Burnout and Crises: Joy in the Face of Chaos · Med Tac Bystander Rescue Care Bystander Rescue Care CareUniversity Series For resource downloads go to: Coronavirus: Preparing a Home

1 © 2020 TMIT Global TMIT Global

SafetyLeaders.org

April 16, 2020 Webinar Month 138

For resource downloads go to:

www.safetyleaders.org

Burnout and Crises:

Joy in the Face of Chaos


SafetyLeaders.org

Charles Denham, MD Chairman, TMIT Global

TMIT High Performer Webinar March 19, 2020 Webinar Month 138

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TMIT Purpose Statement

Our Purpose:

We will measure our success by how we protect and enrich the lives of families…patients AND caregivers.

Our Mission:

To accelerate performance solutions that save lives, save money, and create value in the communities we serve and ventures we undertake.


SafetyLeaders.org

Disclosure Statement The following panelists certify that unless otherwise noted below, each presenter provided full disclosure information; does not intend to discuss an unapproved/investigative use of a

commercial product/device; and has no significant financial relationship(s) to disclose. If unapproved uses of products are discussed, presenters are expected to disclose this to

participants. None of the participants have any relationship medication or device companies discussed in their presentations.

Stephen Swensen, MD, MNN, is a motivational speaker and recognized, well-published expert in healthcare leadership and professional burnout. For three decades he served patients at the Mayo

Clinic. As Director for Leadership and Organization Development he co-led the professional burnout initiative and oversaw the development of 4,100 physicians and scientists, and 232 titled

leaders. As Director for Quality, he established the Quality Academy and the Value Creation System. More than 37,000 colleagues were certified as Quality Fellows during his tenure. As

Department Chair, he and his team used Lean-Sigma and Baldrige to create value for patients and time for professionals. He has nothing to disclose.

Sanjiv Chopra, MD, is professor of medicine and former faculty dean for Continuing Medical Education at Harvard Medical School. He’s also the James Tullis Firm Chief, Department of Medicine,

at Beth Israel Deaconess Medical Center. For 12 years he led the most robust academic Continuing Medical Education enterprise in the world, reaching out to 80,000 clinicians in 150 countries

each year. He has nothing to disclose.

Alicia Kowalski, MD. is a national expert on burnout and professional wellness in the Healthcare Field. For over two decades she has served patients and colleagues at the The University of Texas

MD Anderson Cancer Center in the Texas Medical Center, Houston, Texas. Dr. Kowalski is Professor, Department of Anesthesiology & Peri-operative Medicine, The University of Texas MD

Anderson Cancer Center; Founder and Chair of Burnout to Brilliance, a national CME symposium for Physician Wellbeing and Career Sustainability. She has nothing to disclose.

Mary E. Foley, PhD, RN, is a Clinical Professor at the University of California San Francisco (UCSF) School of Nursing and is the Director in the Center for Nursing Research and Innovation at

UCSF. She is the Assistant Director for the Master’s Entry Program in Nursing at UCSF, and teaches in the Masters in Health Administration and Interprofessional Leadership (MS-HAIL) course at

UCSF. Mary worked with the Collaborative Alliance for Nursing Outcomes (CALNOC) since 2004 and in January 2017 she will serve as Chairperson of the CALNOC Board of Directors. She has

nothing to disclose.

Charles Denham, MD, is the Chairman of TMIT; a former TMIT education grantee of CareFusion and AORN with co-production by Discovery Channel for Chasing Zero documentary and Toolbox

including models; and an education grantee of GE with co-production by Discovery Channel for Surfing the Healthcare Tsunami documentary and Toolbox, including models. HCC is a former

contractor for GE and CareFusion, and a former contractor with Siemens and Nanosonics, which produces a sterilization device, Trophon. HCC is a former contractor with Senior Care Centers.

HCC is a former contractor for ByoPlanet, a producer of sanitation devices for multiple industries. He does not currently work with any pharmaceutical or device company and has not done so for

more than 5 years. His current area of research is in threat management to institutions including conflict of interest, healthcare fraud, and continuing professional education and consumer

education including bystander care. Dr. Denham has been a collaborator with the late Professor Christensen at Harvard Business School.


SafetyLeaders.org

Speakers and Reactors

Dr. Stephen Swensen Dr. Charles Denham Dr. Alicia Kowalski Dr. Sanjiv Chopra Mary Foley, PhD, RN


SafetyLeaders.org

Voice of Patient and Family

Mary E. Foley, PhD, RN, FAAN

Clinical Professor, UCSF School of Nursing

Director, Center for Nursing Research and Innovation

Assistant Director for the Master’s Entry Program in

Nursing

University of California, San Francisco (UCSF)

San Francisco, CA

TMIT Global High Performer Webinar

April 16, 2020


SafetyLeaders.org



April 16, 2020

Webinar 138

In the News Update and

March 2020 Webinar Recap

© 2006 HCC, Inc. CD000000-0000XX 13 Med Tac Bystander Rescue Care

Meaningful Use is dead. Long live something better!

Flattening the Curve: Avoid the Surge

Our Healthcare Capacity


Meaningful Use is dead. Long live something better! Call To Action

https://podnews.net/press-release/the-dennaissance

Dennis Quaid: Patient Safety Champion

Dennis Quaid championed the cause of patient safety

using the story of his twins who survived and completely

recovered from a catastrophic medical error. He narrated

and was featured in both Discovery Channel films, Chasing

Zero: Winning the War on Healthcare Harm and Surfing the

Healthcare Tsunami: Bring Your Best Board. He helped

build awareness of the NQF Safe Practices and the

Healthcare Associated Conditions – the HACs which saved

tens of thousands of lives and billions of dollars. AHRQ

reported at the end of 2014 87,000 lives and $19.9B were

saved. From 2014 to the end of 2016, another 8,000 lives

and $2.9B were saved. We are awaiting final count by the

end of 2019. Although Dennis Quaid and IHI brought

awareness to this opportunity, the hospital teams did the

work. Dennis is excited to continue to help the champion

the cause.

