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Finding the joy of work by creating
satisfied staff to avoid burnout

Sutter Health, a not-for-profit organization headquartered in Sacramento, provides coordinated care to more than three million Californians. Their integrated network has created a connected model of care that delivers coordinated healthcare when, where, and how people need it. They are committed to ensuring healthcare is accessible and inclusive to all by offering comprehensive services and quality health programs tailored to the diverse communities they serve.

Leaders at Sutter Health knew they had an excellent care team, but also knew that U.S. physicians have had the highest record of burnout and the highest rate of suicide, among all professions for more than a decade. In response to these statistics, they formed a Joy of Work wellness team and created a task force to assess burnout, using NRC Health’s Workforce Engagement to evaluate burnout specifically in light of the impact of the COVID-19 pandemic on physicians.


System Governance | Attract & Acquire | Quality & Outcomes | Loyalty & Retention | Service Culture

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Right before the onset of the COVID-19 pandemic, the Joy of Work team—a group of
Sutter clinical and operational leaders—partnered with researchers from Sutter’s Center
for Health Systems Research to engage hospital leads for the program—and their timing couldn’t have been better. The nation-wide burnout rate was already high before the pandemic, and Sutter Health leaders knew it could get worse during the pandemic’s added stress.

Accordingly, one of the first things they focused on was physicians’ mental health,
particularly under the demands of COVID-19. To do that, they contracted with each
hospital to host an Employee Assistance Program to give physicians access to free
and confidential assessments, short-term counseling, referrals, and follow-up services.

Sutter also offered one-to-one peer support—physician to physician—for those
experiencing a tough time. “Physicians may reach out for peer support for a complicated clinical case, a difficult interaction, an outcome that was unexpected,” says Jill M. Kacher Cobb, MD, Chief Medical Executive, Novato Community Hospital and Physician Wellness Lead, Sutter Bay Hospitals, Joy of Work Team. “Maybe they had stress at home, a sick parent, child care needs, or a stressful life event. We advocated so everyone knew they could reach out for peer support, and talk to someone any time they encountered a stressful situation.”

Leaders also knew that not everyone would feel comfortable going to somebody within
their organization for peer support, so they created helpful courses, offered locally and
nationally, and other resources to support their workforce.

“We were able to identify leaders who were passionate about wellness and help them
set up wellness committees at our hospitals,” says Dr. Kacher Cobb. “I think that having
that touchpoint at each facility and knowing that there was a focus on physicians’ wellness helped start our culture change.”

This critical timing, along with their collaboration with NRC Health, gave Sutter the ability to survey their workforce to determine what they needed from their organization and their leadership during COVID-19. They learned that their workforce needed to be heard, cared for, and valued.

“I think the strength of the collaboration between the Joy of Work and Sutter Research teams, is that we don’t have any assumptions going in. We listen, and then we plan our strategy. Our strength comes from not having any preconceived notions about why there’s burnout. We want to listen to our clinicians, gather that information from surveys, and then act on those things.”

Laurie C. Gregg, MD, OB/GYN, leader of the Joy of Work Wellbeing Team at Sutter Health


NRC Health’s Workforce Engagement

NRC Health’s Workforce Engagement solution is a comprehensive program of staff
intelligence. Its digitally administered surveys capture a complete and candid picture of
workplace morale, enabling leadership to design initiatives to enhance morale.
Primarily, the Physician Engagement instrument asks physicians about their passion,
involvement, commitment and connectedness to their organization. The tool also offers
additional items aimed at measuring and understanding the impacts of burnout and
fatigue. NRC’s burnout index measures physical, work-related, and patient-related burnout, attributing burnout to each of these three categories. Shortened and customized wellbeing options are also available. Organizations may field a provider well-being survey as a standalone pulse, or add well-being items to an annual engagement survey.

Cumulatively, the tool provides a strong diagnostic measure of providers’ perceptions of
the workplace culture and offer actionable recommendations for organizations’ leadership to help re-engage providers and in return, help them rediscover the joy of practicing.

