Resilient futures: An individual and system-level approach to improve the well-being and resilience of disadvantaged young Australians.

2018 ◽  
Vol 4 (3) ◽  
pp. 228-244 ◽  
Author(s):  
Ivan J. Raymond ◽  
Matthew Iasiello ◽  
Aaron Jarden ◽  
David Michael Kelly
Keyword(s):  
Well Being ◽  
System Level

scholarly journals Exploring a Culture of Health in the Auto Industry

2021 ◽  
Vol 13 (7) ◽  
pp. 3924
Author(s):  
Wendy M. Purcell ◽  
Brian S. Feldman ◽  
Molly Finn ◽  
John D. Spengler
Keyword(s):  
Auto Industry ◽  
Population Level ◽  
Well Being ◽  
System Level ◽  
Senior Executives ◽  
Negative Impacts ◽  
Health Model ◽  
Business In Society ◽  
Corporate Actions ◽  
Societal Expectations

The Culture of Health framework includes four pillars of societal health and well-being influenced by business, namely: consumers; employees and workers in the supply chain; the community, and the environment. The Auto industry was an ideal crucible in which to explore the interface of public health with business given the confluence of the different domains in this sector. The substantial benefits of mobility, especially for the under-resourced, sit alongside negative impacts from emissions, accidents, products and services. Through interviews with 65 senior executives from seven major automakers, corporate actions reflecting health as a strategic agenda were mapped to the Culture of Health model. While most of the companies did not use the language of health explicitly in their strategy, key examples were present across all four pillars. Given the future of mobility relies on the interface of human experience with technology, it is a population-level challenge demanding system-level changes. Ostensibly, a framework for sustainability, the Culture of Health model could help the Auto industry navigate the disruption caused by the global megatrends and changing societal expectations of business in society and transition successfully to a new mobility economy.

Building community during the COVID-19 pandemic: a system level approach to physician well-being

2021 ◽  
Vol 7 (4) ◽  
pp. 166-170
Author(s):  
Serena Siow ◽  
Carmen Gittens
Keyword(s):  
Emotional Health ◽  
Well Being ◽  
Shared Responsibility ◽  
System Level ◽  
Group Discussions ◽  
Physician Wellness ◽  
Physician Leaders ◽  
Building Community ◽  
Support Team ◽  
Emotional Strain

Before the COVID-19 pandemic, physician burnout was identified as reaching crisis proportions, and the pandemic is expected to worsen the already perilous state of physician wellness. It has affected physicians’ emotional health, not only by increasing workload demands, but also by eroding resilience under increasing pressures. The mental health consequences are expected to persist long after the pandemic subsides. With physician wellness increasingly recognized as a shared responsibility between individual physicians and the health care system, system-level approaches have been identified as important interventions for addressing physician well-being. In this article, we describe two evidence-guided initiatives implemented in our hospitalist network during the current pandemic: a trained peer-support team and facilitated physician online group discussions. These initiatives acknowledge the emotional strain of physicians’ work and challenge the “iron doc” culture of medicine. Our efforts build community and shift culture toward improved physician wellness. We suggest that the pandemic might be an opportunity for our profession to strengthen our support networks and for physician leaders to advance physician wellness in their work environments.

Prevalence and Workplace Drivers of Burnout in Cancer Care Physicians in Ontario, Canada

2021 ◽  
pp. OP.21.00170
Author(s):  
Simron Singh ◽  
Ashley Farrelly ◽  
Catherine Chan ◽  
Brett Nicholls ◽  
Narges Nazeri-Rad ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Gynecologic Oncology ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
System Level ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Questionnaire Response ◽  
Mental Health Patient

