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Reflections: Learning Launch for a Well-Being Programme

Challenge  Physicians burnout is a prevalent issue worldwide and there are increasing studies/articles on  physicians leaving service due to excessive workloads, display of disruptive behaviours due to higher  stress, display of greater dissatisfaction and increased no. of physicians seeking help etc. This is an  important issue as burnout not only affects the individual’s health and well-being, it also affects their  relationship with colleagues and family members, as well as the quality of clinical care, patient safety  and satisfaction etc.     However, we hypothesized that the number of physicians seeking help from the official institutional  support offered (e.g. helpline to offer employee assistance, “SPEAK UP” initiative) is only tip of an  iceberg, as burnout is commonly viewed as a weakness and there is fear of being stigmatized. We also  hypothesized that physicians are more likely to seek help when the situation has become more severe,  and this can be alleviated if there are physicians themselves within the work environment to recognize  the signs and symptoms and intervene at an earlier stage, in comparison to a passive approach.

Selection  A learning launch, or smaller-scale experimentation is selected for the well-being programme due to  the lack of complete data on the level of burnout across the institutions and data on the usefulness of  the existing interventions that we had hypothesized to be under-utilized. Also, burnout is a sensitive  topic to physicians that needs to be carefully managed. Many of our ideas are actually “smart guesses”  that we think may work and are not suitable for a massive implementation yet. We would likely need  to refine the programme based on participants’ feedback, and there can have deeper conversations  when the group size is smaller.     In addition, a learning launch is much faster, easier and cheaper in terms of the efforts and time  required for planning, execution, number of facilitators and support staff required, as well as the  actual expenses such as venue rental, food and logistics.

Application  To overcome the stigma and dissociate from negative connotations with burnout, the well-being  programme was named* in a positive manner that is more uplifting and energizing to motivate  participants to attend. The programme was also framed at an angle that the participants are attending  to help colleagues and juniors, instead of tackling their own stress.      Led by two senior physicians, the organizing team consists of healthcare professionals who are non- physicians and have domain knowledge in psychological health, counselling and therapy to bring in  diverse views and suggestions in planning the programme. They also act as facilitators during the  session to smoothen the implementation and collect feedback for the programme after each segment.  Concurrently, we also leveraged on this opportunity to obtain more data needed to gain a better  understanding on the level and impact of burnout in the participants’ departments/specialty, and  coping strategies used on both the individual and department levels. To enable sparking of new ideas  with different group dynamics or a participant dominating the group conversation, we also changed  the groupings and pairing of facilitators, aimed to bring new insights.     15 physician-leaders in education were invited to participate in this learning launch, as they are likely  to be facing high level of pressure in their leadership roles but are more “nurturing” and able to

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provide constructive feedback for the programme. In addition, they have myriad experience and  wisdom for thriving/surviving in the system, there will also be much insights that we can gain from  their personal stories in overcoming the stressors. If the outcome is successful, not only would they  have benefitted directly, those who are interested can also be appointed as champions for physician  well-being, “planted” in work environment to identify colleagues who are under stress at an early  stage and use the approaches/knowledge learnt to provide support and inspire positively.

Insight   Though I was not one of the domain experts in leading or planning the content, and played more of  the coordination role, it was still a fruitful learning experience through observing, listening to the  sharing, perspectives and feedback. Overall, we gathered more opinions on the issues on the ground  and approaches that can be reviewed from the 13 participants who turned up. The session went on  smoothly and was well-received. There were also tiny surprises that we didn’t think of and can be  considered when planning for the next learning launch. For example, we were playing soft and relaxing  music that were meant to bring a sense of comfort and calmness, as they draw or write out their  recollections related to a selected picture of their choice. It turns out that the surgeon present found  the music a nuisance and shared that most surgeons prefer quiet environment. From this first learning  launch, it does seem like this well-being programme will complement the existing initiatives well.     In my opinion, learning launch is not entirely a new concept but requires a mindset shift and  willingness to take smaller steps then win big at the work environment. For instance, I personally enjoy  looking up recipes and cooking methods, gathering feedback from friends and family members to  experiment and create new dishes. However, it is different when much is at stake (e.g. returns from  time and efforts), established processes and expectations. Hence, there may be some resistance faced  when deviating from the norm. Education about learning launches/ design thinking and how it allows  us to make safer bets with smaller losses or failures with manageable risk will be necessary to  encourage more people to move out of their comfort zones.       Approach   As learning launch is not a one-step solution and perspectives from 13 education-leaders is not  representative of the entire population, we’ll continue to run a series of learning launches with the  feedback received and make improvements to the well-being programme, such as increasing the  group size to 40 participants, holding a session for physicians from a single specialty only, holding a  session for physicians from one institution instead of cross-institutions, holding a session for  physicians who are not in leadership positions, and combining both senior and junior physicians in one  session for different group dynamics.     Moreover, we can explore using the mind-mapping tool during future learning launches, as we are  gathering insights and looking for patterns or common themes in the stressors and what inspires or  motivates the physicians during the programme. It is a visual method where we can place sticky notes  placed on the walls to explore ideas raised in the conversations with the participants directly. This will  also save some time and effort in reviewing the list of feedback provided after the session by the  organizing committee. Who knows? We may find new ideas to further improve this well-being  programme, or new approaches and possibilities for new initiatives.      It is a long way ahead for us.

