Joy in the Workplace: The Mayo Clinic Experience

Abstract

The COVID-19 pandemic has changed dynamics in the healthcare setting, through social distancing guidelines and new protocols to promote safety for employees and patients. Although some find themselves more productive in this spread out or virtual environment, the social aspect of the work day has dramatically changed. Staying connected during the day or week comes with additional efforts to seek out opportunities to network and collaborate with colleagues with this work environment shift. Healthcare workers are already at high risk of occupational burnout. In addition, the COVID-19 pandemic has brought additional stressors to individuals outside of their workload compromising a balanced work–life integration. Consequently, personal well-being may become jeopardized due to physical, mental, and social constraints brought on by the pandemic. Mayo Clinic has implemented a joy in the workplace structure to support individual well-being and create space for healthcare workers to be energized in order to put the needs of the patient first and deliver excellent care. Joy at Mayo Clinic contributes to joy in the workplace, reduced burnout, and personal well-being.

All employees at Mayo Clinic have the opportunity to become well-being champions

The COVID-19 pandemic has contributed to increased stressors in the workplace for individuals in healthcare, due to demands of changing job roles and the need for rapid adaptability during a time of so much uncertainty. As individuals cope with the physical, mental, and social burdens of the COVID-19 pandemic, a personal sense of well-being for those in a healthcare role may become jeopardized. Healthcare workers are familiar with emotional turmoil that is often experienced by those in the field in order to meet the needs of patients, yet this pandemic has exacerbated these already existing issues in a way it never has before. The risk for psychological distress is concerning given the high prevalence of burnout among healthcare workers in the pre-pandemic era.^1,2

Positive experiences and emotions contribute to the upward spiral of personal growth and development, coping strategies, and overall well-being. ³ Research in positive psychology has studied how positive emotions, such as joy, cultivate thriving individuals and communities. ⁴ Individuals experiencing positive emotions are equipped with resources promoting continual growth toward success. For example, infusing joy in the workplace can drive staff performance and success through fostering teamwork and meaningful work environments.^5,6 Positive emotions are also associated with lower rates of turnover and burnout. ⁴ Additionally, individuals with higher levels of self-reported well-being have stronger social relationships including community involvement, friendship and social support, and marriage or partnership. ⁴ Reinforcing a cycle of healthy lifestyle and positive emotions both at home and in the workplace is foundational to promoting well-being and mitigating burnout.

Joy at Mayo Clinic, an enterprise initiative, strives to cultivate joy and well-being in the workplace. This is a discussion of the unique initiative, Joy at Mayo Clinic, and employee wellness benefits supporting joy in the workplace, reducing burnout, and personal well-being among healthcare workers.

Joy at Mayo Clinic

Optimal healthcare performance is evolving from the “Triple Aim,” as outlined by the Institute for Healthcare Improvement, to the “Quadruple Aim” to incorporate healthy work environments. ⁷ Previous studies have demonstrated that joy in the workplace contributes to decreased burnout and a greater sense of job satisfaction.^1,7,8 Consequently, joy in work can contribute to improved patient outcomes as well as patient trust and satisfaction in the healthcare system. As patients continue to enter back in the clinical setting for primary care and specialty needs due to delayed care during the pandemic or other competing health needs, holding high standards of care is necessary. However, having systems in place to support staff to achieve this ongoing high quality level of care in parallel with joy in work is vital. ⁵

Healthcare organizations would benefit from sustainable joyful experiences in the workplace. ⁵ Mayo Clinic has developed an enterprise initiative, called Joy at Mayo Clinic, to infuse joy into the workplace as a priority and strive to eliminate barriers to achieve this as a part of the 2030 strategic plan. In order to engage employees in the process of creating intentional joy in the workplace, the Mayo Clinic Joy Council awards funds for innovative projects cultivating joy. Impact of the project or intervention is measured at 6 and 12 months through recommended surveys including measurements of professional burnout, the Well-Being Index (WBI), or metrics available through the All Staff Survey (practice efficiency, resources, autonomy, work–life balance, control/flexibility, organizational leadership, fairness, meaning in work, and productivity/retention). Themes identified to increase joy include the following: meaning and purpose, recognition and rewards, camaraderie and teamwork, autonomy and control, and resiliency and well-being. Joy at Mayo Clinic maintains a website on the employee intranet to share stories of these themes resonating across the enterprise.

Workplace wellness champions may also contribute to increasing employee awareness of wellness and a higher rating of individual perceived health and wellness. ⁹ All employees at Mayo Clinic have the opportunity to become well-being champions. These individuals promote awareness of health and well-being to their colleagues as a part of the Well-Being Champion Program. The Well-Being Champion Program provides resources to share across the enterprise including a variety of health topics from recipes to participating in laugher yoga. Well-being champions meet regularly to share these common experiences together and continue to develop unique ways to promote wellness in the workplace. We can mitigate the risk of burnout and protect health care worker well-being by helping ourselves and others.

Burnout in the Workplace

Burnout is a syndrome characterized by emotional exhaustion, cynicism related to work, and reduced personal efficacy. ¹⁰ The National Academies of Medicine, Science, and Engineering report has summarized burnout among US nurses ranging from 35% to 45% and US physicians 40% to 54%.^1,11 Studies have also reported occupational burnout as a risk among nurse practitioners, physician assistants, and other healthcare workers as well as medical students and trainees.^12-14 The rate of physician burnout has been reported to be higher than the general US working population and also may vary by medical specialty.^15,16 Burnout is concerning given the personal and professional consequences that have been associated including cardiovascular risks, shorter overall survival, and higher rates of depression and suicidal ideation. Individuals with burnout suffer from job dissatisfaction, turnover, and absenteeism, which increases the cost for healthcare employers.

