Psychologists at Mercy Children’s Hospital created a four-color well-being tracker for leaders to score their team’s stress levels. Clinical team leaders can use scores from the survey to inform their decision to request additional support for their staff. This system operates with 3 main components.

Component 1: Implement stoplight assessment during team meetings

Children’s Mercy developed an anonymous well-being survey that team leaders can routinely use to assess the overall stress level of the team. Clinicians record their feelings as green, yellow, orange, or red, representing a spectrum from low to high stress through a digital survey. The goal of the assessment is not to single out staff members who are struggling. Instead, it’s meant to get a quantitative sense of how each team is coping overall so team leaders can activate organizational support resources as necessary.

Component 2: Translate survey data into actionable next steps

To make the data easy to digest, each color corresponds to a numerical value: green is coded as 1, yellow as 2, orange as 3, and red as 4. When staff complete the survey, team leaders automatically receive a single “team stress index” that is an average of each member’s response. An index score of 1.5 or higher may indicate a high level of team stress, and leaders are encouraged to leverage the organization’s emotional support resources.

Component 3: Activate well-being resources

Children’s Mercy paired their well-being tracker with a series of scoped resources that leaders can leverage to support their teams. Via the institution’s intranet, team leaders can submit an electronic request for a wellness representative to join their next team huddle to facilitate stress reduction exercises. They can also separately request a virtual support group specifically for their team. Beyond these two targeted support pathways, team leaders can direct their staff to the organization’s employee wellness resource page, which is regularly updated with additional well-being resources such as a 24/7 chaplainled inspiration line, one-on-one support with clinical social workers, guided meditations, and relaxation rooms.

Results

Children’s Mercy piloted their well-being survey in May 2020 in four areas: neurology, cardiology, developmental and behavioral, and one non-clinical discipline. They've already seen promising results, including an increase in staff utilization of well-being resources. Leaders attribute this, in part, to the fact that well-being is a standard agenda item for interdisciplinary team huddles. Overwhelmingly, the feedback from the front line to the executive level has been enthusiastic, with managers articulating their appreciation for a transparent way to assess their team’s well-being.

Supporting artifact

In 2009, Coxa Hospital for Joint Replacement in Finland deployed a tool they call Pulssi (Finnish for “pulse”) to assess staff’s emotional capacity on a per-shift basis. Data from the Pulssi tool is evaluated by nursing leaders and unit managers on a regular basis to address areas of concern that require additional attention. Their approach involves three components.

Component 1: Implement Pulssi assessment

Pulssi was created to quantitatively unify subjective experience evaluations with hard indicators. During the few minutes before the end of each shift, frontline clinicians can reflect on their day and record their answers with color-coded options. Pulssi responses are categorized into green (strong well-being), yellow, and red (poor well-being). Yellow and red responses require a short comment on what went poorly during the shift.

Component 2: Escalate Pulssi data to instigate problem-solving process

Unit managers and the director of nursing review the combined data on a daily, weekly, and monthly basis. They meet with staff to discuss significant patterns, assess underlying root causes, and address areas of concern that require attention. Managers are trained to facilitate open and blame-free discussions to engage frontline staff to work together to find solutions to common challenges identified through Pulssi.

Component 3: Implement solutions for root-cause problems

Collection of Pulssi data drew leaders’ attention to problems as soon as staff identified them. By quickly bringing staff and leaders together to respond to the challenge, Coxa ensures that isolated issues do not escalate into larger problems over time.

Results

Coxa reported that Pulssi gave leaders a comprehensive measurement of clinician well-being and led to remarkable changes in the organization’s culture of resilience. Previously, clinicians had a tendency to withhold emotions and blame leaders for frustrations that inevitably occur in daily work. Now, staff feel open and comfortable sharing their feelings and brainstorming solutions. Additionally, recording their responses at the end of their shift allows clinicians to process their feelings. It puts an ends an end to their day, and they can begin their next shift with a fresh outlook.

Supporting artifact