John Bryan Sexton's profile, publications, research topics, and co-authors. The Intersection of Quality, Stress and Fatigue. J. Bryan Sexton, PhD. Associate Professor, Department of Psychiatry. Director of Patient Safety Center, Duke. The month series will be led by well-known health care workforce resilience expert Bryan Sexton, PhD, Associate Professor and Director of the Duke Center.
The Intersection of Quality, Stress and Fatigue. J. Bryan Sexton, PhD. Associate Professor, Department of Psychiatry. Director of Patient Safety Center, Duke. So we turned to Dr. Bryan Sexton, an associate professor at Duke University School of Medicine, to help us demystify the burnout concept and. MHA Keystone Center Culture Webinar. Facilitator: Bryan Sexton, PhD, Duke University. Title: Second Victim of Harm (WISER #8). To register, please follow this.
The month series will be led by well-known health care workforce resilience expert Bryan Sexton, PhD, Associate Professor and Director of the Duke Center. to send a kind thought their way. Thriving vs. Surviving during challenging times: Science of Enhancing. Resilience. J. Bryan Sexton, PhD. Director, Duke Patient. "Humor fulfills a fundamental need to feel connected and safe," said J. Bryan Sexton, PhD, director of the Duke Center for Healthcare Safety.
You may have practiced "three good things" to put a smile on your face by writing down three experiences that went well during a day. Along with Kathryn Adair, PhD, senior research associate and assistant director of the center, the pair have begun duke tips on how "three funny things" can benefit staff and providers.
Sexton works the same as "three good things. You don't have to be phd comedian or bryan jokes, either. It's just about celebrating funny things that you shared with colleagues, kids or a significant other or even saw on TV. Research behind the power of laughter strongly phd how it can help resilience, Sexton said.
It sexton be a "renewable resource" that complements the good things you get to share every day. Laughter boosts good feelings and combats the stress bryan a tough day. Photo: Kathryn Adair, left, and J. Jump bryan. Sections of this page. Accessibility help. Email or Phone Password Forgotten account? Sign Up.
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I would duke wilt. Now, there's a new way to boost your resilience — and add a laugh to your day.
You don't have to be a comedian or make jokes, either. It's just about celebrating funny things that you shared with colleagues, kids or a significant other or even saw on TV. Research behind the power of laughter strongly shows how it can help resilience, Sexton said. It can be a "renewable resource" that complements the good things you get to share every day.
Laughter boosts good feelings and combats the stress of a tough day. Photo: Kathryn Adair, left, and J. Jump to. Sections of this page. Accessibility help. Email or Phone Password Forgotten account? Sign Up. See more of Working Duke on Facebook. Log In. Yet your argument is that they are simply not ready for it. You have to address the burnout before you can address improvement in other domains. BS : It's almost like Maslow's hierarchy of needs—where do you start?
Sometimes where you start is to get people back to their fighting strength so that they can work on process improvements. For example, the leadership at Duke University Health System has resilience in the workforce as one of our strategic priorities in our 5-year plan for patient safety and quality. So we have to measure and know the resilience rates among all of our different units and labs, but we also have to enhance it in places where it's not where it needs to be.
Part of that research is: what's the threshold below which you can do QI and above which you should probably work on the burnout first. It used to be called Bouncing Back from Burnout, but that had a negative ring to it.
When we put work settings through this we found that the resilience is enhanced, the work—life balance improves, sleep quality improves, days of work missed due to illness go down, meals skipped go down, they get to work on time more often, they get home on time more often, and they feel like they're more engaged in what they're doing at work. By working on resilience, the byproduct interestingly is: delays go down, teamwork goes up, and disruptive behavior goes down.
Although we have to wait 2 full years to get the turnover data, we do collect intention-to-leave data and that is also improving. So we can actually keep our good people who we would otherwise lose through burnout and attrition. Utilizing the resilience focus before we even move over to TeamSTEPPS, executive walk rounds, learning from defects, or one of these other kind of quality improvement standards, the teamwork norms and the safety norms improve as well.
It's like there's a glass ceiling, and when you have so much burnout you won't be able to take on anything new and sustain it. By getting that shot in the arm of resilience, we're able to show some additional improvements in teamwork and safety just as a byproduct of focusing on bringing your whole self to work.
RW : In safety you usually hear the term "resilience" to refer to the ability to recover from a glitch or a curve ball. It sounds like that's part of what's going on here, but it's broader than that—the opposite of burnout. BS : I think of it as the polar opposite of burnout. There's more to it than that, but if you want to just boil it down, burnout is: I feel frustrated by my job, I'm working too hard at my job, I feel burned out from my work. And resilience is just the opposite.
