by adgrooms on November 8, 2019

What is "joy in work"? Is it showing up to a weekend overnight ER shift jubilantly singing Lionel Ritchie's "All Night Long" as you burst into the hospital? Not really. A career in healthcare is hard stressful work. Joy in work is a purpose that caregivers feel that they need to give the gift of healing and relief to those who are ill or suffering. It is a purpose to help those who are healthy stay that way and live a long fulfilling life. Joy at work is feeling like you are doing what you are called to do. So how did we get to the point of high turnover with clinicians leaving medicine at a record pace? What can we do about it?

In the spirit of joy, we put together this post focusing on an aspirational outlook instead of what is wrong with the system. What does the ideal look like? What does a healthy institution do to bring about joy in their team? The Institute for Healthcare Improvement (IHI) has created a framework for institutions to improve joy at work. We have included some of their ideas along with some of our ideas for increasing Joy in Work.

Equity and fairness - Institutions need to put an emphasis on Equity and Fairness in the workplace. Everyone is in this together and has the same goal. To provide the best patient care possible.

Team-based care - Collaboration through team-based care can have a positive effect on patient outcomes and bring caregivers together under a common goal. Everyone in the team is responsible for the outcome and appreciates each other's strengths and skills.

Eliminate the moral injury - Over-regulation with productivity metrics and crushing administrative burden can take away from clinicians' purpose of giving the best care to patients. They need less oversight and paperwork and more autonomy to provide the best care they can.

Life/work balance - A balance between life and work is hard to achieve as a physician. The 60+ hour work week leaves little time for family or a life outside of work. Physicians have to sleep too. Optimized scheduling can help maximize time efficiency to give physicians needed breaks and rest.

Listen to team members - Administrators must ask "What do you need?" "What matters to you?". There are complaints about the provider-administration disconnect in many institutions. If the administrators don't listen to providers, how will they know if there is a problem? Establishing good communication throughout the institution can produce an understanding of needs.

Learn from mistakes - Encourage reporting and get rid of blame and shame. Mistakes happen, but individuals need positive support to be open when one happens so everyone can learn from it. The lessons learned can provide a great benefit in quality improvement.

Optimize technology - A technological audit can be done to make sure systems are working at their maximum efficiency. As much as we talk about how EHRs are burdening and slowing providers down, they can be optimized through better workflow setups.

Embrace new technology - Innovative companies are making solutions that may fill a need. Scheduling, EHRs, Communication are all being improved with new technology. Give physicians the latest tools to do their job. Try something new. It may be the breakthrough that fills a big need.

Recognize hard work - A little recognition for the hard work that providers put in can go a long way. Thanking someone for a good job should be routine. Throw a pizza party. Celebrate the fact that physicians are helping people have a better quality of life every day.

Ultimately we would like to see the suicide rate drop to zero. Physicians would not leave medical practice because they are burnt out. It would become the norm for physicians to take leadership positions in healthcare. The doctor shortage would be eliminated because young people would hear what a fulfilling career being a physician is. Job satisfaction would be high because the healthcare systems are run by physician-administrators. Yes, there are problems to overcome, but sometimes an optimistic view can help to see the path forward.