“We’ve had a lot of support from our leadership, who cared about well-being and burnout before COVID-19. So, to have this physician well-being program in place and then see it amplified across a big network of people across Sutter Health helped in many ways. Our Joy of Work team started virtual webinars on all types of wellbeing topics, with a high turnout of clinicians and clinician leaders attending.”

Ellis C. Dillon, Ph.D., Assistant Research Scientist, Center for Health Systems Research, part of Sutter Health’s Research Enterprise


The Joy of Work team focused on the basic wellness concept that burnout is not the fault of a person or a person’s lack of resilience. More often than not, there are systemic factors at play that contribute to workforce wellness. Surveys have become Sutter Health’s direct voice to reach frontline clinicians and gather meaningful input on their well-being and experience of work. Over time and using multiple follow-up surveys, Sutter can look for trends and understand changes within all levels of their workforce.

Based on data from NRC Health, Dr. Kacher Cobb says Sutter has been encouraging its leaders to read each survey, no matter which survey it is, and pore through the
comments section often, because common themes are repeated.

“Being part of a large system—sometimes it seems like you’re operating in a silo. But part of the Joy of Work team’s focus is to break down silos in our organization and bring people together and connect to share all of our great resources across our system.”

Jill M. Kacher Cobb, MD, Chief Medical Executive, Novato Community Hospital and Physician Wellness Lead, Sutter Bay Hospitals, Joy of Work Team

“A key part of our communication is letting the workplace know, ‘Hey, we’ve heard you, we saw your comments. This is what came out of your survey, and this is what we’re working on, and who we are working with,’” Dr. Kacher Cobb says. This kind of communication, she emphasizes, has helped create a stronger culture of trust with physicians.

There isn’t a partner that wellness doesn’t touch,” Dr. Gregg agrees. “My advice
to other healthcare systems would be to start with passionate people and focus on
understanding how that overwhelming, complex web interrelates and can be useful,
whether it goes up, sideways, down, or anywhere.”

With Sutter Health’s workforce-engagement strategies, its leaders are successfully
addressing mental health from a systems-issue perspective. They are providing education about burnout and sharing resources and tools to help our physicians, Dr. Kacher Cobb says. This includes offering EAP, peer support, coaching sessions and virtual wellness workshops to hospital-based physicians. However, this cannot be done in isolation—it’s important to continue to identify and address systems issues that contribute to burnout as well.

What Sutter has found most effective, which other healthcare systems could leverage, is an overall physician engagement strategy that takes action planning across the system and individuals in tandem. So, for instance, the healthcare system has its own action plan that is shared throughout the organization and each individual has an action plan to align with this overall plan. Having these action plans working together so they can have the biggest impact.

“What the program did is, it gave it structure and helped connect all the hospitals and the Joy of Work team leads—so it allowed people to talk about wellness more. We had a culture where we cared for each other before the program, and the program just enhanced that.”

Laurie C. Gregg, MD, OB/GYN, leader of the Joy of Work Wellbeing Team at Sutter Health

Looking ahead

Whether Sutter took action as a system working with supply-chain partners to obtain
necessary PPE, or supporting flexibility of scheduling, it has identified and taken action
on issues with exemplary creativity and flexibility. Working in tandem with system teams, Sutter leaders have found that asking their workforce, “how they are doing” is significant in itself—and finding the theme that physicians crave more recognition and appreciation has allowed them to respond quickly and easily to make a difference, increasing retention and human understanding. The close collaboration between Sutter’s Joy of Work Research Team and local wellness committees at Sutter hospitals, contributed significantly to their physician engagement strategy, increasing its effectiveness.

Sutter Health leaders say the “a-ha moment” was when they began to listen and
open their eyes to workforce issues they may not have thought about. They want to
continue to break down the barriers and stigma surrounding mental-health care and help their employees feel more comfortable reaching out for help when they need it.

For more on  NRC Health solutions,
call 800.388.4264 or visit nrchealth.com/demo.