The Resilience Advantage™ Slides – 3 per page 4/20/2018
© 2013 Institute of HeartMath 1
1
© 2011 HeartMathLLC Creating an Optimal Healing Environment
11th Annual Ambulatory SymposiumRE-silience, Building with HeartMath
Nikki West, MPH – Kaiser Permanente Northern CaliforniaRobert Browning, PhD (h.c.) – HeartMath Institute
© 2014 Copyright Institute of HeartMath
Published Research
© 2014 Copyright Institute of HeartMath
Some Organizations
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath© 2014 Copyright Institute of HeartMath
You, when you have less stress self and more energy
Core Values
© 2014 Copyright Institute of HeartMath
The capacity to prepare for, recover from and adapt in the face of stress, challenge or adversity.
You can learn to build your resilience capacity and sustain your energy.
Resilience
© 2014 Copyright Institute of HeartMath
Domains of Resilience
Physical Emotional
SpiritualMental
Coherence
• Physical flexibility
• Endurance
• Strength
• Emotional flexibility
• Positive outlook
• Self-regulation
• Mental flexibility
• Attention span
• Ability to focus
• Incorporate multiple points of view
• Spiritual flexibility
• Commitment to values
• Tolerance of others’ values and beliefs
The Resilience Advantage™ Slides – 3 per page 4/20/2018
© 2013 Institute of HeartMath 3
© 2014 Copyright Institute of HeartMath
40
60
80
100
120
140
160
0 5 10 15 20 25 30 35 40 45 50 55 60
Minutes
Heart
Rate
(B
PM
)
Husband and Wife Arguing
Wife said something that got
under his skin
Heart rate remains elevated after argument ends
© 2014 Copyright Institute of HeartMath
0 10 20 30 40 50 60
Ch
all
en
ge L
evel
& E
ffo
rt
Embraces challenge and improves performance
Period of maximum efficiency Hyper-reactive
stageEmotional exhaustion
stage
Breakdown
Time (Days)
Stress, Resilience and Performance
© 2014 Copyright Institute of HeartMath© 2014 Copyright Institute of HeartMath
A Short Movie
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© 2014 Copyright Institute of HeartMath© 2014 Copyright Institute of HeartMath
Depleting and Renewing Emotions
© 2014 Copyright Institute of HeartMath
Depleting Emotions
Emotions such as fear, frustration, impatience and anger have a toxic feeling and cause the release of stress hormones. This often results in:
• Reduced muscle mass• Brain-cell death• Impaired memory • Accelerated aging• Impaired mental function• Diminished performance
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath
Emotions and attitudes such as care, courage, tolerance and appreciation create neurochemicals that regenerate your system and offset energy drain, resulting in:
• Increased longevity
• Increased resilience to adversity
• Improved memory
• Improved problem-solving
• Increased intuition and creativity
• Improved job performance and achievement
Renewing Emotions
© 2014 Copyright Institute of HeartMath
Intelligent Energy Management
Resilience, optimal performance, fulfillment and health are grounded in the intelligent management of energy expenditures and the ability to renew energy.
© 2014 Copyright Institute of HeartMath
One of the most important steps in being able to stop energy drains and increase resilience is to identify unnecessary energy expenditures.
Self-Awareness - Depleting
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath© 2014 Copyright Institute of HeartMath
An Intelligent Energy Self-Regulation Technique
™Heart-Focused Breathing Technique
© 2014 Copyright Institute of HeartMath
• Heart-Focused Breathing is a powerful and effective tool for self-regulation.
• It’s the first step in shifting to a more coherent state – you are alert and calm at the same time.
• It can help you maintain your composure in challenging situations.
Heart-Focused Breathing
© 2014 Copyright Institute of HeartMath
Focus your attention in the area of the heart. Imagine your breath is flowing in and
out of your heart or chest area, breathing a little slower and deeper than usual.
Suggestion: Inhale 5 seconds, exhale 5 seconds
(or whatever rhythm is comfortable).
Quick Step: Heart-Focused Breathing
Heart-Focused Breathing™ Technique
The Resilience Advantage™ Slides – 3 per page 4/20/2018
© 2013 Institute of HeartMath 7
© 2014 Copyright Institute of HeartMath© 2014 Copyright Institute of HeartMath
The Physiology of Coherence and Optimal Functioning
© 2014 Copyright Institute of HeartMath
Coherence
An optimal state in which the heart, mind and emotions are aligned and in sync.
