Choosing Resilience The Key to Thriving Through Change€¦ · 4 Wayne M. Sotile, Ph.D , 2016...

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Wayne M. Sotile, Ph.D , 2016

Copyright © 2015 Studer Group. Please do not quote or disseminate without Studer Group authorization

Wayne M. Sotile, Ph.D.Founder

CENTER FOR PHYSICIAN RESILIENCE

Davidson, North Carolina

Choosing ResilienceThe Key to

Thriving Through Change


Crucial Questions

•How happy are you?

•Who are you to the ones you

love and work with?


High Demand

Low Control

Low Support

What’s It Like to Work in Healthcare Today?

Toxic Stress

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The Most Pervasive, Unchecked

Risks to Safety, Quality, Profitability, and

Satisfaction?

Burnout

&

Psychosocial Distress


7395 Medline Publications “Burnout”

0

100

200

300

400

500

600

1977 1982 1987 1992 1997 2002 2007 2012 2017

# Pub

Updated September 29, 2014

MESH: STRESS, PSYCHOLOGICAL 1983-89, STRESS, PSYCHOLOGIC 1969-72


0 10 20 30 40 50 60 70

Prev Med/Occupat Med/Enviro Med

Dermatology

Pediatrics - General

Pathology

Radiation Oncology

Other

Pediatric Subspecialty

Neurosurgery

Psychiatry

Urology

General Surgery Subspecialty

Ophthalmology

Internal Medicine Subspecialty

General Surgery

Average Burnout All Physicians

Participating

Physical medicine and Rehab

Radiology

Obstetrics and Gynecology

Anesthesiology

Orthopedic Surgery

Otolaryngology

Family Medicine

Neurology

Internal Medicine - General

Emergency Medicine

% Reporting Burnout

Shanafelt , Boone, Tan,

Drybe, Sotile et al.

Arch Intern Med. 2012;

172(18):1377-85

Burnout by

Specialty

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• Use Realistic Roadmaps

• Assess Yourself

Coping, Leadership

Change Psychology

• Build Resilience Toolkits

Keys to Resilience


Work Family

SelfIntimate

Relationship

Anxious

Angry Guilty

Realistic Roadmap or Cajun Logic?

The Mythical Balanced Life


Use Realistic Roadmaps

Best Predictor of Clinical and Operational

Outcomes Across Hospital Settings?

•% of Team Showing Burnout

Bryan Sexton, Ph.D.

Duke Center for Patient Safety

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•As Nurse Burnout Rates

Patient Survival Rates

Aiken LH et al. JAMA. 2002;288:1987-1993.

N = 10,184 Staff Nurses

234,342 Patients

Resilience Matters


Does Burnout Matter?

•Medical Errors– Williams ES et al. Health Care Manage Rev. 2007;32:203-212

– Firth-Cozens J & Greenhalgh J. Soc Sci Med. 1997;44:1017-1022.

– Shanafelt TD et al. Ann Intern Med. 2002;136:358-67.

•Medical Malpractice Suits– Jones JW et al. J Appl Psychol. 1988;73:727-35.

• Patient Compliance – DiMatteo MR et al. Health Psychol. 1993;12:93-102.

•Patient Satisfaction– Linn LS et al. Med Care. 1985;23: 1171-78

– Haas JS et al. J Gen Intern Med. 2000;15:122-128

“Burnout adversely affects quality of care”

Wallace JE et al. Lancet. 2009;374:1714-21

Medical Family

DiscordSargent MC, Sotile WM, Sotile

MO, et al. J of Bone and Joint

Surgery. 2009. 91;2395-405.


Make the Case

• Crucial Cross-Correlations:

– Work Outcomes / Provider Health

– Quality of Collaboration

– Career Satisfaction

– Your Family’s Satisfaction with You

– Your Happiness

Sotile W.M. & Sotile M.O. The Resilient Physician. AMA Press, 2002

Sotile W.M. & Sotile M.O. Letting Go of What’s Holding You Back. Harry Abrams, 2007

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Beware of Cajun Logic

Treating Paradoxes Like Problems

Problem(has a clear solution)

Paradox(a situation, person, or thing

that combines contradictory features or qualities)

Ralph Jacobson


•Hardiness

•Character

•Teamwork

•Emotional Intelligence

Resilience Keys: Use Realistic Roadmaps


Choosing Resilience

Emotional Intelligence

Self Management

• Self-Awareness

• Self-Regulation

• Motivation

Relationship Skills

• Empathy

• Social Skill

• Capacity for Influence

Positive Psychology

Wellbeing Meta Factors

Positive Emotions

Engagement

Relationships

Meaning

Accomplishment

Resilience

Simonds G & Sotile WM. Promoting Resilience in Neurosurgery Residents, 2015.