Apple podcast link:

https://podcasts.apple.com/us/podcast/feed/id1503394153?at=11lo6V&ct=podnews_podcast

Google Podcast Link:

https://podcasts.google.com/?feed=aHR0cHM6Ly9yc3MuYXJ0MTkuY29tL3RoZS1kZW5uaXN

zYW5jZQ==






https://podcasts.apple.com/us/podcast/feed/id1503394153?at=11lo6V&ct=podnews_podcast

https://podcasts.google.com/?feed=aHR0cHM6Ly9yc3MuYXJ0MTkuY29tL3RoZS1kZW5uaXNzYW5jZQ==

https://podcasts.google.com/?feed=aHR0cHM6Ly9yc3MuYXJ0MTkuY29tL3RoZS1kZW5uaXNzYW5jZQ==



(CNN) More than 9,200 health

care workers have been infected

with Covid-19, the US Centers

for Disease Control and

Prevention has found in its first

look at the issue.

The number is likely an

underestimate, since most

reports of coronavirus cases

don't include whether the

person worked in healthcare.


Meaningful Use is dead. Long live something better! Essential Critical Infrastructure Workers


Meaningful Use is dead. Long live something better! Call To Action

Join Us!

We can Serve Now!

www.GlobalPatientSafetyForum.org Emerging Threats Community of Practice

http://www.globalpatientsafetyforum.org/

Readiness for Epidemics including preparedness for testing and

volume surges

© 2006 HCC, Inc. CD000000-0000XX 20 © 2020 TMIT

Cardiac Arrest

Meaningful Use is dead. Long live something better! High Impact Care Hazards to Patients, Students, and Employees

Opioid Overdose

Infection Care

Bullying

A Medical-Tactical Approach undertaken by

clinical and non-clinical people can have

enormous impact on los of life and harm

from very common hazards:

• High Impact Care Hazards are frequent,

severe, preventable, and measurable.

• Lifeline Behaviors undertaken by anyone

can save lives.

Choking & Drowning

Anaphylaxis

Major Trauma

Transportation Accidents

20

Med Tac

Story Article

Active Shooter

Healthcare Article

AED & Bleeding

Control Gear Article

Rapid Response

Teams Article

Battling Failure to Rescue

Automated External

Defibrillator

& Bleeding Control

Gear Placement

21

21

www.MedTacGlobal.org

Bystander Rescue Care

for Failure to Rescue

23

23

24

Emerging Threats

Community of Practice

Med Tac Bystander Rescue Care


CareUniversity Series

March 18, 2020 CareUniversity Webinar #136

For resource downloads go to:

www.MedTacGlobal.org

Coronavirus - Protecting You & Your Family:

First Responder & Family Briefing

25

Emerging Threats





Speakers

Reactors

Jennifer Dingman

Dr. Charles Denham Chief William Adcox Dr. Gregory Botz

Dan Ford Randy Styner Dr. Chris Fox Tom Renner David Beshk

26 Med Tac Bystander Rescue Care

68%

8%

13%

5% 2% 3%

1% 0% 0% 0%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative to

Neutral

4

95% Agreed and 77% Strongly or Very Strongly Agreed,

and 68% Very Strongly Agreed

Anonymous Survey Questions

Source: CareUniversity Bystander Rescue Care Webinar Series; Coronavirus - Protecting You & Your Family: First Responder & Family Briefing – March 18, 2020

I would like another webinar on

RESPONDING TO THE CORONAVIRUS THREAT

27 Med Tac Bystander Rescue Care

55%

15%

7% 4%

2% 1% 1% 1% 0%

14%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative to

Neutral

4




Source: CareUniversity Bystander Rescue Care Webinar Series; Coronavirus - Protecting You & Your Family: First Responder & Family Briefing – March 18, 2020

I am interested VIDEO updates on the

CORONAVIRUS THREAT

28

28

29

Emerging Threats





For resource downloads go to: www.MedTacGlobal.org

Coronavirus: Preparing a Home Care Room

A Survival Guide

for All Families

Originally prepared for Professional

Caregivers, First Responders, and

Essential Critical Workers


Preparing Your Care Room

GRAPHICS SOURCE: USA TODAY Adrianna Rodriguez, Veronica Bravo and Janet Loehrke, 03-21-20

Coronavirus: Preparing a Home Care Room “Your home is your spacecraft”



PREPARING A HOME CARE ROOM

• Critical Concepts

• How the Viruses Spread

• Why Checklists are Important

• Care Room Set Up Checklist

• Caregiver Protection Checklist

• Supplies Checklist

• Leading a Home Care Team

Keeping You and Your Family Safe

Understand the Basics

Create a Plan & Checklists

Set Up a Care Room

Family Team Readiness

Preparing Your Care Room: A Step by Step Approach

Step 1

Step 2

Step 3

Step 4


Meaningful Use is dead. Long live something better! Keeping You and Your Family Safe

PREPARING A

HOME CARE ROOM

• Critical Concepts

• How the Viruses Spread

• Why Checklists are Important

• Care Room Set Up Checklist

• Caregiver Protection Checklist

• Supplies Checklist

• Leading a Home Care Team


Meaningful Use is dead. Long live something better! Checklists


Meaningful Use is dead. Long live something better! Person-to-Person Transmission

34

Infectious Droplets &

Droplet Nuclei Travel Length

1-3 Feet 3-5 Feet 5-160+ Feet

© 2006 HCC, Inc. CD000000-0000XX 35 Med Tac Bystander Rescue Care 35

How Long Does Corona Virus Live on Surfaces?

