Access to Mental Health and PCP Appointments Fatigue Mitigation Psychological Safety Well-Being National Resources The ABCs of Psychological Safety

Well-being 1: Access to Mental Health and PCP Appointments

Disseminate list of PCPs and dentists covered by Banner insurance at intern orientation (level 2)

Tools: Implementation:
  • During orientation or the first month of residency/fellowship, have current trainees in your program share the list.
  • Set a calendar reminder or change the agenda to ensure that this happens as planned.
Create relationship with specific office (Banner FM or IM) to schedule residents with faculty physicians. (level 2)

Tools: Implementation:
  • Send by email to all new trainees in your program in the first month.
  • Include the link for how to let the program know of their scheduled time.
Create a pathway, well known to residents and fellows, that allows immediate time off when needed for personal/immediate family medical and mental health appointments. (Level 2)

Tools: Implementation:
  • Have a process for reminding residents and faculty of this process quarterly with different voices.
  • Set a calendar reminder or change the agenda to ensure that this happens as planned.

Well-being 2: Fatigue Mitigation

Training to recognize the signs of fatigue and sleep deprivation, alertness management & fatigue mitigation processes (level 2)

Tools: Implementation:
  • Invite faculty from sleep medicine to present on shift work disorder during didactics.
  • Distribute fatigue mitigation tip sheet and duty hour logging FAQ at key times:
    • The start of training
    • As a reminder when questions arise about duty hours including if a resident/fellow logged something incorrectly.
    • The start of rotations with the most hours and those with night rotations
Create a written procedure to highlight resources and processes for getting assistance when maximally fatigued (level 2)

Tools: Implementation:
  • Have a process for reminding residents and faculty of this process at the start of every rotation with high duty hours.
  • Add this as a card in their U of A College of Medicine – Phoenix "sleeping bag."

Well-being 3: Psychological Safety

Program Leadership Approachability

Tools: Implementation:
  • Plan CHIM events or other social times for program leaders to get to know trainee's and express interest in their lives and unique backgrounds.
  • Talk to another PD when you get difficult feedback to brainstorm, share ideas, and get support.
Forums for Residents/Fellows to share ideas and where the program can welcome challenging feedback and demonstrate the actions being taken based on it

Tools: Implementation:
  • Ombudsperson program
  • At regular intervals, monthly or quarterly provide an update to your PEC action plan to the residents/fellows
  • Each time that you update about improvements, remind them of how to report ideas/concerns (Program and institutional feedback)
Program flexibility and support for individualized goals

Tools:

The Leader's Tool Kit for Building Psychological Safety

  1. Setting the Stage 2. Inviting Participation 3. Responding Productively
Leadership Tasks: Frame the Work
  • Set expectations about failure, uncertainty, and interdependence to clarify the need for voice
  • Framing is ongoing process
Emphasize Purpose
  • Identify what's at stake, why it matters, and for whom it matters
 Demonstrate Situational Humility
  • Acknowledge gaps
  • Be inclusive
Practice Inquiry
  • Ask good questions
  • Model intense listening
Set Up Structures and Processes
  • Create forums for input
  • Provide guidelines for discussion
 Express Appreciation
  • Listen
  • Acknowledge and thank
Destigmatize Failure
  • Look forward
  • Offer help
  • Discuss, consider, and brainstorm next steps
To Accomplish: Shared expectations and meaning Confidence that voice is welcome Orientation toward continuous learning

The ABCs of psychological safety

The ABCs Table of psychological safety

Well-Being National Resources (update quarterly)

Do you have a well-being tool to share or need more help? Contact Keri.Watley@arizona.edu and Steven.Brown@bannerhealth.com