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Department Spotlight: A ‘Well-Being Buffet’ of Resources

Duke Center for Healthcare Safety and Quality provides tools and strategies to build resilience and joy

Left to right: Duke Center for Healthcare Safety and Quality employees Cindy Gordon, Christen Noratel, Carrie Adair, Kyle Rehder, Erin Eckert, Jon Bae, Matthew Ryan, Julie Ferrell and Aaron West attend the 2019 Duke Health Quality and Safety Conference.
Left to right: Duke Center for Healthcare Safety and Quality employees Cindy Gordon, Christen Noratel, Carrie Adair, Kyle Rehder, Erin Eckert, Jon Bae, Matthew Ryan, Julie Ferrell and Aaron West attend the 2019 Duke Health Quality and Safety Conference.

Department: Duke Center for Healthcare Safety and Quality

Number of employees: 16

History: The Duke Patient Safety Center launched in 2008 when J. Bryan Sexton joined Duke to direct the center as an associate professor in Psychiatry and Behavioral Sciences. 

The center’s purpose is to support Duke Health by developing quality improvement, safety, professionalism and teamwork strategies. The center aims to improve the healthcare experience of patients, their families and employees by taking a preemptive approach to address healthcare worker burnout. Many of these strategies and resources will benefit anyone working at Duke during these trying times.

Sexton, who researched patient safety and quality while working at Johns Hopkins University, said that by establishing a program to improve teamwork, safety practices and workplace culture, Duke better positioned itself to support patients and providers during COVID-19.    

J. Bryan Sexton talks with guests at the Center for Healthcare Safety and Quality' Well-Being Ambassador Forum in 2019.“At the time, there weren’t many people or organizations focusing on burnout,” Sexton said. “If you want to launch quality improvement in a work setting where everybody is burned out, then you’re on a fool’s errand. Duke leadership agreed that we needed to put energy and effort into assessing and addressing burnout.” 

Originally called the Patient Safety Center, the center’s name changed to the Duke Center for Healthcare Safety and Quality in 2018 to reflect the growth of work on resiliency, well-being and supporting healthcare quality improvement.  

What the center does: Staff and faculty with the Center for Healthcare Safety and Quality teach and support the connections between culture, quality improvement, patient safety and well-being.

Researchers at the center have published nearly 160 articles arguing that caring for ourselves and effective interprofessional interactions improve the overall quality and safety of care. The research provides the evidence for  the center’s work supporting quality improvement strategies for Duke Health and other organizations. 

Staff lead webinars and in-person courses on resilience, burnout, professionalism in the workplace, patient safety, well-being, teaching evidence-based practice, and interprofessional teamwork for healthcare workers from around the world. They host the annual Duke Health Quality and Safety Conference, which brings healthcare workers together to learn about progress in safety and quality improvement.

When the conference started 15 years ago, Dr. Jon Bae said about 20 people attended. At last year’s conference, 700 people attended. 

“Duke has been ahead of the game in addressing workplace safety and culture,” said Bae, associate chief medical officer for Patient Safety & Clinical Quality and mental and emotional well-being co-convener for Healthy Duke

The Duke Health Quality and Safety Conference is part of the center’s work with the Duke Patient Safety and Clinical Quality Office. Together, the two offices run safety leadership courses, workshops on teaching evidence-based practice and the Patient and Family Advisory Councils, a group of trained volunteers and staff who work together to provide input on issues that affect care and the patient experience. 

About 700 people attended the 2019 Duke Health Quality and Safety Conference.With COVID-19, the Center for Healthcare Safety and Quality continues to provide training and resources for healthcare workers. Erin Eckert, education coordinator for the center, is teaching a free webinar in May on high-performance teamwork during disasters and emergency incidents for about 1,000 people in conjunction with the American Hospital Association’s Team Training Program. 

“The more we can support workers improving communication and mindfulness, the better health care people can provide,” Eckert said.

Christen Noratel, program coordinator at the center, organizes monthly webinar series that focuses on well-being and safety topics. Upcoming topics in May and June focus on strategies for getting better sleep and providing support to others. 

“There’s a need right now for healthcare workers to be supported with quick and effective well-being and resiliency tools,” Noratel said. “If you can’t take care of yourself, how are you going to take care of others?”  

What they can do for you:  The Center for Healthcare Safety and Quality’s website has a list of resources, including teamwork and well-being toolkits for everyone, to work better with others, prevent burnout, enhance positivity and bring joy into your day.

Among the resources are 17 resilience tools, which each take between 2 to 20 minutes to complete. Activity topics include “3 Good Things,” an exercise in which you write down three good things that happened during your day and your role in the outcome. There’s also happiness strategies and short videos about the fundamentals of teamwork

“Everyone experiences stress. Everyone can struggle with work-life balance. Regardless of your current role or stress level, there is value in using these tools,” said Sexton, the center’s director. “We have created a well-being buffet. See what looks appetizing.”

Since the COVID-19 outbreak, Sexton has started a new video series on the center’s YouTube page. In clips under four minutes, he explains how brief practices of gratitude mitigate stress and provides tips for coping under pressure. 

“With all our tools, we imagine trying to convince a busy nurse an in an emergency department to complete the activities,” Sexton said. “Everything we’re providing is stripped down the most helpful pieces."

Significant achievement: Sexton is proud of his team’s preparedness and response to COVID-19. 

Duke Center for Healthcare Safety and Quality employees meet over Zoom while working from home in April.Staff took on additional work to support COVID responders.  They create a new webpage to curate discounts and other promotions for healthcare workers, organize meal donations from local restaurants and community members to Duke Health employees (over 10,000 to date and growing) and worked with Duke Health System Human Resources, Duke Personal Assistance Service, Duke Palliative Care, Chaplain Services, Healthy Duke and Social Work Services to organize emotional support resources for employees.

“We never thought something like COVID-19 could happen,” Sexton said. “But, it became apparent to us quickly that we were ready."

Overall web traffic to the Center for Healthcare Safety and Quality’s website has increased by 800 percent in the last 30 days. The webpage of discounts for healthcare workers has received 17,000 views in 30 days. 

Well-being tip: Sexton recommends the “Three Good Things” exercise.  

Write down three things that went well at the end of each day for 2 weeks. This significantly improves your well-being, according to research published in 2019 by Sexton and Dr. Carrie Adair, assistant director of the Center for Healthcare Safety and Quality. 

“It makes all the difference in the world,” Sexton said. “We’ve seen that depression goes down, happiness goes up and sleep improves in people who practice reflecting on what went well at the end of the day.” 

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