Kevin Mabbutt:Welcome to Intermountain's Thanks For Asking podcast. I'm Kevan Mabbutt, Senior Vice President and Chief Consumer Officer. Every week I'll be bringing you this podcast where caregivers ask our CEO, Dr. Mark Harrison, anything that's on their minds. Look out for a new episode every week, and listen at the end to learn how to be a part of the podcast.
Marc Harrison:Hello. I'm Dr. Marc Harrison, CEO of Intermountain Healthcare. Today I'm with Mary Helen Stricklin, nursing system director of palliative care, and Dr. Ted Moon, pulmonary critical care physician and medical director of critical care services. Thank you very much for joining me. Can you tell me a little bit about yourselves and your jobs? Then I'd love to talk to you about some of the exciting things you're working on to reduce caregiver burnout.
Ted Moon: I'm Ted Moon. I joined Intermountain six years ago. I was asked to become the medical director of critical care services here at Dixie about three years ago. My background is in pulmonary critical care medicine. I did my training at LA County General Hospital for internship, residency, chief residency, and fellowship. I was in private practice in Arcadia, California, for about 11 years before I came to St. George.
Mary Helen Stricklin: I'm Mary Helen Stricklin. I've been a registered nurse, master's prepared, for 40 years, working with Intermountain for 20. At Dixie I've been primarily working on palliative care most recently, and the post-acute care team with nurse practitioners in our transition of care and chaplaincy. I'm excited to have the opportunity to chat today.
Marc Harrison: I'm really pleased to chat with both of you. It seems like I'm talking with people who are wearing a number of different hats in the interest of our patients, so thank you for your service. I really appreciate it. Where would you like to take our conversation today?
Mary Helen Stricklin: We spent some time, Dr. Moon and I, talking about how we could support caregivers, especially during this year of transition to One Intermountain. There was a lot of stress and change, and chaplaincy being under my roof, was something that really trying to help use the resources we had, as limited as they are with chaplains, to understand that hospital chaplains that are trained to support caregivers as much as they support patients and families. Some of our work that we did was looking at, ‘Are there specific activities we could do, especially during this last year when it was so intense, to try to help support the caregivers?’ Dr. Moon had an idea from a previous hospital and a national best practice to try to do something called Tea for the Soul. We put together a pilot to try it out, see how it would work.
Basically the idea is we got a massage therapist come in to do chair massages. It was kind of like our hook to come into what we called Tea for the Soul. The ICU staff and everybody on duty from the housekeepers to the physicians and everybody in between could come in, have some refreshments, fruit and coffee, tea, and the chaplains, myself, the chaplains were there to support it along with some administrators. We just gave people the opportunity to talk and relax. The intensive care unit was very busy. We've had multiple deaths, a lot of change. We created a little tiny survey that helped them feel out where we were, if we wanted to do it again. We did it in the day shift and the night shift.
One of the exciting things we could see was just how that relaxation changed out and it rippled through the 12 hour shift. The feedback that we got was very positive. People felt supported. It let you fill your cup a little bit in the middle of really hard things. Tea for the Soul was one of the things that we did thanks to Dr. Moon's support and the administration's support here, and it went over very well. We're going to try it again in an organized fashion to expand that throughout the hospital because there's a lot of stress and a lot of need.
Marc Harrison: Great. Ted, did you want to add anything to that?
Ted Moon: What I would say is that I think that pastoral care, particularly in a hospital situation, fills a very unique need. When I was in practice in Southern California, I was at Methodist Hospital of Southern California, and in an environment like Los Angeles County where there are so many different perspectives and different cultural belief systems, they were able to help navigate the story of healing for not just the patients but also for the caregivers, and help them understand that no matter what the situation is that we were all here to provide healing, no matter what the outcome was going to be physiologically.
I asked Mary Helen and Jay Buyer, our hospital chaplain, if they thought that Tea for the Soul might be something that would help invigorate and create a healing experience for our providers. To put that in context, I think that just from the physician data there's quite a bit of evidence that physicians are burnt out. I would say that, I think this was in the Mayo Clinic proceedings, they said that among U.S. physicians, burnout prevalence is over 50 percent. Excessive fatigue was reported at 45 percent. Then suicide rate was three to five times higher than the other individuals in their socioeconomic class. We have providers who are under a lot of stress, and that stressful burnout producing environment also leads to medical errors and safety issues. It's just as much of an issue as it is when we talk about unit safety grades, which we have a big emphasis on with our Zero Harm initiatives.