Physiologically, the immune, hormonal and nervous systems function in a state of energetic coordination.
© 2014 Copyright Institute of HeartMath
Parasympathetic
Constrict bronchioles
Slow down heartbeat
Increase secretion
Stop secretion
Sympathetic
Dilate bronchioles
Speed up heartbeat
Secrete adrenaline
Decrease secretion
Constrict
Secrete saliva
Dilate
gland
Stomach
Bladder
Spinal
cord
Sympathetic
ganglion
chain
Parasympathetic
Parasympathetic
Adrenal
© 2014 Copyright Institute of HeartMath
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath
Heart Rate Variability (HRV)
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Heart Rhythm Patterns Emerge
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Emotions and Heart Rhythm Patterns
Incoherence: Impairs performance, amplifies energy drain
Coherence: Promotes optimal performance, builds resilience
Inhibits
Brain Function
(Frustration)
Facilitates
Brain Function
(Appreciation)
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© 2014 Copyright Institute of HeartMath
CoherenceFacilitates Brain
Function
Heart signals affect the brain centers involved in decision making, reaction times, social awareness and the ability to self-regulate.
Heart Rhythms Directly Affect Physical and Mental Performance
IncoherenceInhibits Brain
Function
© 2014 Copyright Institute of HeartMath
Research Showing Increased HRV and Baseline Shift
Resting HRV
baselines before
and after four
months of
practicing
HeartMath
techniques.
© 2014 Copyright Institute of HeartMath
Another important step in being able build energy and increase resilience is to identify situations and feelings that renew you and recharge your inner battery.
Self-Awareness - Renewing
The Resilience Advantage™ Slides – 3 per page 4/20/2018
© 2013 Institute of HeartMath 10
© 2014 Copyright Institute of HeartMath© 2014 Copyright Institute of HeartMath
An Intelligent Energy Self-Regulation Technique
Quick Coherence® Technique
© 2014 Copyright Institute of HeartMath
Emotions and Feelings that Create Coherence
• Courage, Honor, Dignity
• Confidence
• Appreciation, Gratitude
• Kindness
• Care, Love
• Compassion
• Tolerance, Patience
• Enthusiasm, Joy
© 2014 Copyright Institute of HeartMath
Quick Coherence® Technique
Focus your attention in the area of the heart. Imagine your breath is flowing in and out of your heart or chest area, breathing a little slower and deeper than usual.
Suggestion: Inhale 5 seconds, exhale 5 seconds
(or whatever rhythm is comfortable).
Step 1:
The Resilience Advantage™ Slides – 3 per page 4/20/2018
© 2013 Institute of HeartMath 11
© 2014 Copyright Institute of HeartMath
Quick Coherence Technique
Step 2:
Make a sincere attempt to experience a regenerative feeling such as appreciation or care for someone or something in your life.
Suggestion: Try to re-experience the feeling you have
for someone you love, a pet, a special place, an
accomplishment, etc., or focus on a feeling of calm or ease.
© 2014 Copyright Institute of HeartMath
1. Heart-Focused Breathing
2. Activate a positive or renewing feeling
Quick Coherence® Quick Steps
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Outcomes
photo
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34
© 2011 HeartMathLLC Creating an Optimal Healing Environment
% of responses: often – always: Pre Post (2 weeks)
I feel optimistic about the future 76% 97%
My life is deeply fulfilling 62% 85%
Grateful 74% 88%
Dynamic 55% 76%
Peaceful 41% 68%
Relaxed 29% 47%
Tired 53% 12%
Fatigued 41% 9%
Anxious 18% 6%
Worried 35% 6%
Unhappy 18% 3%
Annoyed 24% 6%
I get upset easily 21% 3%N = 34
Northern California (Medical Surgical Staff)
35
© 2011 HeartMathLLC Creating an Optimal Healing Environment
% of responses: often – always: Pre Post
My sleep is inadequate 41% 21%
Body aches (joint pain, backaches, etc.) 38% 12%
Muscle Tension 33% 6%
Headaches 9% 3%
% who agree or strongly agree: Pre Post
A strong rapport with my supervisor 36% 56%
Tension b/w management and staff 41% 26%
I feel very useful in my job 74% 94%
I am creative and innovative 53% 74%
Conflict b/w work & personal priorities 29% 15%
We have great confidence about being successful in the future.