If you're a resilient unit you're going to bounce and not break. If a colleague committed suicide, if you went live with Epic , if you got a new manager, if you moved into a new building—you bounce, you do not break.
But if you're lacking in resilience it just takes little things to push people over the edge and you see disruptive behavior flare-ups. When you're burned out you're not engaged, so you do things that are more expensive, you make the same mistakes again and again, and tragically, you don't even notice that you're making the mistakes.
RW : You've said that it's very hard to train people on new things and innovation and get them engaged when they're burned out. I imagine it's hard to train them on getting unburned out when they're burned out. How do you approach that? BS : One of the most frustrating things about working in burnout is you have to have a lot of compassion. Because you'll schedule a meeting and nobody will show up. You'll agree to something and nobody does it.
So it takes really small baby steps with very, very minimal amounts of commitment on their part to get these things up and running. Unlike a unit where everybody is showing up and they're firing on all pistons, on these burned out units you have to start really small. The first couple of meetings we have to help them find a way to talk about what's going on.
Because they usually think it's something else. They oftentimes will say, "Well, the problem around here is that Mark's an idiot. If somebody would just fire Mark we'd be fine. Maybe there are system issues going on here. And now everybody's leaning forward and wanting to work on that. They don't want to work on a clinical outcome when they're not feeling connected to their work.
But if you can show that by doing some little things to help them take care of themselves better, then ultimately they can take better care of their patients and that's even more rewarding for them. It starts with those little steps. RW : I would suspect that in addition to "If Mark was gone life would be better," you also hear, "if we had more money," or "if we worked fewer hours, life would be better. BS : At the Patient Safety Center, we work with a lot of different health care systems and many of them think that they know what the problem is with their lab or ICU or pharmacy.
When you do these structured interviews or spend a little time doing a debriefing with staff you'll find out that they've got a problem with a particular issue, maybe a technology, maybe a manager, maybe a process that they do, and they've been saying it for many years and no one's listening. What ends up happening is these people who feel powerless, they start punching sideways. And what a lot of organizations characterize as a disruptive behavior environment or an environment where there's a lot of "bad apples," from my research perspective, it looks like these guys have been neglected for a long time.
So they do what anybody does on a desert island—they take it out on each other. We find that by working on the burnout, conflict goes down and sleep quality improves. We haven't actually demonstrated an increase in sleep quantity, but sleep quality improving is a consistent finding across our studies. And that is directly related to disruptive behaviors, delays, and handoffs. Ultimately, I think that's a big part of what we're doing, relabeling what needs to be addressed in some of these "problematic" areas.
RW : As we think back on the early years of the quality and safety movement, let's say, 8 or 10 years ago, do you think we made an error approaching quality and safety with great enthusiasm and building these programs and teamwork training and measurement programs without addressing the burnout, or do you think this is an inevitable stage? You begin with early enthusiasm and early adopters and some success stories, and then you always realize that you've left some people behind and you've got to slow down a little bit and make sure everybody's on board?
BS : I remember these very explicit conversations with industry leaders where their concerns were: "I just don't think we have the bandwidth to take all of this on all at once, did we make a mistake? At the same time, I don't think that people who were tweaking and improving processes in health care had any idea that what started off in one project making life easier for patients and for health care workers, a couple of years later it becomes this incredible burden.
I don't think that that was a misstep, but going forward, patient-centered care requires a high level of resilience in our health care workers people-centered care. As patient-centered care is our goal, we have to do much more deliberate work for health care workers. The reason that's complicated in terms of building resilience is because health care workers are just not good at taking care of themselves.
It's so easy to come in early, stay late, skip the meal, finish that e-mail, see that last patient, squeeze one more in, and not go to the bathroom. Schedule - All webinars take place at p. ET on the scheduled dates below:.
Bryan Sexton Burnout is increasingly common, compromises clinical and operational outcomes, and is treatable. In this session we will demonstrate what happens in our heads when we get burned out. Bryan Sexton The absence of something bad burnout is not the same as the presence of something good resilience. Here we will demonstrate the links between well-being metrics and show how they vary at the individual and the work setting level. Your burnout may have more to do with your colleagues than you thought….
Bryan Sexton This session demonstrates a simple, enjoyable and effective tool for improving well-being by cultivating gratitude. We see improvements in resilience, sleep quality and depression. Bryan Sexton The most popular of our resilience tools is back this month.
This simple, enjoyable and remarkably effective tool can be used for days, with measurable improvements across a variety of resilience metrics that endure for over a year. Bryan Sexton What should you eat on a stressful day? How long is a good nap? The answers might surprise you. Here we recognize, anticipate and respond to human limitations associated with sleep deprivation.