Joy in Work and Leader Rounding: Fostering Relationships and Resolving Workforce Concerns

Abstract

Problem: Healthcare workforce burnout is associated with poor patient, worker, and institutional outcomes, and occurs when job demands exceed the physical, social, or organizational resources needed to care for patients. Leader rounding at an academic medical center revealed recurrent themes of leader concern for workforce well-being and undefined structures to prioritize and resolve workforce concerns. Purpose: The purpose of this quality improvement project was to redesign leader rounding based on the Framework for Improving Joy in Work to balance workforce demands with resources by a) fostering leader-worker relationships during leader rounding and b) revising structures to resolve workforce concerns. Methods: Leaders including the Chief Nursing Officer and Associate Chief Medical Officer attended a virtual Joy in Work course. A conversation guide based on Joy in Work principles was created to foster relationship building during leader rounding and promote existing resources. A leader rounding data collection form was modified based on Joy in Work principles, and an electronic dashboard was created to streamline concern resolution. Results: Over 16 weeks, 22 rounds were completed by three leaders over six inpatient units with 100% rounding form utilization. Of the 66 workforce concerns expressed during leader rounding, 17 (26%) were resolved with organizational changes and 20 (30%) are actively under consideration. The leading concern themes regarded influence in decision-making, and half (n = 33/66) of concerns related to patient safety. Conclusions: A relationship-based approach to leader rounding with a streamlined concern resolution structure resulted in organizational change which addressed the primary workforce concern themes. This unified approach to leader rounding required substantial leader commitment and collaboration. While burnout was not measured, this method both reduced demands and enhanced resources.