72% 91%
N = 34
Northern California (Medical Surgical Staff)
© 2014 Copyright Institute of HeartMath
43%
29%
10%
23% 23%
10%
24%
14%
4%
11% 9%
4%
0%
10%
20%
30%
40%
50%
Tired Exhausted Depressed Anxious Annoyed Angry
Pre
Post
44%6
52%6
60%6
52%6 61%6
60%6
Before and six weeks after HeartMath Training
(N=5692)
©2014 Institute of HeartMath
Improvements in Mental & Emotional Well-Being
Percentage of individuals responding often or always
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath
33%6 44%6
43%6
63%6
44%6
44%6
(N=5692)
©2014 Institute of HeartMath
Improvements in Physical Symptoms of StressBefore and six weeks after taking the HeartMath Program
Percentage of individuals responding often or always
38
© 2011 HeartMathLLC Creating an Optimal Healing Environment
N = 12
50%
42%
25% 25% 25%
8%
25%
8% 8%
0% 0% 0%
Fatigued Exhausted Anxious Cynical Resentful Depressed
Kaiser NCAL Chief Nurse Executivespre post (2 - 4 weeks)
% of CNE’s feeling the following “often to always”
Impact on Leaders
39
© 2011 HeartMathLLC Creating an Optimal Healing Environment
N = 12
25%
33%
45%
75%
83%
58% 58%
92%
100% 100%
Peaceful Relaxed Calm Thankful Motivated
Kaiser NCAL Chief Nurse Executivespre post (2 - 4 weeks)
% of CNE’s feeling the following “often to always”
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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40
© 2011 HeartMathLLC Creating an Optimal Healing Environment
N = 12
27%
36%
42%
17%
8%8%
17% 17%
8%
0%
Indigestion, heartburn,stomach upset
Body aches Muscle Tension Headaches Rapid heartbeats
Kaiser NCAL Chief Nurse Executivespre post (2 - 4 weeks)
% of CNE’s feeling the following “often to always”
41
© 2011 HeartMathLLC Creating an Optimal Healing Environment
N = 12
42%
75%
55%
42%
8%
25%
42%
25% 25%
0%
I'm aware of powerstruggles that damage
morale
I feel pressed for time Conflict between workand personal
It takes a lot of effort tosustain my performance
I feel like leaving thisorganization
Kaiser NCAL Chief Nurse Executivespre post (2 - 4 weeks)
% of CNE’s who “agree or strongly agree” to the following
42
© 2011 HeartMathLLC Creating an Optimal Healing Environment
• “Gratitude, calm, relaxing.” - Linda• “I rediscovered it is all within me.” - CNE• “Peace, contentment” - CNE• “I feel like myself again.” - Jo-Ann• “I got a sense of inner peace!” - Marilyn• “I was able to develop more self- awareness.” - Marellen• “A gift… for my commute.” - Lisa• “Time for reflection!” - Terri• “It was a renewing experience. Thank you!” - CNE• “I am in control of my responses!” - CNE• “The ability to take a moment to do something for myself that in
turn will help others!” - Jodi
Chief Nurse Executive Quotes…
“What is your experience using these resilience tools in your life?”
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath
• Reduced Turnover (Delnor, Duke, Tenet, HCA)• 1st year Savings: $800K, $1M, $2.1M, and $3.9M• Double-digit improvements in the 1st year
• Increased Satisfaction (Chicago, IL)• Patient Satisfaction rose 73rd to 93rd percentile in 1styear.• Held above 90% for 6 years. • Ranked # 1 in Employee Satisfaction for 5 years. • Won 1st place, ACHE Congress, Best Management Innovation.
• Safety / Quality (National)• 220 pharmacists, 40-71% reduction in incidents. • Significant improvements in fatigue, anxiety, depression, anger, stress,
morale issues, and time pressure.
• Reduced Health Care Costs (RCA)• Annual cost savings = $585 per participant.
• Other: Reduced absenteeism; medical claims and increased productivity
Organizational Outcomes
© 2014 Copyright Institute of HeartMath
Our thoughts and emotions affect the heart’s magnetic field, which energetically affects those in our
environment whether or not we are conscious of it.