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Resilience matters

No perfect…

Respect paradox

It’s a journey!

Character

Teamwork

EQ

Keys to Resilience



• Assess Yourself

Coping

Leadership

Change Psychology

Keys to Resilience


Does Problem Solving Motivate?

Identifies –

problem

Conducts –

analysis of cause

Brainstorms –

solutions

Develops –

action plans

http://appreciativeinquiry.case.edu/

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Content

Structure

ProcessHow can we use our

resources

to build resilience

and deepen

our relationships?

Choosing ResilienceThe absence of hassles (or paradoxes)

does not predict resilience


What Drives Satisfaction?

Culture

Recognition/ Appreciation

Compassion

Communication

Conversation / Inclusion

Re-thinking

Re-framing


Assess Yourself

Your relationships

won’t feel any better

than you do

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Does Your Leadership Really Matter?

Biggest correlation with staff work

satisfaction?

•The perception of

supervisor support

Studer Group. Work Life Balance Among

Women in Healthcare Survey. 2008


• N = 2813 employed physicians and scientists

• Vital Leadership Behaviors?

• Inform

• Engage

• Inspire

• Develop

• Recognize

Shanafelt TD et al. Mayo Clin Proc. 2015:1-9.

Impact of Organizational Leadership on

Physician Burnout and Satisfaction

Provider Ratings of

Division/Department Chair

↨

11% of variance in burnout

47% of variance in

satisfaction with the

organization


Choosing Resilience

Assess Yourself

Your relationships

won’t feel any better

than you do

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25

The Psychological Underbelly

of Changing for Good

The

“Yea, Not Really”

Mentality



• Assess Yourself

Are you a smart motivator?

Focus on structure & process

Streeeeetch, don’t strain

Expect “Yeanotreally”

Practice wonderment

Keys to Resilience



• Assess Yourself

• Build Resilience Toolkits

Keys to Resilience

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Wonderment

….seeing the familiar

in unfamiliar ways


Working fewer hours

in a job you’re not engaged in

will resolve none of your work/life

balance issues.

Engagement is the key!

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Re-Think “Balance”

Wayne & Mary Sotile. Letting Go of What’s Holding You Back.. 2007


Resilience Meta Factor:

Shaping Resilience

Counter Daily Hassles with

Daily Uplifts

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Resilience Meta Factor

The 3:1 Ratio of Uplifts : Hassles

• Joy

• Gratitude

• Serenity

• Hope

• Interest

• Amusement

• Inspiration

• Awe

• Pride

• Love

Fredrickson, B. Positivity. (2009)


Combine Problem Solving with

Appreciative Inquiry

Appreciates –

What gives life?

Imagines –

What might be?

Determines –

What should be?

Creates –

What will be?

Identifies –

problem

Conducts –

analysis of cause

Brainstorms –

solutions

Develops –

action plans

Problem Solving Appreciative Inquiry

http://appreciativeinquiry.case.edu/

+


Keys to Resilience

Recalling what’s been right

about our past

helps to create

Shared Notions/Images About

Our Desired Future

Leadership

Tool

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Resilience is Not an Event-Self-check

-Made adjustments

-Self-check

-Make adjustments

-Self-check

-Make adjustm..

Shaping Resilience


Just showing up

is not enough..


A hero is someone

who creates safe spaces

for other people

—The Resilient Physician. Sotile & Sotile, 2002

Be a Hero

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When you end

a dysfunctional legacy,

you justify your lifetime.

Wayne & Mary Sotile. Letting Go of What’s Holding You Back.. 2007


1. Protect Happiness

2. Use Coping Realistic Roadmaps

3. Recognize Your Risks

4. Manage Your Change Psychology

5. Counter Hassles With Uplifts

6. Believe in Something Bigger than Yourself

7. Deepen Your Relationships

8. Manage Your Coping Style

9. Rethink “The Balanced Life”

10. Be a Hero

Keys to Personal Resilience


•Believe in Yourself

•Appreciate Each Other

•Be Generous

•Be Gracious

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Lessons from My Grandparents

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Thank You!

Wayne Sotile, Ph.D.

CENTER FOR PHYSICIAN RESILIENCE

www.TheResilientPhysician.com

Email: [email protected]

336/794-0230

Choosing Resilience The Key to Thriving Through Change€¦ · 4 Wayne M. Sotile, Ph.D , 2016...

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