PURPOSE: Provider well-being has become the fourth pillar of the quadruple aim for providing quality care. Exacerbated by the global COVID-19 pandemic, provider well-being has become a critical issue for health care systems worldwide. We describe the prevalence and key system-level drivers of burnout in oncologists in Ontario, Canada. METHODS: This is a cross-sectional survey study conducted in November-December 2019 of practicing cancer care physicians (surgical, medical, radiation, gynecologic oncology, and hematology) in Ontario, Canada. Ontario is Canada's largest province (with a population of 14.5 million), and has a single-payer publicly funded cancer system. The primary outcome was burnout experience assessed through the Maslach Burnout Inventory. RESULTS: A total of 418 physicians completed the questionnaire (response rate was 44% among confirmed oncologists). Seventy-three percent (n = 264 of 362) of oncologists had symptoms of burnout (high emotional exhaustion and/or depersonalization scores). Significant drivers of burnout identified in multivariable regression modeling included working in a hectic or chaotic atmosphere (odds ratio [OR] = 15.5; 95% CI, 3.4 to 71.5; P < .001), feeling unappreciated on the job (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), reporting poor or marginal control over workload (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), and not being comfortable talking to peers about workplace stress (OR = 3.0; 95% CI, 1.1 to 7.9; P < .001). Older age (≥ 56 years) was associated with lower odds of burnout (OR = 0.16; 95% CI, 0.1 to 0.4; P < .001). CONCLUSION: Nearly three quarters of participants met predefined standardized criteria for burnout. This number is striking, given the known impact of burnout on provider mental health, patient safety, and quality of care, and suggests Oncologists in Ontario may be a vulnerable group that warrants attention. Health care changes being driven by the COVID-19 pandemic provide an opportunity to rebuild new systems that address drivers of burnout. Creating richer peer-to-peer and leadership engagement opportunities among early- to mid-career individuals may be a worthwhile organizational strategy.

scholarly journals Improving community health networks for people with severe mental illness: a case study investigation

2015 ◽  
Vol 3 (5) ◽  
pp. 1-234 ◽  
Author(s):  
Vanessa Pinfold ◽  
Daryl Sweet ◽  
Ian Porter ◽  
Cath Quinn ◽  
Richard Byng ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Community Health ◽  
Well Being ◽  
Personal Networks ◽  
System Level ◽  
Network Type ◽  
Care System

IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals The interrelation of sleep and mental and physical health is anchored in grey-matter neuroanatomy and under genetic control

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Masoud Tahmasian ◽  
Fateme Samea ◽  
Habibolah Khazaie ◽  
Mojtaba Zarei ◽  
Shahrzad Kharabian Masouleh ◽  
...  
Keyword(s):  
Physical Health ◽  
Large Scale ◽  
Grey Matter ◽  
Well Being ◽  
System Level ◽  
Sleep Habits ◽  
Physical Conditions ◽  
Age Range ◽  
Mental And Physical Health ◽  
Shared Genetic

AbstractHumans need about seven to nine hours of sleep per night. Sleep habits are heritable, associated with brain function and structure, and intrinsically related to well-being, mental, and physical health. However, the biological basis of the interplay of sleep and health is incompletely understood. Here we show, by combining neuroimaging and behavioral genetic approaches in two independent large-scale datasets (HCP (n = 1106), age range: 22–37, eNKI (n = 783), age range: 12–85), that sleep, mental, and physical health have a shared neurobiological basis in grey matter anatomy; and that these relationships are driven by shared genetic factors. Though local associations between sleep and cortical thickness were inconsistent across samples, we identified two robust latent components, highlighting the multivariate interdigitation of sleep, intelligence, BMI, depression, and macroscale cortical structure. Our observations provide a system-level perspective on the interrelation of sleep, mental, and physical conditions, anchored in grey-matter neuroanatomy.

Faculty wellness in academic medicine: Addressing stressors in the workplace

Work ◽  
2021 ◽  
pp. 1-7
Author(s):  
Claudia Finkelstein ◽  
Anne Ordway ◽  
Kurt L. Johnson
Keyword(s):  
Health Care ◽  
Organizational Context ◽  
Well Being ◽  
Professional Autonomy ◽  
Individual Responsibility ◽  
System Level ◽  
Physician Burnout ◽  
Structured Interviews ◽  
Physician Wellness ◽  
Promotion System

BACKGROUND: Burnout is widely regarded as a syndrome resulting from chronic occupational stress. While physician burnout has been the subject of extensive research, physician wellness has been proposed as an alternative framework for understanding physician distress. OBJECTIVE: The purpose of this qualitative study was to understand the organizational context of faculty wellness within an academic health care system. METHODS: Semi-structured interviews were conducted with 24 chairs of clinical and non-clinical departments in a US university school of medicine. RESULTS: Chairs described several system-level factors perceived to interfere with faculty wellness such as a stricter regulatory environment, the loss of professional autonomy, the up or out promotion system, limitless hours, and the rise of shadow work. While all chairs articulated some degree of responsibility for the wellness of their faculty, some said they lacked the skills or knowledge of resources to fully engage in this role. CONCLUSIONS: Findings from this study are consistent with recent research on physician burnout, which has pivoted from describing burnout as an individual responsibility to including the professional, organizational, and societal factors which likely contribute to physician job satisfaction and well-being. As health care organizations, including academic medical centers, move toward systems-based solutions for physician occupational health, it will be incumbent upon organizational leaders to make administrative decisions favoring physician wellness.

