Annual Meeting August 18, 2018

Transcription

1 Annual Meeting August 18, 2018

2 Poll Everywhere Audience Response ACPE requires active learning and most prefer real time participation rather than a graded posttest We are utilizing Poll Everywhere software for this process. You may join to participate by 3 different ways: Text Messaging: Text ushp to Web Browser: Go to PollEv.com/ushp Poll Everywhere app: Download app and join ushp presentation For each question, you can click on the correct answer in Web Browser or App or text correct answer to 22333

3 Evidence-Based Strategies to Enhance Individual Resilience Megan Call, PhD Associate Director Resiliency Center, University of Utah Health

4 Disclosure I have no conflicts of interest to disclose. I will not be discussing off-label uses of drugs.

5 Learning Objectives At the conclusion of this activity, pharmacists should be able to successfully: 1. List 3 resilience strategies they are currently using or are interested in trying 2. Define mindfulness 3. Employ the S.T.O.P. practice (a mindfulness technique)

6 Learning Objectives At the conclusion of this activity, pharmacy technicians should be able to successfully: 1. Define resilience 2. Describe the difference between mindfulness and meditation 3. List 3 resilience strategies they are currently using or are interested in trying

7 Introduction

8 Resiliency Center Vision Faculty and staff passionate about and energized by work The Center aims to: Promote personal resilience Reduce individual burden Create an optimal work environment Amy Locke, MD

9 Resiliency Center Areas Support Personal Resilience System Resilience Discovery Pexels

10 Resiliency Center Areas Support Personal Resilience System Resilience Discovery

11 Resilience

12 Resilience: Common Metaphor

13 Resilience Definition Resilience is the capacity to respond to stress in a way such that goals are achieved at minimal psychological and physical cost; resilient individuals bounce back after challenges while also growing stronger. Epstein 2013

14 Resilience: Realistic Metaphor

15 Don t Ask Us to Be More Resilient Resiliency Training

16 Features of High Achievers Delay gratification Perfectionistic Competitive Skeptic & pessimistic Repress emotions Put your head down and push through.

17 Burnout Wolfgang Stiller, Matchstick Men Maslach 1981

18 3 Components of Burnout Emotional exhaustion Depersonalization Decreased sense of personal accomplishment

19 3 Components of Burnout Emotional exhaustion Depersonalization Decreased sense of personal accomplishment Maslach 1981

20 Factors that Contribute to Burnout Sense of control/autonomy Documentation requirements Productivity pressure Work hours: schedule/ flexibility Poor sleep/activity level Perceived stress Job satisfaction Team function Perceived appreciation Keeton et al. 2007

21 Burnout & Pharmacists No specific reported burnout rate (current) Reported ranges for job satisfaction job stress increased workload Look to other health professional fields for rates Bridgeman et al, 2018

22 Failure to Respond Individual, team and institutional consequences Medical errors & worse patient outcomes Patient satisfaction & adherence Loss of professionalism, disruptive behaviors Decreased productivity Loss of empathy Faculty satisfaction & engagement Cost of recruitment & retention oestimated $250,000 - $1,000,000 to replace a faculty Family disruption & divorce Depression, anxiety, substance abuse, suicide Linzer, 2014

23 What makes a person more resilient?

24 2013

25 Traits Associated with Resilience Sources of gratification Doctor-patient relationships Efficacy of medical decision making/abilities Behavioral routines Leisure activities Relationships Personal refection Work boundaries Limit work hours/take vacation Attitudes Acceptance and realism Self awareness/monitoring Appreciating the good things Interest in person behind symptoms Admit when don t know Recognizing when change is necessary Zwack & Schweitzer 2013

26 Traits Associated with Resilience Sources of gratification Doctor-patient relationships Efficacy of medical decision making/abilities Behavioral routines Leisure activities Relationships Personal refection Work boundaries Limit work hours/take vacation Attitudes Acceptance and realism Self awareness/monitoring Appreciating the good things Interest in person behind symptoms Admit when don t know Recognizing when change is necessary Zwack & Schweitzer 2013