*At 71 to 65 relative humidity

Adapted From Business Insider

Source: New England Journal of Medicine (NEJM) and The Lancet Microbe (L-M)

*At 69.8 to 73.4 degrees F (21 to 23 Degrees C) and 40% Humidity

Paper and Tissue

Paper**

Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days

Stainless Steel*

Polypropylene

Plastic*

Glass**

Paper Money**

Outside of

surgical mask **

2-3 days

3 days

4 days

4 days

7 days

Contact Surfaces

36 © 2020 TMIT

Global Survey Questions

I would like to serve in the

CORONAVIRUS Community of Practice

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative

to Neutral

4

The way I can serve in my community to help support

CORONAVIRUS CARE and SAFETY is:

36

Emerging Threats




37 © 2020 TMIT

Global Survey Questions

The topics I wish to see covered in

CORONAVIRUS CARE and SAFETY are:

37

Emerging Threats





SafetyLeaders.org

David Marx, JD

Just Culture Leader & Innovator

Principle, Outcome Engenuity Center

Eden Prairie, MN


March 19, 2020

Just Culture: A 2020 Update

39 © 2020 TMIT

64%

12% 13%

5% 4% 1% 1% 0% 0% 0%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative to

Neutral

4




Source: TMIT High Performer Webinar Series; Mortality Reviews and Patient Safety: A 2020 Update – February 20, 2019


MORTALITY REVIEWS by COLLABORATORS

40 © 2020 TMIT

• Action planning after opportunities are identified

• Admin support and lack of for culture change

• Administrative support

• Any topic, this was so insightful

• Anything

• Anything quality related to help take care of patients better.

• Benefits of risk and quality committee involvement for OFI and issues.

• Best team approach and phases as well as data for trend analysis

• Capturing SOI/ROM

• Changing culture to just culture and removing punitive mindset. Helping

senior leaders understand the infrastructure that is required for a robust

quality and safety program. One FTE where six are needed just doesn't cut it.

• Classifying and quantifying system level changes, identifying the rate of

adverse events, learning to identify unanticipated deaths

• Common threads; focus areas

• Continue with the same educational line, I love how it addresses that if we

don't fix the omissions, there will be more burn out and severe depression in

medical staffs

• Creating a mortality review committee and examples of review format and

training.

• Culture of safety

• Deep dive into the review methodology

• Deeper into risk adjusted mortality indexes

• Diagnostic errors

• Disease specific concerns

• Do you have a worksheet or allorhythmia that you recommend to initiate the

mortality reviews?

• Ed mortalities

• Emergency dept mortality reviews

• End of life

• End of life - how can we increase awareness about palliative care vs. Hospice

care among our communities (patients, families and even our internal

professional healthcare staff). So few people have a good understanding or

awareness of how beneficial both end of live specialties are and that they

should get these specialties involved earlier in their care journey. The majority

either don't consult palliative care nor refer to hospice OR they do, but it's a

few days prior to the day that the patient dies.

• End of life care, advanced directives

• Expand on the actual process or data points reviewed during mortality

reviews.

• Expand on the interdisciplinary reviews, how to begin

• Finding the common thread

• Further drill down into best key metrics and data points to capture


The topics I wish to have covered in another webinar on

MORTALITY REVIEWS

41 © 2020 TMIT

• General

• Getting started

• Getting started with mortality review. More detail on how to start.

• Great information

• HACS/hai's

• Hear from the staff that are doing the work, the process, tools overcoming

barriers and staff that are disengaged

• How do you work with organizational barriers to have providers involved?

Such as RN restrictions on spending additional time, MDS over scheduled,

prioritization by management, dealing with independent MDS?

• How to achieve these robust reviews. Role of student monitoring in patient

safety

• How to get leadership engaged in understanding bedside caregivers need to

have the tools to provide the best care; free from errors

• How to moving from discovery to improvement

• How to perform a motility review

• I would like to hear more from this presenter.

• Implementing change

• Improved care for the prison population

• Incorporating safety into traditional M&M

• Interested in a series on what dr. Huddleston is learning

• Interested in hearing more about why we need to shift the focus beyond

preventability. Would this change event classification?

• Intraoperative injuries and deaths

• Is there a mortality review template you could share? Also, how do you go

about obtaining by-in from providers related to mortality review?

• Items to look for while doing mortality reviews, trends, high risk items.

• Learners vs doers

• Managing critical patients issues up to leaders

• Medication error

• MI mortality

• More about the review process

• More details of the safety learning system

• More info on SBAER, case studies utilizing clutter and common thread

analysis

• More information about focusing on opportunities instead of

preventability/causality. This is very interesting

• More inf

• More on how to address OFI

• More on lifting up the blind spots to leaders uncovered from mortality reviews

using your framework.



MORTALITY REVIEWS

42 © 2020 TMIT

• More specifics on how how to do these chart reviews, perhaps a form that

prompts people to look for specifics? Also what types of findings and how

those are put into practice.

• Mortality review data collection

• Mortality review data collection

• Mortality review process

• Moving from identified OFI to improvement

• Near misses

• Nurse quality outcomes specialist escalating cases for physician review.

• Nurses workplace violence

• Opioid events

• Palliative care

• Palliative care delay

• Pediatric mortality

• Peer review best practices

• Practical tips for implementation of review system; suggestions to help

identify and elevate the "below the iceberg" problems to leadership; how did

you structure your team & engage the disillusioned; practical ideas for

systemic learned helplessness

• Preventable complications

• Process

• Quality measures in total cost of care environs

• Readmissions

• Recognizing medical problems in patients admitted for behavioral health event

• Recognizing physical aspects of burnout

• Report building, review process & escalation, inclusion of medical staff

• Review of the application of the CMS guidelines for mortality exclusion charts.

• Screening/review forms

• Sepsis

• Templates for mortality review & database

• The connection with earlier palliative intervention. What evidence is there that

earlier palliative involvement will positively affect mortality rates or

readmissions.

• Tips to improve mortality

• Tools for analysis

• What do the nurse reviewers look for when reviewing a mortality and is that

shared with the MD or do they review individually then compare?

• What was done to improve several issues?

• When improvements are identified in your mortality reviews, how do those get

handled or funneled through? Who's responsible? Many times improvements

are identified and then there's the...Then what?

• When palliative care consult should be involved; aspiration pneumonia; sepsis



MORTALITY REVIEWS

43 © 2020 TMIT

35%

9%

19%

9% 6%

12%

6% 3%

1% 0%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative to

Neutral

4





I am interested in a series of webinars on

BURN OUT

44 © 2020 TMIT

• After involved in patient safety event

• Bouncing back after burning out

• Burn out resulting from staffing shortages

• Burn out wouldn't be a topic that I'm extremely interested in at this point.

• Clinician burnout and moral distress among nurses

• Compassion fatigue and the impact

• Difference between physicians versus other disciplines and the differences in approach

• Finding a balance

• Healthcare providers, I see much about physicians and nurses, what about the interdisciplinary team?