Mary Helen Stricklin: A couple of stories just to tell you about it. On our little survey we could put down do you want to follow up with the chaplain, so it's anonymous as far as people in the room. When they would check off their survey they could fill in their name. The chaplain then would follow back with those caregivers that wanted more conversation. A couple of EAP referrals occurred as a result of us pausing and listening and creating that environment of trust.
Seeing individuals so stressed, including someone that was already suicidal and had a suicidal plan, and we were able to move that caregiver into an effective EAP. It's a mindful way for us to use chaplaincy, that pastoral spiritual distress of work among caregivers to recognize they’re stressed, they’re burned out, perhaps they're at their edge, and how we can support them. It was exciting to see the people respond once they realized what we were doing and that it was safe and that it was good. They just, they were thirsty for more. That's where we are today.
Marc Harrison: That's really helpful. I love it. You guys are passionate and you've done incredible work. If I could just interject for one second, I really appreciate the commentary around stress, around transformation. No doubt that's true, but I actually probably think the more relevant piece is what Ted was saying is that we have problems in our whole industry. When half of the physicians in the United States are burned out, and the statistics for nurses are not very much different, I think there's something really systematic going on. In fact, the transformation we're going through hopefully will alleviate a lot of that stress over time. I really applaud and appreciate what you're trying to do to holistically engage our caregivers and help them be resilient.
If we think that change is over in our industry, we're crazy. We're not planning any massive restructurings at Intermountain at this point in time, but things are changing day by day, week by week. Not only in our industry, but in all industries. Roma and the Green Book are both Netflix films. Five years ago who would have ever thought that Netflix would have had two Oscar award winning films. That industry, the folks at Fox Studios are not very happy right now I'd guarantee you. The world's changing. The question is how do we take the wonderful people we work with and actually prepare them to be resilient and positive and healthy in the face of change. I think you guys are onto it.
I guess I'd be curious about, as you spread your work across your hospital, how do you plan on sharing your results so the rest of us can learn from you so that maybe there's an opportunity in a One Intermountain fashion to adopt best practices where relevant? Could you talk a little bit about that?
Mary Helen Stricklin: Yesterday we did a presentation to the senior leadership around the expansion of chaplaincy and in an organized way how that might look, the fact that there can be support both to patients and families, and the opportunity to think about that in a more organized way so that I'm sure there's bright spots other places with Intermountain. Through the Office of Patient Experience, at least to begin with, we have a forum and a support perhaps to say what does it look like, and how if we were going to put wholeness into healthcare for body, mind, and spirit, and that view of how to deliver care both to the caregivers and the patients and families, how we might do that differently. We were excited to have that very piece at the table yesterday in that presentation.
Marc Harrison: Well that's great. I hope you also heard I'm whole heartedly in support of a much more formal and expanded chaplaincy program for all the reasons that you're able to articulate much more thoroughly than I can. I guess I'd just like to say thank you for your creativity and for your hard work, and for being willing to innovate on behalf of our patients and our caregivers. Is there anything else you'd like to add? This has been really a very fascinating conversation.
Ted Moon: I think the one thing I'd like to say is I want to thank you Dr. Harrison and your team for creating this venue that allows the great ideas that come out of Intermountain. I think one of the biggest responsibilities of leaders is to make sure that when you have engagement and innovation and inspiration that we need to sort of help put that spark into tinder, and then put that tinder onto fuel so that we can create something really powerful and expansive that can go across silos and make big changes in the lives of not only our patients but also our own shareholders here in the hospital. Thank you.
Marc Harrison: Thanks to both of you. This is a great conversation. I really, really appreciate it.
Mary Helen Stricklin: Appreciate the time and the opportunity.
Marc Harrison: You bet.
Kevan Mabbutt: Thank you for listening. Join us next time for more caregiver questions and answers. You can find this podcast and others you may enjoy on intermountainhealthcare.org/podcast, or subscribe to the Intermountain podcast on iTunes. If you're a caregiver with a question you'd like to ask, please send an email to healthyfuture@imail.org. We'd love to hear from you.