-being in the workplace have become common topics in the mainstream media, in practitioner-oriented magazines and journals and, increasingly, in scholarly research journals. In this article, we first review the literature that serves to define health and well-being. We then discuss the primary factors associated with health and well-being, the consequences of low levels of health and well-being, and common methods for improving health and well-being in the workplace. Finally, we highlight important future directions for future theory, research, and practice regarding health and well-being from an organizational perspective.

This paper presents a model of team learning and tests it in a multimethod field study. It introduces the construct of team psychological safety—a shared belief held by members of a team that the team is safe for interpersonal risk taking—and models the effects of team psychological safety and team efficacy together on learning and performance in organizational work teams. Results of a study of 51 work teams in a manufacturing company, measuring antecedent, process, and outcome variables, show that team psychological safety is associated with learning behavior, but team efficacy is not, when controlling for team psychological safety. As predicted, learning behavior mediates between team psychological safety and team performance. The results support an integrative perspective in which both team structures, such as context support and team leader coaching, and shared beliefs shape team outcomes.

This resource is found in our Actionable Strategies for Health Organizations: Empowering Worker & Learner Voice (Psychological Safety).

This paper sets out to establish what is meant by shared governance, analyses the literature on shared governance implementation, and discusses emergent issues. The paper is based on research funded by the Department of Health (England) and by North Staffordshire NHS Trust. A literature search was undertaken using the terms 'shared governance' and 'empowerment', restricted to English language. The databases used were CINAHL, British Nursing Index, Medline, Social Sciences Citation Index and FirstSearch, and the search period was January 1988–May 1998. Initially, nearly 500 articles were identified. This search also highlighted articles describing participative management, professional practice models, and self-managed work teams. For the purposes of this review, only published articles which either described and/or evaluated the implementation of shared governance were analysed. According to these criteria, 48 studies, which were obtained by the cut-off date, were included for detailed assessment.

This resource is found in our Actionable Strategies for Health Organizations: Establishing Commitment & Shared Governance (Shared Governance).

Burnout research has considered a wide range of organizational correlates of burn out. It is argued that integrating these various organizational qualities into a com prehensive model of organizational environments will further research on burnout. The primary themes in burnout research fit readily into six areas of worklife; work load, control, reward, community, fairness, and values. These areas are sufficiently broad to encompass the rich variety of research approaches taken in the field while being sufficiently precise to permit clear distinctions among them. The review identifies a consistent body of research on the relationships of these six areas with burnout. The review concludes by considering issues for a research agenda on the organizational antecedents of burnout and noting the implications of a focus on mismatches for interventions.

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This resource is found in our Actionable Strategies for Health Organizations: Meaningful Rewards & Recognition

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A scale designed to assess various aspects of the burnout syndrome was administered to a wide range of human services professionals. Three subscales emerged from the data analysis: emotional exhaustion, depersonalization, and personal accomplishment. Various psychometric analyses showed that the scale has both high reliability and validity as a measure of burnout.

With burnout and staff turnover in health care continuing to rise at alarming rates, this resource is intended to help leaders guide conversations with colleagues about “What matters to you?” — Step 1 of the Four Steps for Leaders, described in detail in the IHI White Paper, IHI Framework for Improving Joy in Work.

This resource is found in our Actionable Strategies for Health Organizations: Aligning Values (Establish a Culture of Shared Commitment).

Discover essential tools and resources designed to empower hospital staffing committees in implementing the 2023 safe staffing law.

This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Safe & Appropriate Staffing).

AMA STEPS Forward^® open-access resources offer innovative strategies that allow physicians and their organizations to thrive in the new health care environment. These resources can help you prevent physician burnout, create the organizational foundation for joy in medicine, and improve practice efficiency.

This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Reducing Administrative Burdens).

The burden of clinical documentation on professionals, such as work done in the EHR, has had a proven negative impact on health care. This burden leads to a variety of negative outcomes including clinician burnout and decreased job satisfaction, increased medical errors and hospital-acquired conditions.

This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Reducing Administrative Burdens).

Workplace violence can be prevented, and nurses can lead the way. This  webinar addresses what every nurse needs to know about the challenge of workplace violence against nurses. Topics addressed include:The scope and cost of WPV in healthcare for nurses, patients, and healthcare organizations;Common factors related to organizational culture that can prevent implementation of successful WPV programs;Core components of a program to manage and prevent WPV;What you can do to support effectiveness and sustainability of a WPV program and culture of worker and patient safety;Resources from ANA and other sources that nurses can access to enhance or develop a WPV program.

KEY POINTS

• Workplace violence can happen to any type of worker in any work setting, though some workers have a higher risk.
• Workplace violence can cause long-term effects, both physical and psychological.
• NIOSH funds, conducts, and publishes research to reduce workplace violence.