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The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath
A Boy and His Dog
© 2014 Copyright Institute of HeartMath
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© 2011 HeartMathLLC Creating an Optimal Healing Environment
“Thank you for a transformational experience! I use the Quick Coherence technique with my
patients and am inspired by how effective it is. Once for a person feeling anxious before cardiac
surgery. Yesterday, for a woman in respiratory distress.
Usually, I would put her on rescue Bipap. Instead, she was able to tune into her heart, activate a
feeling of appreciation for her garden and improve her oxygenation and breathing while remaining
on nasal cannula O2 therapy. Not only did it change her physiology, but it left her smiling, and
created a caring moment between the two of us. Her hospitalist observed this interaction and
stated, “I want all of our nurses to be able to do this for our patients!”
I am now even more motivated to help train and certify staff RNs. These nurses will be
comfortable with Quick Coherence and competent to not only use the technique to find a coherent
state in themselves, but also to help heal patients.
Sending love and appreciation!”
Sincerely,
Ashley McDonald, RN, BSN
Caritas Coach, HeartMath Certified Trainer, Critical Care RN
Kaiser Permanente South San Francisco
How it can touch our members…
© 2014 Copyright Institute of HeartMath
• Blood Pressure in Hypertensive Employees (Hewlett-Packard)20% reduction in diastolic and systolic blood pressure.
• Diabetes (LifeScan)30% increase in quality of life metrics; 1.1% reduction in HbA 1c.
• Congestive Heart Failure (Stanford Hospital)Increased functional capacity, reduced stress and depression.
• Heart Arrhythmias (Kaiser Permanente)75% of the patients had significantly fewer episodes of atrial fibrillation and 20% were able to stop medication altogether.
• Pain Reduction in Veterans (Dorn VA Hospital, SC)Reduced pain and emotional distress, and limitations in activity.
• Asthma (Robert Wood Johnson Medical School)Over 50% of patients experienced a decrease in airway impedance, symptom severity and medication consumption.
Study Results
The Resilience Advantage™ Slides – 3 per page 4/20/2018
© 2013 Institute of HeartMath 17
Oakland
Redwood City
South San Francisco
South Sacramento
San Rafael
Fremont
Fresno
OaklandRegional Offices
Santa Clara
San Leandro
1
1
3
3
7
7
4
1
1
2
2
4
3
3
1
1
15
3
HeartMath Trainers
Caritas Coaches
People who are both HM Trainers
and Caritas Coaches
62
2
1
2
5
6
2
2
1
3
3
60
24
3
8
3
4
1
3
1
1
1
3
5
3
1
2
1
2
5
1
2
1
2
2
1
1
1
© 2014 Copyright Institute of HeartMath
2013-2018• 87 new certified trainers in 18 medical centers.• 21 CNE’s trained - strong resilience improvements.• Care Experience Leaders – Self Care & Strategic Integration• STAR Leadership training – 1,200 leaders.• Integrated into Middle Management programs.• Nurse Residency, Nurses Week & Advancing Care
Experience Programs.
2008-2013• 43 Legacy Trainers; 10 medical centers• 3,800 PCS staff educated, call centers, pain clinics• Increased Resilience metrics in majority NCAL units• Improved HHCAHPS in home health/continuum
Core Kaiser-HeartMath Projects Building Resilience
© 2014 Copyright Institute of HeartMath
Multiple ways to share HeartMath tools with staff:
• Heart to Heart: • In person workshops - leadership, staff.• In person micro sharing - unit huddles, staff
meetings, lunches, grand rounds.• Mentoring – staff to staff; staff to patients
• On line-Learning:• Animated & Webinar
• Technology:• HRV portable devices for practice/sustainability.
• Visual reminders:• Tool cards, posters (doors, hand sanitizers), pins ...
Sharing Heart with Staff:
The Resilience Advantage™ Slides – 3 per page 4/20/2018
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© 2014 Copyright Institute of HeartMath
The Quick Coherence® TechniqueSharing Heart with Staff:
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© 2011 HeartMathLLC Creating an Optimal Healing Environment
Thank you!
Nikki West: [email protected] Robert Browning: [email protected]
54
© 2011 HeartMathLLC Creating an Optimal Healing Environment
Thank you.
Nikki West: [email protected]
Robert Browning: [email protected]; 831-247-9778
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