scholarly journals Tailoring Healthy Workplace Interventions to Local Healthcare Settings: A Complexity Theory-Informed Workplace of Well-Being Framework

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Sarah L. Brand ◽  
Lora E. Fleming ◽  
Katrina M. Wyatt
Keyword(s):  
Complexity Theory ◽  
Behaviour Change ◽  
Complex Adaptive System ◽  
Scale Up ◽  
Well Being ◽  
System Level ◽  
Workplace Interventions ◽  
Healthcare Settings ◽  
Local Setting ◽  
Healthy Workplace

Many healthy workplace interventions have been developed for healthcare settings to address the consistently low scores of healthcare professionals on assessments of mental and physical well-being. Complex healthcare settings present challenges for the scale-up and spread of successful interventions from one setting to another. Despite general agreement regarding the importance of the local setting in affecting intervention success across different settings, there is no consensus on what it is about a local setting that needs to be taken into account to design healthy workplace interventions appropriate for different local settings. Complexity theory principles were used to understand a workplace as a complex adaptive system and to create a framework of eight domains (system characteristics) that affect the emergence of system-level behaviour. This Workplace of Well-being (WoW) framework is responsive and adaptive to local settings and allows a shared understanding of the enablers and barriers to behaviour change by capturing local information for each of the eight domains. We use the results of applying the WoW framework to one workplace, a UK National Health Service ward, to describe the utility of this approach in informing design of setting-appropriate healthy workplace interventions that create workplaces conducive to healthy behaviour change.

Flourishing in adaptive community: balancing structures and flexibilities

2018 ◽  
Vol 3 (2) ◽  
pp. 123-136 ◽  
Author(s):  
Sabre Cherkowski ◽  
Kelly Hanson ◽  
Keith Walker
Keyword(s):  
School Improvement ◽  
Well Being ◽  
System Level ◽  
Fundamental Aspect ◽  
Research Approach ◽  
Organizational Research ◽  
Content Type ◽  
Research And Practice ◽  
Research Activities

Purpose This paper documents findings from a qualitative research project on flourishing in schools using a positive organizational research approach. The purpose of this paper is to uncover and bring to description educators’ experiences of the conditions, forces and influencing factors for flourishing in their context. The main objectives were to inform research and practice in school improvement from a positive perspective, provide knowledge and practice about noticing and growing well-being for educators and to encourage an attention on individual and collective well-being as an organizational imperative. Design/methodology/approach To gain a rich description of what it means for educators to feel a sense of flourishing in their work, the researchers used qualitative, case study methods and appreciative research activities. For the case study reported on in this paper, data were collected through open-ended, appreciative, focus group conversations and researcher observations in the participants’ classrooms. Conversations were recorded and transcribed. The researchers analyzed the transcripts using an iterative process of coding, categorizing and abstracting data. Findings Participants grew their adaptive communities through balancing structures (collaboration, purpose, administrator support) with flexibilities (synergy, creativity, tinkering, friendships) for adaptation and co-creation. Well-being was connected with feeling collegial support, care, shared meaning and engagement and where positive relationships were central in their work. These relational conditions seemed to contribute to building a social container that promoted flourishing. This led to innovation as teachers worked together in ways that promoted their learning and growth as a group, and increased their sense of vitality in their work. The researchers found that the principal plays a vital role in fostering, encouraging and sustaining conditions for teachers to cultivate adaptive community. Research limitations/implications While small in scale and not generalizable across contexts, this research offers particular examples of what is working well for these teachers. Insights from these examples are intended to be generative, potentially resonating with and inspiring others to examine the possible benefits and potentials that may come from a positive approach to research and practice in school improvement in their own contexts. Engaging in positive organizational research in schools led to new insights on the work of teaching, learning and leading in schools. The researchers suggest that this positive, appreciative and generative perspective offers potentials and benefits for new understandings on school improvement. Practical implications The findings from this case study indicate that more attention is needed to supporting educators to cultivate the conditions necessary to experience rich and meaningful relationships within which they will thrive, grow and innovate in their teaching. At a system level, the authors argue for a re-orientation of schools toward well-being and a more holistic and human-development perspective on schooling. Social implications Currently and internationally, schooling is under re-design as the authors learn more about the need to organize the schools in ways that encourage the kinds of teaching and learning necessary to prepare young people for an increasingly unpredictable future. The findings from this study highlight the importance of attending to teacher well-being as a fundamental aspect of encouraging the kind of teaching needed for the kinds of learning desired in schools across all contexts. Originality/value This case study provides the findings that illustrate the potential and benefits of research on school organizations from a positive organizational perspective. Additionally, this study is a reminder of the systemic nature of all living systems, such as schools, and the associated need to ensure well-being for all members of the learning community.