• How burn out impacts patient safety and interaction with colleagues.

• How to address staffing issues

• How to measure burn out contributing to safety events-what questions to ask when investigating

• How to not get los

• How to prevent healthcare worker burn out to maintain long term employees

• I believe burn out is a wonderful topic, that is very important to the global organizations. I am not in a

place to focus on more than one topic aat this time, so mortality is my focus.

• I would like to see the topic expanded beyond physician burnout

• Identification

• Improving quality by avoiding burnout

• Increasing education on additional staff

• Increased staff demands amid decreased staffing

• Lack of communication and emotional reasons for burnout

• Lack of support

• Never enough. Its never enough staff to comfortably perform gentle care. It's never enough of your

dedication to administration. It just seems like it is never enough.

• Not sure but would really like to see safety study repeated since technology added. Has it helped or

added different issue?

• Not sure, but an important topic in what we do.

• Nurse burn out

• Nurses, sleep deprivation and caffeine

• Nursing shortage

• Patient safety due to errors from burn out

• Prevention of burnout, remedies

• Provider engagement

• Recognition, prevention, intervention and honestly, what can we really do about it when we have no

budget. Thanks!

• Recognizing burnout in advance

• Recognizing signs. How to create more whitespace. How to recognize things that make someone feel

burned out, when it may not exactly be burn out. Examples: person is in the wrong job. Toxic culture.

Not enough resources to get the work done (might still stay in discipline, just need more resources.)

• Recommended actions, not just a presentation how burn out exists and it's impact, but more on ways

to prevent and address.

• Recommended supports for burn out (internal, local and on-line). Who should approach the person to

have the discussion to ask if they are okay vs. Burnt out? How can we reduce the stigma of talking

about mental or emotional health?

• Signs and symptoms

• Similar to above comment/ overcoming the learned helplessness barrier

• Strategies to reduce nurses' burnout

• Stress management

• Type of errors that correlate to provider burnout


The topics I wish to have covered in the upcoming webinar on

BURN OUT


SafetyLeaders.org

Burnout and Crises: Joy in the Face of Chaos

Stephen Swensen, MD, MMM

Professor Emeritus, Mayo Clinic College of Medicine

Senior Fellow, Institute for Healthcare Improvement

Rochester, Minnesota


April 16, 2020

Burnout and Crises:

Joy in the Face of Chaos

Stephen Swensen, MD, MMM Senior Fellow, Institute for Healthcare Improvement

Former Director Leadership and Organization Development, Mayo Clinic

Professor Emeritus, Mayo Clinic College of Medicine

Hans Christian Anderson

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiBiIXD2d3ZAhVm44MKHTyPBnMQjRwIBg&url=http://www.history.com/news/here-are-6-things-albert-einstein-never-said&psig=AOvVaw0SIYs_ug2siqb0RDJCpnLF&ust=1520631843971434

POSITIVITY >> NEGATIVITY

Esprit de Corps

©2016 MFMER | slide-51 Losada, (2004). The Role of Positivity and Connectivity in the Performance of Business Teams. American Behavioral Scientist, 47(6), 740-765.

Gottman, John (2003). Mathematics of Marriage. MIT Press.

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=2ahUKEwim9dGS4-bjAhUxgK0KHZGUBmYQjRx6BAgBEAU&url=https://www.gottman.com/about/john-julie-gottman/&psig=AOvVaw1go2it7nAfXyzh-vh3pRrS&ust=1564924176661181


SUPPORT RESOURCES = JOB

Esprit de Corps

Stress with

Sufficient Support Resources

Esprit de Corps


Behaviors Self-Care Mindset

Fair & Just

Compassion Connectedness

Safe Havens

SUPPORT RESOURCES

Swensen, Shanafelt. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace. Oxford University Press. 2019



Fair & Just


Safe Havens

Esprit de Corps


I've learned that people will forget what you said… Maya Angelou

Each of us needs to

withdraw from the

cares which will not

withdraw from us.

Shanafelt TD, Lightner DJ, Conley CR, Petrou SP, Richardson JW, Schroeder PJ, et al. An organization model to assist individual physicians,

scientists, and senior health care administrators with personal and professional needs. Mayo Clin Proc. 2017 Nov;92(11):1688-96.

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwijwcuQhLPlAhWCpZ4KHf9hD1UQjRx6BAgBEAQ&url=/url?sa%3Di%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dimages%26cd%3D%26ved%3D%26url%3Dhttps://www.harpercollege.edu/services/counseling/index.php%26psig%3DAOvVaw3junNr3ZIH_LoTzIhX11Rb%26ust%3D1571942246898593&psig=AOvVaw3junNr3ZIH_LoTzIhX11Rb&ust=1571942246898593

Epstein, Krasner, Physician resilience: what it means, why it matters, and how to promote it. Acad Med, 2013. 88(3): p. 301-03. Sood. Mayo Clinic. The Mayo Clinic Guide to Stress-free Living. First Da Capo Press edition. Da Capo Press/Lifelong Books, 2013.

Tuesday…



Fair & Just


Safe Havens

Esprit de Corps


Scott, et al. Caring for Our Own: Deploying a Systemwide Second Victim Rapid Response Team. May 2010 Volume 36 Number 5. 233-240

Shanafelt. Ann Surg 2010 Jun;251(6):995-1000. Burnout and medical errors among American surgeons. Kimberly Hiatt

http://www.nbcnews.com/id/43529641/ns/health-health_care/t/nurses-suicide-highlights-twin-tragedies-medical-errors/#.VypPEtj2bcs

©2013 MFMER | 3239472-63

Am J Psychiatry. 2004 Dec;161(12):2295-302

BAD PROCESS…

Swensen. Esprit de Corps & Quality

The case for eradicating burnout. J Healthcare Management. 63(1), 2018

https://www.google.com/url?sa=i&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjf1vPmuZzbAhVl5IMKHfCmDKkQjRx6BAgBEAU&url=https://pt.slideshare.net/umarkanju/edwards-deming-quality-guru&psig=AOvVaw1UaRu1ACbGtQqSi6ILCkd_&ust=1527186070713158

Reason J. Human error: models and management. BMJ. 2000 Mar 18; 320:768-770. Marx D. (2001) Patient Safety and the “Just Culture”: A Primer for Health Care Executives. Columbia University, New York, NY.

Swensen, Shanafelt. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace.:Oxford University Press. 2019

Fair and Just Compassion

www.GreatPlacesToWork Root of the tree is trust. Michael C. Bush

Neff, K. D. & Germer, C. (2017). Self-Compassion and Psychological Wellbeing. In J. Doty (Ed.) Oxford Handbook of Compassion Science, Chap. 27. Oxford University Press.

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwiH-IP49-jdAhUCE3wKHcRbDW4QjRx6BAgBEAU&url=https://pixabay.com/en/hand-in-hand-holding-hands-2065777/&psig=AOvVaw3zr56Uf1t3_FsoJcjxGJ_f&ust=1538610189301238

Tuesday…



Fair & Just


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Esprit de Corps

Five Leader Behaviors

Shanafelt, Menaker, Buskirk, Gorringe, Swensen. Leadership Dimensions. Mayo Proceedings. 4/2015 90(4) Swensen, Shanafelt. Org Framework Professional Burnout. Joint Comm Quality & Safety 2017 43(6) 308 Swensen Gorringe Caviness Peters Leadership by Design. Journal of Mgmt Development 35 (4) 2016 Shanafelt, Swensen. Annual Reviews to Reduce Burnout and Promote Engagement. Am J Medical Quality 2017

(P<0.001)

(P<0.001)

Five Leader Behaviors

Dyrbye, et al. Organizational Leadership and Employee Burnout and Satisfaction Mayo Clinic Proceedings, Volume 95, Issue 4, 698 - 708

(P<0.001)

(P<0.001)

Appreciation Career Ideas Transparency



Swensen Gorringe Caviness Peters . Leadership by Design. Journal of Mgmt Development Vol. 35 (4) 2016

©2013 MFMER | slide-75

Coaching Mentor Culture…Elephant and baby Engagement = Leading Indicator What is the best way to succeed at Mayo? 12 Dimensions Swensen Gorringe Caviness Peters . Leadership by Design. Journal of Mgmt Development Vol. 35 (4) 2016

Chua. Costs of Ambient Cultural Disharmony. Academy of Management. 2013, 56(6)545.

Rouse. Blind Auditions. September-November. American Economic Review. Swensen Gorringe Caviness Peters . Leadership by Design. Journal of Mgmt Development Vol. 35 (4) 2016

Shanafelt, Menaker, Buskirk, Gorringe, Swensen. Leadership Dimensions. Mayo Clinic Proceedings. 4/2015 90(4) Shanafelt, Swensen. Using the Annual Review to Reduce Burnout and Promote Engagement. American J Medical Quality 2017

Leader Index

Tuesday…



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Esprit de Corps


Keller. Health Psychol. 2012 Sept 31(5): 677–684 43% 90% Lyubomirsky 2005.

Fredrickson. Uplifts-to-Hassles Resilience J Pers Soc Psychol. 2008 (11)95(5) Baumeister, et al. Bad Is Stronger Than Good. Review of General Psychology 2001. Vol. 5. No. 4. 323-370

Fredrickson, Joiner. 2002 Positive emotions & well-being. Psychol. Sci. 13, 172–175.

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjzqsPCxazdAhUn9YMKHVabAicQjRx6BAgBEAU&url=https://www.meredith.edu/news/positive-psychology-expert-barbara-l.-fredrickson-to-receive-merediths-2018&psig=AOvVaw0mS8YBLCQQ9LdPLtIBC5IM&ust=1536535066445543

Grant. “Impact and the Art of Motivation Maintenance: The Effects of Contact with Beneficiaries on Persistence

Behavior,” Organizational Behavior and Human Decision Processes. 05/2007; 103(1):53-67 (3x)

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwj81pC-qNTdAhUs6IMKHeBUCgsQjRx6BAgBEAU&url=https://www.cnbc.com/2018/04/02/wharton-professor-adam-grant-how-handle-criticism-in-a-productive-way.html&psig=AOvVaw05S52eRmaGhey6kE8Pxbud&ust=1537901649558084

Income

Balance

Meaning

Promotions

Job Security Cascio (2003). Changes in workers, work, and organizations. In Borman, Ilgen, Klimoski (Eds.), Handbook of psychology: Industrial and organizational psychology, Vol. 12, pp. 401-422). Hoboken, NJ, US: John Wiley & Sons Inc.

https://www.grandforks.af.mil/News/Photos/igphoto/2001277980/

Berg, Grant, Johnson Crafting work in pursuit of occupational Callings. Organization Science, 21(5), 973-994. Shanafelt et al. Arch Intern Med. 2009: 25;169(10):990-5.

Baard, Deci, Ryan. Journal of Applied Psychology. 2004, 34, 10, pp. 2045-2068 Job. Career. Calling.

20%

Berg, Grant, Johnson Crafting. Organization Science, 21(5), 973-994. Buckingham, M. & Clifton, D.O. (2001). Shanafelt et al. Arch Intern Med. 2009: 25;169(10):990-5.

Danner, Snowdon, Friesen, Wallace. (2001). Positive emotions in early life and longevity: Findings from the Nun Study. Journal of

Personality and Social Psychology, 80(5), 804-813. Journal of personality and social psychology. 80. 804-13

Lee, et al. Optimism is associated with exceptional longevity in two epidemiologic cohorts of men and women.

Nurses’ Health Study + Veterans Affairs Normative Aging Study Proc Natl Acad Sci U S A. 2019 Sep 10; 116(37):

Certain things catch your eye…

Pursue only those that

capture your heart.

Native North American Proverb



Fair & Just


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Esprit de Corps

Peterson, Luthans. "The positive impact of hopeful leaders", Leadership & Organization Development Journal, Vol. 24 Issue: 1, pp.26-31,

https://www.wsj.com/articles/altitude-training-in-london-requires-extra-effort-11556967601 - Alex Richardson: Positive People + 8,200’

Holt-Lunstad (2010) Social Relationships and Mortality. https://doi.org/10.1371/journal.pmed.1000316

Mubanga, et al. Dog Ownership and Survival. Circulation. 2019

Kniffin. Workplace Commensality and Performance of Firefighters. Human Performance, 28:281–306, 2015 West, Dyrbye, Rabatin…Shanafelt. Physician Well-being. JAMA Intern Med. 2014;174(4):527-533.

Commensality

This is the power of gathering:

It inspires us, delightfully, to be more hopeful, more

joyful, more thoughtful: in a word, more alive ~ Alice Waters

Pennebaker. Disclosure and Immune Function. T-cell Blastogenesis. J Clin Psychology. 56 (2) 239

Tuesday…



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Allostatic Load

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwijpcv21ZHfAhURm-AKHefaC2gQjRx6BAgBEAU&url=http://www.wikiwand.com/en/C-reactive_protein&psig=AOvVaw1AgmuhYtwQNPnB3Ifz385k&ust=1544407707225170

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwiippqcpqTeAhXHqIMKHTVOBlkQjRx6BAgBEAU&url=https://en.wikipedia.org/wiki/Tetrahydrocannabinol&psig=AOvVaw2Txwg8RGcwx1qn0jzS1-dJ&ust=1540649865234071

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjqpuCvt4neAhUd3YMKHR6kCUEQjRx6BAgBEAU&url=https://en.wikipedia.org/wiki/File:Cortisol2.svg&psig=AOvVaw0AzjoqwI_fEnA3-2wXu0OT&ust=1539726772637282

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwi648vgt4neAhWNq4MKHWXuDBAQjRx6BAgBEAU&url=https://en.m.wikipedia.org/wiki/File:Oxytocin.png&psig=AOvVaw19IwyhNOB3HMD9kEKNeXkv&ust=1539726869316439

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwi3itP_uIneAhUhw4MKHdZ2AG4QjRx6BAgBEAU&url=https://commons.wikimedia.org/wiki/File:Dopamine.svg&psig=AOvVaw1dNexnLNfELCTNMWX0owil&ust=1539727211437315

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjjpoPWuIneAhVE5YMKHVZJDf0QjRx6BAgBEAU&url=https://en.m.wikipedia.org/wiki/File:Serotonin.svg&psig=AOvVaw1SEMT6ZU1qXqtLuwTXkz1W&ust=1539727123854864

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwj-z7WT0qreAhVn6oMKHY8uBo4QjRx6BAgBEAU&url=https://www.samanthagilbert.com/glutamine-is-this-powerful-nutrient-safe-for-you/&psig=AOvVaw1Qytu8WRiYKLX_MNFZ4Ev7&ust=1540867777134802

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjduqKZz5HeAhWMFXwKHXifCDcQjRx6BAgBEAU&url=https://www.worldofchemicals.com/chemicals/chemical-properties/nitric-oxide.html&psig=AOvVaw3g5wC-dZ04VKdSg4a6AKqS&ust=1540008010058832

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjLvPqL4vTeAhWPyIMKHbovBqcQjRx6BAgBEAU&url=https://en.wikipedia.org/wiki/Melatonin&psig=AOvVaw3WlFzQX8OAhy88bSDCQhxf&ust=1543414643061038

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwinqdip4_TeAhVp5oMKHUqMA6kQjRx6BAgBEAU&url=https://en.wikipedia.org/wiki/Alpha-Neoendorphin&psig=AOvVaw2Emr4_xosLydn7ofHby_Jy&ust=1543414943995437

Swensen, Shanafelt. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace.:Oxford University Press. 2020

Pick One…

McCraty, et al(1998). Integrative Physiological & Behavioral Science, 33(2), 151-170. Epstein, Krasner, Physician resilience: what it means, why it matters, and how to promote it. Acad Med, 2013. 88(3): p. 301-03.

Sleep

Energy

Optimism

Fatigue

Backaches

Headaches

Doyle, (2013). British Medical Journal, 3(1). Hsu, I, et al. (2012) Patient Ed Counseling. 88(3). Cosley, J Experimental Social Psychology 46.5 (2010) 816-823.

Hibbard. Health Affairs, Feb 2013: 32(2): 216. Lyubomirsky. Kindness 2005. Barsade. Companionate Love. Admin Science Quarterly. 5.29.2014

Epstein, Krasner, Physician resilience: what it means, why it matters, and how to promote it. Acad Med, 2013. 88(3): p. 301-03. Sood. Mayo Clinic. The Mayo Clinic Guide to Stress-free Living. First Da Capo Press edition. Da Capo Press/Lifelong Books, 2013.

Slatcher & Pennebaker Journaling 2006

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwisncadzPTdAhXr54MKHZL2CEkQjRx6BAgBEAU&url=https://www.rphfm.org/line-cros-11-eme-dictee-noire/&psig=AOvVaw0xkUcXerqU6w30MdUdRYA3&ust=1539010783782847

Blomkvist: Occup Environ Med 2005;62e1; Psychosomatic Med 67: 2005Ulrich: Science 224: 1984

Hobfoll. Conservation of Resources - Stress. Am Psychol. 1989;44:513

Sánchez-Villegas. Mediterranean dietary pattern and depression: the PREDIMED randomized

trial. BMC Medicine201311:208.20 September 2013

Fidler MacCarty Swensen, et al. Feasibility of Using a Walking Workstation During CT Image Interpretation. JACR. 2008;5(11):1130-1136 Laskowski, Walking Keeps Depression (and a Host of Other Health Problems) Away. Mayo Clin Proc. August 2016; 91(8): 981-983

Shanafelt, Sinsky, Dyrbye, West. Mayo Clin Proc. 2016;91(11):1667-8. ( hours BO)

More than half of Americans did not use all of their vacation .http://www.projecttimeoff.com/research/state-american-vacation-2016

http://www.projecttimeoff.com/research/state-american-vacation-2016







Sood, Amit,, and Mayo Clinic. The Mayo Clinic Guide to Stress-free Living. First Da Capo Press edition. Da Capo Press/Lifelong Books, 2013.

