Joy-in-Work & Postgraduate Medical Education:

The Problem:
Physician burnout has serious and pervasive consequences on physicians’ health, patient safety, and quality of care. Residents experience burnout more intensely due to lack of autonomy and self-efficacy and, sometimes, exposure to mistreatment. Residents form a unique group as learners and future healthcare providers but also as frontline workers in healthcare. Organization-led interventions mostly focus on building individual resilience and mindfulness without addressing system-level issues. 

Our Approach:
By sharing our experience, we will outline the process of adapting Joy-in-Work framework successfully into a residency training program. Joy-in-Work, a quality improvement framework developed by the Institute for Healthcare Improvement (IHI), aims to decrease burnout and improve psychological safety by shifting the paradigm to address broader system-level concerns. Engaging residents as essential stakeholders in leading and implementing change: by providing them with an opportunity to identify system problems that are meaningful to them, residents become empowered and ultimately regain a sense of autonomy and agency. Furthermore, the team-based engagement process provide opportunity for  residents to engage in quality improvement initiatives, an important area of competency in residency programs. 

Instructional Methods:
This session will be highly interactive and will present the definition, key drivers, and consequences of burnout. The session will discuss the 4 steps of the Joy-in-Work framework and the crucial role leaders play in engaging stakeholders and establishing psychological safety. Through small group discussions and role play using breakout rooms, participants will practice leading “what matters to you?” conversations and will identify impediments to Joy-in-Work in their programs. This session will demonstrate the utilization of quality improvement tools including Ishikawa diagram, driver diagram, and the plan-do-study-act (PDSA) cycle and participants will apply the knowledge through small group discussions. By attending the session, participants will be able to describe the key drivers of burnout; outline the four steps of Joy-in-Work Framework; practice leadership skills that promote psychological safety; and utilize QI tools to implement and measure change.