by Elizabeth Hofheinz, M.P.H., M.Ed.
Think of the last time you dragged yourself to the office after a rough night’s sleep. Wait … that was in a pre-COVID-19 world. Instead, you might be dragging yourself to your dining table to work. Now more than ever, it takes energy to work. It takes lots of energy to work at your peak. And in this new climate, your peak may look pretty different.
Despite new and shifting working conditions, the fact remains that the litany of energy-draining things in life do show up at the workplace. And the stakes are extra high if your workplace is an OR. 
A role model for proactivity, Johnson & Johnson is not waiting until employees’ energy reserves run out.
Melinda Thiel is Vice President of Health Systems Value Transformation at Johnson & Johnson Medical Devices Companies. She commented to OSN, “Johnson & Johnson is doing its utmost to foster a culture of mental, physical and emotional health in the workplace. We are helping customers to think about investing in their culture in novel ways.”
Indeed, Johnson & Johnson offers a suite of resources under its Healthy Workforce umbrella, with one component of the program – the Human Performance Institute – having a 30-year track record.
Theil said, “The genesis of our Healthy Workforce offerings emanated from the work we did in partnering with customers to help bring our expertise and capabilities to those health systems. We have numerous competencies as a healthcare company and have come to appreciate that our customers value and trust our knowledge, so this program is an intersection of customer priorities and J&J’s competencies.”
Raphaela O’Day, Ph.D., is a behavior scientist and Senior Performance Coach and Innovation Catalyst for Johnson & Johnson Human Performance Institute. She commented to OSN, “Our overarching aim is to help employees assess their lives in a holistic manner. It’s about helping people be their best selves, not just in the context of a work environment, but when they are ‘off the clock’ as well.
This program creates space for people to explore any discrepancies between who they are at their best and what may be getting in the way of that at different times. What we often observe as individuals explore this concept is that they sacrifice self-care in order to meet the demands and challenges of their environment. In order to ‘get more done’ they often give up time spent on taking care of themselves. The problem with this approach is that they are eroding the very foundation that supports their ability to get ‘things done’ in the most effective and efficient way … themselves. During times of crisis, this seems to be even more prevalent, because people often feel that self-care is self-centered and they may even have a sense of guilt around it. This is a challenge because it may contribute to a downward spiral.”
So what does this program look like?
Dr. O’Day notes, “The Institute focuses on the science of human performance. Essentially, how one can maximize their energy and foster resilience. Much of the Institute’s work is built off of the established research that sprung from the sports world, military’s Special Forces and Fortune 500 CEOs. We have successfully translated this knowledge into resources for healthcare organizations.”
“At the Human Performance Institute, we offer trainings of varying lengths, as well as a Train-the-Trainer program. In our performance program, we combine behavior science, performance psychology, exercise physiology and nutrition science to holistically train individuals to manage their energy and support their wellbeing.”
“We also offer a resilience program where participants learn about managing uncertainty, preventing burnout, applying strategic recovery, and building a growth mindset. We have found that both the performance and the resilience programs are pertinent to healthcare and even more relevant given the current pandemic. Although we have always recognized that much of the discussion is about helping build skills and behaviors that close the gap between demand and our capacity to meet that demand, we recognize that the gap is likely more pronounced now more than ever. When speaking with different audiences, we take into consideration that some content areas such as recovery and how we perceive and feel about the current situation has important impact on what we focus our coaching on. It really is about meeting people where they are with evidence-based strategies to support them in the context of their current experience.”
So how does this work?
Thiel told OSN, “We work with chief wellness officers, CEOs and CMOs who are staunchly committed to investing in their employees. It is evident that there is no ‘one size fits all’ program. When we work with a company, sometimes we bring in the entire leadership team and take them through the HPI program. Then they bring those resources and skills back to the workplace so that the leadership team can champion it within the system. An ideal example is when, say, the head of orthopedics and the head of nursing attend a training together and then form a united front when it comes to advocating for wellness.”
“Other companies may prefer to offer the program on-site and bring everyone in for a one-day experience. Another option is a virtual module; the goal is to be flexible so that we can assure that the information is transmitted as widely as possible.”
