Resident-Led Physical Wellness Initiative Linked to Less Burnout for Emergency Physicians during COVID-19 Pandemic

Introduction: The COVID-19 pandemic has taken a significant toll on societal, physical, and psychological health. Emergency physicians (EPs) are susceptible to burnout under ordinary circumstances and may be particularly vulnerable during the pandemic. To reduce pandemic-related burnout, we implemented a residency-led physical wellness initiative and evaluated the effect on burnout among EPs. Methods: In the spring of 2020, we invited all resident and attending EPs in our department to participate in a four-week physical wellness initiative as part of a prospective study. After completing or opting out of this wellness initiative, EPs responded to an online survey comprised of five sections: demographics, participation, opinion on wellness initiative, opinion on the impact of COVID-19, and the Maslach Burnout Index (MBI-HSS). We stratified respondents by initiative participation, described the characteristics of each group, and then compared the perceived impact of COVID-19 and the MBI-HSS results between the two groups. Results: Out of 110 eligible participants, 57 EPs completed the survey (51.8%). Thirty-five respondents completed the wellness initiative. Few (37.1%) documented their progress, though most worked with accountability partners (85.7%). Most enrollees enjoyed participation (Likert Score 3.2-5, CI 2.9-3.5) and would participate again (3.3, CI 3.0-3.6). The reported effect of the COVID-19 pandemic on mental wellbeing was lower for participants, although this was not significant (2.1, CI 1.5-2.1 vs 2.4, CI 2.0-2.7, p=0.312). On the MBI-HSS, participants had a lower emotional exhaustion score (1.4, 95% CI 0.9-1.8) than non-participants (2.2, 95%CI 1.8-2.6, p=0.005).

A Model for Developing Comprehensive Initiatives to Improve the Health of the Worksite: The WorkWell KS Strategic Framework

Background: Worksite wellness programs that target individual employees, rather than worksites, have demonstrated limited long-term success. The purpose of this overview was to describe the theoretical basis for implementing an effective worksite wellness initiative, WorkWell Kansas (WorkWell KS). WorkWell KS is not a traditional worksite wellness initiative, as its goal is to create healthy worksites, rather than target workers. Methods: The WorkWell KS Strategic Framework is based on academic research that identified successful worksite wellness elements that produce sustainably healthy worksites. The curricula were built around the 3-4-80: three modifiable behaviors (tobacco use, poor access to nutritious foods and beverages, and physical inactivity) contribute to at least four chronic diseases (heart disease, type II diabetes, lung disease, and some cancers), which in turn contribute to approximately 80% of the premature deaths in the United States. Findings: To properly address these modifiable behaviors, the WorkWell KS Strategic Framework was developed to guide worksites to first build a solid worksite wellness foundation, which consists of five elements: the wellness committee, exercising leadership, communications, incentives, and data. Once built, worksites are then encouraged to employ a socio-ecological approach to developing a comprehensive, multi-strategy (information, program, benefit design, policy, and environment) intervention, focusing on one health behavior at a time. Conclusions/Application to Practice: The goal of WorkWell KS was to create healthy worksites, which creates environments for employees to practice these healthy behaviors. Worksite wellness committees, occupational health professionals, and others interested in altering health behaviors at worksites have an opportunity to reframe their approach using this framework.