27 Resilience Strategies

28 Increase Self-Awareness

29 Know Your Story If it s getting in the way, then change it.

30 What am I saying to myself right now?

31 Be Wary of the 3 P s Personal Pervasive Permanent Ciarrohochi

32 Judgment Truth Ciarrohochi Ciarrohochi Look at your thoughts instead of from them

33 Values: What do I want to stand for?

34 You Can Return to Values Any Time

35 Reflect: On a scale of 1-10, how vital and alive do you feel right now?

36 Experiment: Kindness How can you live more in accordance with the value of kindness right now?

37 Reflect: On a scale of 1-10, how vital and alive do you feel right now?

38 Values: What do I want to stand for?

39 Exercise Your Discomfort Muscle

40 Get Out of Your Comfort Zone - Daily Train your body to work with stress. McGonigal 2015; Jamieson et al. 2012

41 And Remember to Take Breaks Create regular opportunities to recover from stress.

42 Give & Receive Support Giving Support Random Acts of Kindness Gratitude Letter Receiving Support Who can you call at 3am? Who are your mentors? Seligman 2011

43 Practice Awe, Optimism & Humor

44 Awe A sensation of being part of something much larger than yourself. Piff et al 2015

45 Optimism Acknowledge a challenge or setback with hope. Seligman 2011

46 Optimism: 3 Good Things Exercise What are three things that went well today? How did these things occur?

47 Humor & Laughter Increases/ Improves Pain tolerance Immune functioning Cardiovascular health Mood Group bonding

48 Experiment: Humor with Ryan Hamilton

49 Summary: So Far Burnout rates can be high Person & system-level intervention necessary Personal resilience increase self-awareness exercise discomfort give & receive support practice awe, optimism & humor

50 Stretch

51 We Struggle with Thoughts & Feelings

52 Mindfulness paying attention with flexibility, openness, curiosity, & kindness

53 Mindfulness Benefits Improved health (depression, anxiety, chronic pain) Decreased absenteeism Decreased burnout Improved patient centered approach to care Higher patient ratings Associated with reduced brain aging Marchand 2015; Fortney et al 2013; Kurth et al 2017

54 National Geographic

55 When Practicing Mindfulness, Remember you aren t doing it wrong you aren t bad at it you can t clear your mind you might feel better you will never be done

56

57 Summary Mindfulness: paying attention with flexibility, openness, curiosity, & kindness Variety of ways to practice & many benefits A thousand mile journey begins with a single step

58 Mindfulness Resources Mindfulness Websites meditations Mindfulness Apps Headspace Insight Timer ACT Companion

59

60 Test Question 1 What is the definition of resilience?

61 Test Question 2 List 3 resilience strategies

62 Test Question 3 What is a definition for mindfulness?

63 Test Question 4 Describe the difference between mindfulness and meditation.

64 Test Question 5 What are the 4 actions within the S.T.O.P. practice?

65 References Bridgeman, PJ, Bridgeman, MB & Barone, J. (2018). Burnout syndrome among healthcare professionals. American Journal of Health-System Pharmacy, 75(3): Epstein, RM & Krasner, MS. (2013). Physician resilience: What it means, why it matters, and how to promote it. Acad Med, 88(3): Forteny et al. (2013). Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: A pilot study. Ann Fam Med, 11(5): Harris, R. (2018). Acceptance and Commitment Therapy at Jamieson, JP, Nock, MK, & Mendes, WB. Mind over matter: Reappraising arousal improves cardiovascular and cognitive responses to stress. J Exp Psychol Gen, 141(3): Keeton, K, Fenner, DE, Johnson, TR & Hayward, RA. (2007). Predictors of physician career satisfaction, work-life balance, and burnout. Obstet Gynecol, 109(4): Kurth, F, Cherbuin, N, Luders, E. (2017). Promising Links between meditation and reduced (brain) aging: An attempt to bridge some gaps between the alleged fountain of youth and the youth of the field. Front Psychol, 8: 860. Linzer, M, Levine, R, Meltzer, D, et al. (2014). 10 bold steps to prevent burnout in general internal medicine. J Gen Intern Med, 29(1): Maslach, C & Jackson, SE. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2): Marchand, W. (2012). Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Zen meditation for depression, anxiety, pain and psychological distress. Journal of Psychiatric Practice, 18(4): McGonigal, K. (2015). The upside of stress: Why stress is good for you and how to get good at it. Random House: New York. Piff, PK, Dietze, P, Feinberg, M, Stancato, DM, & Keltner, D. (2015). Awe, the small self, and prosocial behavior. Journal of Personality and Social Psychology, 108(6), Seligman, M. (2011): Flourish: A visionary new understanding of happiness and well-being. Free Press: New York Zwack, J & Schweitzer, J. (2013). If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med, 88(3):