And what are the chiefs saying?
Thiel: “We have spoken with a number of orthopedic chairs, who are telling us, ‘I want to foster an environment where people can be comfortable talking about their daily struggles. We want it to be routine for a surgeon to grab a colleague and say, ‘Hey, I need to talk to someone about this case.’”
Not reinventing the wheel…
“Most healthcare facilities have some version of an employee wellness program. Thus, we target our efforts in a way that dovetails or builds on what they have already instituted.”
Dr. O’Day: “We talk to leaders about how their own energy and resilience may contribute to the energy and/or resilience of those they manage. Much of the time people are just trying to feel in control in an environment that feels out of their control. Time is finite so one thing we do is encourage a shift from the number of hours you work to the quality of energy that someone brings to their day. That is the first part of the conversation. We help people realize that they have an opportunity to shape the way their day goes, and by extension, the day of those around them.
During times of uncertainty, this is a particularly poignant conversation, since leaders are culture creators. We look to leaders as role models for acceptable and even expected behavior. Leaders have the unique opportunity and responsibility to establish ‘good norms’ for others. Role modeling behaviors that prioritize self-care, recovery and positive mindset are just a few ways to support others in doing the same. Doing this can support others in recognizing that although we may not always have control over our environment, we can control how we respond. Although not easy, it is empowering to take back control where we can, and when leaders model the same, it maybe a little easier.”
Shifting sands of power…
“The common—and valid—refrain is that physicians are losing autonomy. Wellbeing is an area where they can retain—and even enhance— control … no matter what is going on around them. We cover physical health (nutrition, activity, sleep), as well as emotional health (coping skills). We know that these factors are interconnected, i.e., if you are exhausted due to lack of sleep or you cannot be entirely present and focused when you are with a patient, then doctors cannot provide the best level of care—to the detriment of all. In addition, we assist participants in identifying a sense of purpose as well as how to live into that daily.”
Published studies show that the Institute’s programs improve vitality and purpose, and that these improvements are sustained over time.
But they don’t rest on their laurels.
Thiel: “Part of our process has involved defining measure of success. I just met with a customer in a major healthcare system who told me, ‘We struggle with the concept of ROI because some elements are difficult to nail down. Yes, we want to reduce absenteeism, but it is hard to say which one or two things drive the outcomes.’ Now some systems are looking at return on value, which is a broader recognition of the value these kinds of programs bring (for example, net promoter scores.)”
Buy in critical
Asked how they bring people through the program, Dr. O’Day noted, “Executives must buy in to the idea and serve as role models for each of the program elements. If the leaders are the first to implement changes, then the rest of the facility will more easily know how to undertake the changes. In addition, if possible, it is best to bring an entire treatment team to the program together as it creates a holistic focus on them in the context of the team as well as their broader lives. We know that every environment has slight differences that contribute to stress, thus having a conversation about how to manage these things in the specific context of that team reinforces new behaviors and builds shared accountability.”
Learning to remain steady amidst change…
Commenting on cultural shifts, Thiel says, “The executives we work with tell us that the thinking is shifting as the healthcare system moves from volume to value. With more and more patients and an increasing pressure to improve profitability, there are special challenges regarding culture. When people are pushed to do more with less, then the way they work is affected.”
Dr. O’Day indicates that they are laser focused on three areas. “We recognize that a challenge such as burnout has a variety of contributors across healthcare. Our goal is to help facilities prepare and manage this complex environment. With this in mind, we focus on supporting individual health and wellbeing through both the holistic management of personal energy and building of resilience. Additionally, we help individuals identify and live into their personal purpose to unleash their performance in both work and life. ”
“Helping individuals be the best version of themselves in this complex environment requires an open dialogue about the holistic elements that come together for optimal physical, emotional, mental, and spiritual wellbeing. Recognizing that these are a combination of individual and organizational factors is important,” says Dr. O’Day.
Winston S. Churchill said, “It’s not enough to have lived. We should be determined to live for something.”
J&J is bringing that “something” a whole lot closer for a great many people.