scholarly journals Seniors’ Campus Continuums: Local Solutions for Broad Spectrum Seniors Care

2020 ◽  
Author(s):  
Frances Margaret Morton-Chang ◽  
Shilpi Majumder ◽  
Whitney Berta
Keyword(s):  
Older Adults ◽  
Social Care ◽  
Well Being ◽  
System Level ◽  
Integrative Model ◽  
Term Care ◽  
Integration Of Care ◽  
Health And Social Care ◽  
Community Supports ◽  
Housing Options

Abstract Background: As demand and desire to “age-in-place” grows within an aging population, challenges exist to realizing this wish. Changing demographics and new areas of need have governments nationally and internationally calling for more focused attention on integrative approaches to health and well-being. Seniors’ Campus Continuums are models of care that seek to broaden access to an array of services and housing options to meet the growing health and social needs of aging populations in their communities . The objective of this study is to increase understanding of this integrative model through the exploration of factors that influence Campus development, functioning, and scope and extent of integration of care for older adults wishing to remain in their own home and community.Methods: This research uses a comparative case study approach across six bounded cases offering four physically co-located components – mixed independent housing options, internal community supports to residents, external community supports to the broader community, and a long-term care home – to explore how Seniors’ Campus Continuums operating in various contexts across Ontario, Canada integrate health, housing and social care for older adults.Results: Seniors’ Campus Continuums come in different shapes, sizes, and geographies however, they share many influencing factors in their evolution, design, function, and ability to integrate a broad range of supports and services for older adults with different and progressive needs. Enabling factors include i. rich historical legacies of helping people in need; ii. organizational vision and readiness to capitalize on key windows of opportunity; iii. leveraging organizational structure and capacity; iv. intentional physical and social design; v. broad services mix, amenities and innovative partnerships. Impeding factors include vi. policy hurdles and rigidities; vii. human resources shortages and inequities; and viii. funding limitations. A number of benefits afforded by campuses at an individual, organizational and system level were observed. Conclusion: Findings from this research provide detailed descriptions of campus continuums from inception to expansion and highlight opportunities to optimize their potential on many levels. At an individual level, campuses increase local access to a coordinated range of care services, supports and housing options that can be tailored to benefit their health and social care needs. At an organizational level, campuses offer enhanced collaboration opportunities across providers and partners to improve consistency and coordination of care, access to shared resources, expertise and infrastructure, improved economies of scale, and rich environments for training/research, education and volunteering. At a system level, they offer potential to address a diversity of health, social, financial, and housing needs to help seniors avoid premature or inappropriate use of higher intensity care settings. This study fills a gap in evidence-based research on this integrative model and offers lessons to consider for future “age-friendly” policy development.

scholarly journals “The Tip of the Iceberg”: Commentary on Sports, Health Inequity, and Trauma Exacerbated by COVID-19

2020 ◽  
Author(s):  
Kemba Ceronne Noel-London ◽  
Crystal Grimsley ◽  
Jessie Porter ◽  
Anthony P. Breitbach
Keyword(s):  
Athletic Training ◽  
Return To Sport ◽  
Health Inequities ◽  
Well Being ◽  
Health Inequity ◽  
System Level ◽  
The Social ◽  
American Health Care ◽  
Systemic Health ◽  
Training Practice

Objective To discuss the relevance of system-level health inequities and their interplay with race in sports and athletic training, particularly during and after the coronavirus disease 2019 (COVID-19) pandemic. Background Health inequity is a systemic and longstanding concern with dire consequences that can have marked effects on the lives of minority patients. As a result of the unequal consequences of the COVID-19 pandemic, the magnitude of the outcomes from health inequity in all spheres of American health care is being brought to the fore. The discourse within athletic training practice and policy must shift to intentionally creating strategies that acknowledge and account for systemic health inequities in order to facilitate an informed, evidence-based, and safe return to sport within the new normal. Conclusions To continue to evolve the profession and solidify athletic trainers' role in public health spaces post–COVID-19, professionals at all levels of athletic training practice and policy must intentionally create strategies that acknowledge and account for not only the social determinants of health but also the effects of racism and childhood trauma on overall health and well-being.

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