Why It Matters
“Please don’t talk to me about joy in work.”
The plea came from a health system senior leader at last December’s IHI Forum. He told me about the acute financial distress his system was experiencing. At a time when so many of his discussions were about budget cutting and how to make ends meet, he made clear that the notion of joy in work felt painfully out of touch.
I can understand this sentiment. Leading an organization at any time is not easy, and the last three years have come with so many challenges:
- Dealing with COVID and other infectious diseases
- Staffing issues
- Rising costs
- Supply problems
- Patient and workforce safety concerns
- Racism
- Gun violence
- The impact of climate change on health
The list goes on. Facing any one of these issues would be difficult. Taking them on simultaneously can take a toll.
Candidly, discussions of joy in work years ago used to make me similarly uneasy. Talking about joy initially felt hollow in the face of so many serious problems in health care. I have come to see joy in work differently, however.
The health care workforce is tired, out of steam, and out of breath — and this, of course, makes it hard to focus on anything other than getting through the day. But these circumstances are precisely why attending to joy and workforce well-being is absolutely essential in this moment.
Far from being out of touch, leaders who work to reconnect the health care workforce to a sense of purpose and restore the meaning behind what we do and how we do it are facing some of health care’s biggest challenges head on. Health care leaders have to understand that their choice is not between addressing all the pressures on the system or supporting the workforce. To improve our whole system and get out of this morass we find ourselves in today, leaders have to first support those who devote their lives to health care.
The System Is Not Working for Anyone
Clinicians often feel that leadership creates conditions that do not allow them to practice the way they were trained to do. But leadership often feels its hands are tied. Who is supporting the health care leaders, many of whom have also dedicated their entire careers to health care? Increasingly, we are starting to recognize that health care leaders are also tired, frustrated, and experiencing burnout. We are seeing a massive number of retirements and early retirements among CEOs, chief operating officers, chief nurses, and chief medical officers in the US.
I believe this is happening because the leaders of our systems are also not having the kind of success and joy in work that they might have experienced in the past. Patients are unhappy, clinicians are unhappy, and administrators are unhappy.
Opportunities for Change
Although I understand that this sounds depressing, I also see opportunities for radical change in these circumstances as new alliances could take shape.
Examples are all around us if we look:
- Teams are co-producing better care with patients and partnering with others in their communities to address tough societal issues we know are intertwined with health, including homelessness and racism.
- Organizations are learning how to address social determinants of health that are having the biggest impact on their patients’ lives.
- Teams are even enhancing joy in work while cutting costs.
According to a recent survey conducted by the American College of Healthcare Executives, workforce challenges ranked first on the list of top concerns for hospital CEOs. We all agree that the system is not working for anyone. We should use this alignment between administrators, clinicians, and patients to create something wholly new. We should develop something that fulfills our oaths as healers and clinicians, but also fulfills our oaths as administrators to create conditions that allow the healers to heal and the patients to thrive.
Editor’s note: Look for more each month from IHI President and CEO Kedar Mate, MD, (@KedarMate) on improvement science, social justice, leadership, and improving health and health care worldwide.
You may also be interested in: