Children’s hospitals don’t need new statistics on workforce shortages and health care staff burnout—it has become the top priority across the country for nearly every hospital, as well as for Children’s Hospital Association, which represents them.
To help hospitals and health systems restore and empower the strained workforce, the Institute for Healthcare Improvement (IHI) designed and tested a practical framework for improving joy in work. Informed by experts and organizations both in and outside of health care, the Joy in Work Framework outlines nine critical components of a system for ensuring a joyful, engaged workforce and the steps leaders and teams can take to get there.
As IHI engaged with partners in thinking about how to restore, foster, and nurture joy in the health care workforce, it became evident that leaders have a difficult time finding a way to begin the work effectively. So IHI created four steps to help leaders get started. Whether children’s hospitals are using this framework or simply looking for changes to improve the workplace, these four steps will help inform initiatives that engage and value employees.
1. Ask staff, “What matters to you?”
Discovering what matters relies heavily on trusting relationships and assumes that leaders know how to listen. Teams have found success with using communication boards, surveys, regular staff meetings or more informal meetings to engage, inform and listen. Some conversation questions may include:
- What makes for a good day for you?
- What makes you proud to work here?
- When we are at our best, what does that look like?
These conversations are all about listening and learning. Leaders don’t need to worry about what kind or how much feedback they will receive—they don’t have to fix everything. These conversations are a starting point to making the work environment and patient care better and communicates “we are in this together.”
2. Identify impediments in the local context
Explicitly asking employees what impediments they face in addition to other real-time data collection and surveys enables leaders to build a comprehensive understanding of what contributes to joy in work in the organization, as well as what doesn’t. Identifying local impediments in daily work—the “pebbles in their shoes”—allows leaders to address the psychological needs of employees. Leaders work with colleagues to identify hindrances, set priorities, and address them together.
3. Commit to shared responsibility
Leaders at all levels of the organization must dedicate time, attention, skill development, and necessary resources to improving joy in work. Although there is a shared responsibility, not everyone does everything. Leaders at the local level—program, department, or clinic—are tasked with guiding the work in their respective areas. These leaders need the time and skills to facilitate the “What matters?” conversations and to act on the concerns that arise. It is also vital to have a constant champion dedicated to the work to ensure momentum and sustainability.
4. Use improvement science to test
Using principles of improvement science, organizations can determine if the changes they test are leading to improvement, are sustainable, and are effective in different programs, departments and clinics. In all cases, the teams set a goal for their work, decide on measures of progress, and select components of the framework in which to test changes. Some principles to achieving this include:
- Make sure the aim is clear and numerical (how much, by when).
- Start small and use data to refine successive tests.
- Make sure the change idea works before getting more people involved or spreading the change.
- Track results of every test, using process measures first and then ultimately outcome measures; share results openly and help team members understand and use the data.
With these four steps, children’s hospitals will be on their way to cultivating joyful, engaged workforce.
For full descriptions of each step and more on Joy in Work, view IHI’s white paper.
