NRC Health’s Patient No Longer podcast is in search of what’s new, what’s next, and what makes healthcare human again. The latest episode, “Exploring replenishment in the era of burnout, resignation, and resilience,” features Dan Collard, partner and co-founder of Healthcare Plus Solutions Group, discussing the idea of healthcare replenishment and the best questions senior executives should ask leaders for improved employee and patient satisfaction.

“As we’ve looked back a little bit, what bothers most clinicians about the term resiliency, or being asked to be resilient, is that it really means you must just keep going,” Collard says. “With resiliency, there’s no pause. But there’s real power in the pause. There’s real power in taking that breath as we lead a vibrant conversation about well-being, stress, and trauma. Because we think a lot of what the industry has gone through is not necessarily stress, but trauma. We’ve really happened upon this whole concept of, You can’t give what you don’t have.”

The veteran healthcare leader validates how hard this concept is. Collard brings up the illustrative image of “pouring into” your staff, and points out that you can’t pour out of an empty cup. Encouraging those around you, then, becomes about replenishing yourself, your team, and your organization.

“There’s a real deliberateness about the order there, because all too often, leaders have always been so good in healthcare about taking care of their team and their staff,” he says. “But we’ve found that leaders haven’t been taking care of themselves.”

If we have burned-out leaders, he says, we have burned-out staff—which bears serious implications for patient care. With that in mind, Collard advises that instead of just being a resilient leader, leaders should develop some deliberate, well-designed exercises to replenish themselves. It’s not the solution many healthcare providers think of first. But all this, Collard insists, brings us right back to the reason most of us got into healthcare in the first place: to provide better patient care.

Asking the Right Questions of the Right Leaders

Most senior leaders work from some sort of to-do list. But, Collard asks, does anyone have to-stop lists? He says a good place to start with senior leadership teams is to pause and ask, “Are we doing things today that we could pause or stop doing, and lighten the load a little bit for these middle leaders?” Because when push comes to shove—not unlike with healthcare pre-pandemic—the real key is middle leadership: those directors and managers who are not frontline or senior leaders.

Collard points to a truism in healthcare: those organizations with the best middle leaders win. To get there, he says, we’ve got to think about lightening their load. In doing so, one technique that he says has proved successful for him is, during a director or manager meeting, occasionally putting a “replenishment question” on the table:

• How are we taking care of the team?
• Why did you get into healthcare?
• Why do you work in this organization?
• Why do you stay here?

“What we have found is, cracking open those conversations has been so helpful to return people to the roots of their passion,” Collard says. “The roots of why they got into this to begin with—as simple as it sounds—are simple conversations that we have seen pay dividends in organizations.”

He says that this process must begin with senior leadership, with directors and managers, and then flow down to the staff level. “Because when we think about this whole burnout-and-resiliency order of things, these folks have just been working their tails off,” he says. “They work a shift, they go home, they come back, and they work a shift—and it’s been sort of nose-down, shoulders-forward.”

Physician Well-being Results

In partnership with an academic medical center in the Midwest, Collard created a well-being assessment survey that included questions about getting enough sleep and family balance—but that also asked physicians and advanced-practice clinicians about self-medication.

“Of those who responded to the survey, 34% said that they had experienced increased use of tobacco, alcohol, and cannabis throughout the pandemic,” Collard says. “Those in our industry are least likely to reach out for help. And there are a number of subtexts to that. As a doctor, I might not reach out because I don’t want anybody to know I’m reaching out. It’s my reputation…it’s my license. We found that physicians who had to go through their own insurance company were less likely to reach out, because there was sort of a trail there.”

Still, Collard says, there are opportunities to apply those replenishing exercises, because physicians absolutely enjoy and have found value in partaking in them.

“Just asking a couple of questions can make a big difference,” he says.

Learn more about why it’s so important that an organization’s mission, vision, and values aren’t just plaques on the wall in this episode of Patient No Longer.