Applying a pragmatic approach using lifestyle medicine strategies can help in preventing and reducing burnout. ¹⁷ The 6 pillars of lifestyle medicine include stress management, increased physical activity, healthy diet, sleep, social relationships, and avoidance of risky substances. These lifestyle interventions address healthy habits that can buffer against burnout. ¹⁷ Helping patients achieve desirable health outcomes consequently builds provider satisfaction and purpose within the workplace.

In addition to providing wellness services for patient care, Mayo Clinic has also implemented various employee well-being programs throughout the institution. Employee benefits include access to these wellness resources through the Dan Abraham Healthy Living Center (DAHLC) in Rochester, Minnesota. Healthy lifestyle experiences, such as health coaching, physical activity, mindfulness and meditation, massage therapy, nutrition, and resiliency skills, are some of the resources available. For Mayo Clinic employees experiencing emotional distress, the Employee Assistance Program (EAP) is available for confidential and professional short-term counseling at no cost. System level solutions to address burnout are needed more than ever as healthcare workers continue to experience psychological distress at an amplified level during the COVID-19 pandemic. ¹⁸ Organizational change can benefit by incorporating lifestyle intervention strategies in the workplace.

Well-Being

Well-being addresses positive characteristics of an individual’s life encompassing the following 3 dimensions: physical, mental, and social. ¹⁹ A personal sense of accomplishment contributes to well-being, but when absent has been reported to be a predictor of burnout among healthcare workers.^20-22 In addition, a study of nurses found an association of self-reported unprofessional behaviors increasing the risk for burnout. ²³ Understanding personal and professional distress experienced among healthcare workers may explain gaps between achieving a sense of well-being and mitigating the risk of burnout.

The National Academy of Sciences, Engineering, and Medicine previously reported that individuals are energized when they find satisfaction and meaning in their work. ¹ Finding joy in the workplace may be one approach in reclaiming well-being. Cultivating an environment of community within the workplace through peer support has been reported to contribute to physician well-being. ²⁴ However, constraints on healthcare workers through system demands including time spent on documentation and the endlessly growing productivity demands have dissolved the space for this culture of community to flourish. Many providers are left to complete these clerical tasks outside of their scheduled work hours, compromising work–life integration. It has been reported that physicians spend, on average, over 8 hours on administrative tasks. ²⁵ Excessive time spent on clerical work has been correlated to burnout and lower career satisfaction.^25,26 A study of 976 advance practice nurses (APNs) reported greater work hours to be associated with higher burnout and lower reported satisfaction of work–life integration. ¹²

Work–life integration has also been addressed as a component of organizational strategies to improve burnout and contribute to individual well-being. Physicians experiencing burnout, who are at an increased risk for burnout relative to other US workers, report less satisfaction with work–life integration.^16,24 A study of 8638 nurses reported that nurses have similar risk of burnout compared to other US workers but experience greater dissatisfaction with work–life integration. ²⁰ Promoting a comprehensive approach to infusing positive psychology interventions both at home and in the workplace can contribute to well-being.

The COVID-19 pandemic has exponentially grown the delivery of healthcare through virtual systems, which has contributed to dramatic change for the social and collaborating aspect of the work day. The virtual healthcare delivery system has created a silo for healthcare workers as these types of visits need dedicated private spaces to maintain patient privacy. Healthcare providers working in virtual care may lose collaboration with their colleagues remaining isolated in this type of work setting. Staying connected during the day or week comes with additional efforts to seek out opportunities to network and collaborate with colleagues with this work environment shift.

Additionally, organizations should provide resources to promote healthcare workers’ well-being and self-care. It has been reported that resources should address work–life integration, an exercise or fitness component, sleep hygiene, dietary measures, financial health, relationship health, personal hobbies, and preventative medicine. ²⁴ The COVID-19 pandemic has complicated these offerings for healthcare organizations and employees. For example, the primary Mayo Clinic employee exercise facility, located at the DAHLC, had been shut down for greater than 12 months during the pandemic. As an employee benefit, Mayo Clinic employees, volunteers, retirees, and spouses are eligible to belong to this facility and encourage utilization by incentivized membership discounts based upon frequency of use. Some offerings, such as personal training and group fitness classes, were modified into a virtual model to accommodate fitness needs during the pandemic.

In addition to cost, another barrier to consuming healthy food may be convenience within the healthcare setting. Although the cooking courses, often held over the lunch hour, were suspended, the DAHLC cafeteria remained open to sell healthy, affordable food options. Organizational policy could expand by offering these meals in all institution cafeterias, covering all shift workers, in order to promote nutrition as a method to reduce and prevent burnout among healthcare workers. ²⁷

Conclusion

Healthcare systems should be aware of the high records of occupational burnout. As the COVID-19 pandemic has brought additional stressors to individuals outside of their workload, personal well-being may be compromised due to underlying or new physical, mental, and social constraints. Organizations should implement programs to promote joy in work. This supports well-being and creates space for healthcare workers to be energized in order to put the needs of the patient first while delivering excellent care. Additional research would benefit healthcare organizations and policy surrounding workplace well-being programs. System methods for creating joy in the workplace may reduce burnout and contribute to personal well-being among healthcare workers.