Tuesday…



Fair & Just


Safe Havens

Esprit de Corps

©2011 MFMER | 3085330-116

©2011 MFMER | 3085330-117 Swensen, Shanafelt. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace. Oxford University Press.

2019

Hans Christian Anderson

Just living is not enough said the butterfly

one must have sunshine freedom

and a little flower.



Fair & Just


Safe Havens

Esprit de Corps

https://www.stephenswensen.com/

mailto:[email protected]

https://www.stephenswensen.com/

mailto:[email protected]

Swensen, Shanafelt. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace. Rochester (MN): Mayo Clinic

Scientific Press and New York: Oxford University Press. 2019

Potential Competing Interests: Dr. Swensen is the author of Mayo Clinic Strategies to

Reduce Burnout: 12 Actions to Create the Ideal

Workplace (Oxford University Press). 100% of author

royalties are donated to charity.

As an expert on the topic of the well-being of health

care professionals, Dr. Swensen often presents grand

rounds/keynote lecture presentations and workshops.

He also advises health care organizations on health

care professional leadership and well-being. He

receives honoraria for some of these activities.

[email protected] https://www.stephenswensen.com/

References Swensen, Shanafelt. Organizational Framework to Bring Back Joy in Practice. The Joint Commission Journal on Quality and Patient Safety 2017

Sinsky, C.A., et al., In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices. The Annals of Family Medicine, 2013. 11(3): p. 272-278.

Swensen, S., A. Kabcenell, and T. Shanafelt, Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. Journal of healthcare management / American College of Healthcare Executives, 2016. 61(2): p. 105-127.

Johnson, J.V., et al., Long-term psychosocial work environment and cardiovascular mortality among Swedish men. American Journal of Public Health, 1996. 86(3): p. 324-331.

Baard, P.P., E.L. Deci, and R.M. Ryan, Intrinsic Need Satisfaction: A Motivational Basis of Performance and Weil‐Being in Two Work Settings1. Journal of applied social psychology, 2004. 34(10): p. 2045-2068.

Swensen, S., et al., Leadership by design: intentional organization development of physician leaders. Journal of Management Development, 2016. 35(4): p. 549-570.

Thirioux, B., F. Birault, and N. Jaafari, Empathy Is a Protective Factor of Burnout in Physicians: New Neuro-Phenomenological Hypotheses Regarding Empathy and Sympathy in Care Relationship. Front Psychol. 2016;7:763. doi:10.3389/fpsyg.2016.00763.

Swensen, Stephen & Meyer, Gregg & Nelson, Eugene & C Hunt, Gordon & B Pryor, David & Weissberg, Jed & Kaplan, Gary & Daley, Jennifer & R Yates, Gary & R Chassin, Mark & James, Brent & Berwick, Donald. (2010). Cottage Industry to Postindustrial Care - The Revolution in Health Care Delivery. The New England journal of medicine. 362. e12. 10.1056/NEJMp0911199.

Krasner, M.S., et al., Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. Jama, 2009. 302(12): p. 1284-1293.

References Swensen, Shanafelt. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace. Rochester (MN): Mayo Clinic Scientific Press and New York: Oxford University Press. 2019

Taris, Rrelationship between burnout and performance? A critical review of 16 studies. Work & Stress, 2006. 20(4): p. 316-334.

Swensen, S.J., et al., The Mayo Clinic Value Creation System. Am J Med Qual, 2012. 27(1): p. 58-65.

Beckman, H.B., et al., The impact of a program in mindful communication on primary care physicians. Academic medicine : journal of the Association of American Medical Colleges, 2012. 87(6): p. 815-9.

West, C.P., et al., Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med, 2014. 174(4): p. 527-33.

Linzer, M., et al., A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) study. Journal of general internal medicine, 2015. 30(8): p. 1105-1111.

Sinsky, C., et al., Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Annals of Internal Medicine, 2016. 165(11): p. 753-760.

Shultz, C.G. and H.L. Holmstrom, The use of medical scribes in health care settings: a systematic review and future directions. J Am Board Fam Med, 2015. 28(3): p. 371-81.

Wu, A.W., Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. 2000 Mar 18;320(7237):726-7.

Scott, Deploying a system wide second victim rapid response team. Communication of Critical Test Results, 2010.

Swensen. Esprit de Corps & Quality …the case for eradicating burnout. J Healthcare Management. 63(1), 2018

References West, C.P., et al., Association of resident fatigue and distress with perceived medical errors. Jama, 2009. 302(12): p. 1294-1300. 17 | P a g e

Williams, E.S., et al., The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health care management review, 2007. 32(3): p. 203-212.

Swensen, S.J., et al., The business case for health-care quality improvement. J Patient Saf, 2013. 9(1): p. 44-52.

Ruotsalainen, J.H., et al., Preventing occupational stress in healthcare workers. The Cochrane Library, 2015.

Laskowski, E.R. Walking Throughout Your Day Keeps Depression (and a Host of Other Health Problems) Away. in Mayo Clinic Proceedings. 2016. Elsevier.

Epstein, R.M. and M.S. Krasner, Physician resilience: what it means, why it matters, and how to promote it. Acad Med, 2013. 88(3): p. 301-3.

Sood, A., et al., Stress Management and Resiliency Training (SMART) Program among Department of Radiology Faculty: a pilot randomized clinical trial. EXPLORE: The Journal of Science and Healing, 2014. 10(6): p. 358-363.

Panagioti, M., et al., Controlled interventions to reduce burnout in physicians: A systematic review and meta-analysis. JAMA Internal Medicine, 2016.

West, C.P., et al., Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet. 388(10057): p. 2272-2281.

Shanafelt, T.D., et al., Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort. Mayo Clinic Proceedings. 91(4): p. 422-431.

Personal Goals

•Leading Self:

•I commit to ________ for myself.

•Leading Team:

•I commit to ________ for my team.

•Leading Organization:

•I commit to ________ for my organization.