‍This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Workplace Violence Prevention).

[This is an excerpt.] For decades, long-standing inequities have exacerbated health issues in low-income communities and communities of color, resulting in persistent health disparities. Accountable Communities for Health (ACHs) provide a powerful framework for tackling those inequities by breaking down barriers and promoting a new way of working together. [To read more, click View Resource.]

This resource is found in our Actionable Strategies for Health Organizations: Aligning Values (Invest/Advocate for Patients, Communities, & Workers).

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[This is an excerpt.] The ongoing pandemics — both COVID-19 and racism — have laid bare the dehumanizing and damaging effects of structural racism throughout our country. Regrettably, we see these effects in academic medicine as well. As we wrote in our June 1, 2020, statement, all academic medicine leaders — including the AAMC — must step up and transform rhetoric into action. We as individuals, as an association, as part of the academic medicine community, and as members of society need to do our own work, individually and collectively, to create a shared vision of the AAMC and academic medicine institutions as diverse, equitable, inclusive, and anti-racist organizations. We acknowledge this work can and will be difficult for even the most skilled, experienced, and well-intentioned. This framework will serve as a strategic imperative; guide our own internal efforts at the AAMC; and help amplify, support, and accelerate the efforts of our member institutions to catalyze change in academic medicine. The shared vision should emanate from our own thinking at the AAMC and from lessons learned from our members and affinity groups, the communities of which we are a part, and the communities we serve. Through our efforts, we can address and work toward eliminating racism not only within academic medicine but also in our communities and the nation. The sense of urgency called out in our June 1, 2020, statement has ignited discussions among our staff, leaders of our member institutions, and our constituents, and it has led us to identify four sets of concrete actions to pursue as the AAMC. [To read more, click View Resource.]

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This resource is found in our Actionable Strategies for Professional Associations: Spotlights: Professional Associations Relational Strategies (Improving Diversity, Equity, & Inclusion).

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Through the Respect for People program, staff receive mandatory training on these listening and collaboration behaviors, which are incorporated in VM’s leadership expectations; patient and team member experience efforts; diversity, equity and inclusion strategy; and process improvement work. How does this build trustworthiness? The Virginia Mason Medical Center Respect for People program builds trust by fostering an inclusive, psychologically safe workplace climate in which all team members foster respectful behavior (e.g., listening to understand, keeping one’s promises) during interactions with patients and each other, and where individuals feel safe to ask for help, discuss problems and admit errors as we work together toward our vision to be the quality leader and transform health care.

This resource is found in our Actionable Strategies for Health Organizations: Empowering Worker & Learner Voice (Worker & Learner Engagement).

[This is an excerpt.] Having a family member who is a health careworker presents special challenges for those who love them. If you are a spouse, significant other,parent, or friend of a health care worker who has been on the frontline during the COVID-19pandemic, you are likely struggling with how to best support them through this time of crisis. While these health care workers are experiencing the same disruptions and challenges most adults in our country are experiencing, including social isolation,financial insecurities, and extreme changes in daily routines, they are also experiencing unique stressors that cannot be underestimated. In the early days and weeks of the pandemic, our health care workers had to deal with fear of the unknown and the uncertainly about how to protect themselves and their families from this novel coronavirus. Access to personal protective equipment (PPE) was limited, and concerns grew daily about bed and ventilator availability and the adequacy of nursing and physician staffing. The physical exhaustion of long hours, the need to don full PPE for every patient contact, continually changing procedures, working in isolation, and being in a constant state of high alert quickly began taking a physical toll. But the unseen emotional toll may be even greater than the physical toll. Nurses, doctors, and other health care workers all share the challenges of watching so many physically suffer, having patients die alone, supporting family members who can’t be at the bedside of their loved ones due to visitor restrictions, and being unable to do more. We have called these health care workers “heroes,”as indeed they are. Now we need to acknowledge that they are also human and require special supports to ensure that their personal physical and emotional needs are met. By understanding their needs, you as a family member or a friend are in a unique position to provide these tailored supports. Consider the following steps,modeled from the NOVA Crisis Response, for supporting your special health care worker throughout this COVID-19 pandemic. [To read more, click View Resource.]

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This resource is found in our Actionable Strategies for Working & Learners: What the Public Can Do

[This is an excerpt.] Our caregivers continued to demonstrate heroism in the second year of the COVID-19 pandemic, responding to challenges, including new variants and surges, with empathy and courage. We continued to invest in our caregivers’ safety and resilience, keeping them informed during a time of rapid change and uncertainty. Caregiver teams across the enterprise came together to maintain, improve and expand programs to support and recognize their colleagues. [To read more, click View Resource.]

This resource is found in our Actionable Strategies for Health Organizations: Empowering Worker & Learner Voice (Worker & Learner Engagement).