Swensen, Shanafelt. Mayo Clinic Strategies to Reduce

Burnout: 12 Actions to Create the Ideal Workplace. Rochester (MN): Mayo Clinic Scientific Press and New York:

Oxford University Press. 2019


SafetyLeaders.org


Sanjiv Chopra, M.B.B.S, M.A.C.P Best Selling Author


SafetyLeaders.org


Sanjiv Chopra, MD, M.A.C.P

Professor of Medicine

Harvard Medical School

Editor in Chief Hepatology Up To Date

Marshall Wolf Master Clinician Educator

Brigham and Women’s Hospital

Boston, MA

135 © 2020 TMIT

National Survey Questions


Burn Out – Detailed Program

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative

to Neutral

4


Burn Out – Detailed Program

135

136 © 2020 TMIT

National Survey Questions

I would like a WEBINAR on

CORONAVIRUS CARE and SAFETY as Part of this Series

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative

to Neutral

4

The topics I wish to have covered in WEBINAR on

CORONAVIRUS CARE and SAFETY in this series

136

137

Emerging Threats






Founder Med Tac Bystander Rescue Care

Med Tac Bystander Rescue Care March 18, 2020 CareUniversity Webinar #134

Protecting our Seniors


Care of the At Risk & Seniors at Home Coronavirus Response



Care of the At Risk & Seniors at Home Coronavirus Response


Supplies Checklist:

Prescription Medications On Hand: Have at least 90 days of prescription medications on hand. If insurance will allow it, get a 120-day supply. If not, keep track of when they can renew them and then have them filled so they have them on hand.

Over the Counter Medications: Make sure they have over the counter medications for headache, colds, and other ailments they may have not needing prescriptions.

Thermometers: Every home should have a thermometer on hand to so that inhabitants can monitor their temperature whether healthy or sick. Many will get colds or the flu and may be frightened they may have Coronavirus.

Food and Bottled Water: It is important to have food on hand that will not spoil. If power goes out as it can in ordinary circumstances, it may take longer to repair if service personnel are sick. Food that does not require refrigeration or to be stored in freezers needs to be on-hand.

Flashlights and Batteries: (better than candles for reasons of risk) and batteries incase power goes out.

Cleaning and Disinfectant Supplies: Soap and water is very effective to kill the virus because it dissolves fats and the virus has a fat layer. Liquid Soap and water is even better than alcohol disinfectants for both hands and for contact surfaces for killing the Coronavirus. • If alcohol and soap runs out, bleach may be diluted to 1:10 Bleach to Water concentration for

contaminated clothing. • Dilution of 1:50 Bleach to Water concentration fordisinfecting contact surfaces. • Dilution of 1:100 Bleach to Water for skin cleaning. • Having plenty of liquid soap, buckets, and rags are important if caring for someone at home.

Paper towels may be in short supply – rags and towels cleaned in washing machines are safe. Kitchen Rubber Gloves: Two to three pairs of rubber gloves will be good to have on hand if one

has to take care of someone in the home. They should be used for disinfecting the surfaces. Some surfaces will sustain the virus for a few hours. Some, however, can sustain the virus for three to nine days. The virus lasts longer on-porous surfaces like door handles

Full Tank of Gas: If the supply chain is disrupted by illnesses of those transporting or operating gas stations, you may have a hard time getting fuel. We need to be as prepared as we would with a storm or during any natural disaster or emergency.

Reading Materials & Recordings: In the extreme case cable systems and internet providers may go down and seniors should have access to reading materials and recordings to inspire them and maintain hope. Our faith-based communities can provide tremendous support of them here.

Process Checklist: In Case of Emergency - ICE Contact List: Phone numbers and email addresses of friends and

family members who know they are going to be called if an individual experiences an emergency should be on an accessible list. The In Case of Emergency phone numbers should be generated. It should include those who have a Power of Attorney for healthcare and for business issues.

All Caregivers Contact Information: A master list of the doctors, nurse practitioners, pharmacists, and caregiver's office phone numbers, emergency numbers, and addresses should be on an easy to read list.

Local Support Individuals: Names and mobile numbers of friends and family who can pick up supplies for them, transport them, care for them, and check on them.

“If I Get Sick Plan”: A plan of “what if I get sick” directions. For instance – what signs and symptoms should prompt them to call for help. A certain temperature or other developments to drive action.

Hospital of Choice: If an individual has been under the care of a hospital, their medical records are very important to future care. They may identify that hospital or a hospital as a first choice for care.

Medical Power of Attorney: Everyone over the age of 18 will need to execute a medical power of attorney if they are to allow another person to make decisions regarding care if the victim is unable to do so. For instance, college students going to school in another state who are in another state get sick, parents will need one to get medical records.

Regular Expenses & Payment Mechanism: Create a list of regular bills and how to pay them if a person is in the hospital and unable to take care of them.

Regular Home Chores: A list of tasks that must be undertaken if residents become ill and are taken to the hospital should be created. They might include watering indoor and outdoor plants, pet care, and pet care.

Daily Check In Calls: Seniors and those with underlying conditions such as heart, lung, or kidney disease as well as those with immune compromised conditions such as chemotherapy and transplant patients should have someone check in on them if they are alone.

Food Replenishment Process: A process for regular replenishment of food and supplies should be set up.

Meals on Wheels & Support Programs: If seniors and those who qualify can be added to such programs, they should consider such support.

Sick Care Room: A room or section of the home should be identified where a family member can be treated in case, they become ill. This is whether they get the Coronavirus, a cold, or the flu.


SafetyLeaders.org

Speakers and Reactors

Dr. Stephen Swensen Dr. Charles Denham Dr. Alicia Kowalski Dr. Sanjiv Chopra Mary Foley, PhD, RN


SafetyLeaders.org

Voice of Patient and Family

Mary E. Foley, PhD, RN, FAAN

Clinical Professor, UCSF School of Nursing

Director, Center for Nursing Research and Innovation

Assistant Director for the Master’s Entry Program in Nursing

University of California, San Francisco (UCSF)

San Francisco, CA


April 16, 2020


SafetyLeaders.org

ADDITIONAL

RESOURCES


Can We Still Have Fun Through the Curve? Coronavirus Response


Social Distance Means Distance

and No Mutual Contact Surfaces

Documents

Burnout and Crises: Joy in the Face of Chaos · Med Tac Bystander Rescue Care Bystander Rescue Care CareUniversity Series For resource downloads go to: Coronavirus: Preparing a Home