October 26, 2017

How to Start Conversations that Move Your Organization toward Greater Health

News Alerts:
The Doors to Wellness Will Be Opened at ACEP17
Featuring the last part of the Health Promoting Work Systems 3-Part Series by Katherine Sanders, PhD


Editor's Note: The following is the last article in her 3-part Health Promoting Work System series, by Katherine Sanders, PhD. Dr. Sanders will also be the Keynote speaker at our upcoming section meeting at ACEP17. – Dr. Randy Levin


Shift your organization’s culture conversation-by-conversation by talking about work system health, developing a common language and strengthening your relationships with your colleagues.

In the spring newsletter we looked at ways to support physician health with work system initiatives that identify and reduce workplace stressors.

In the summer newsletter we focused on how physicians can prepare themselves to shape health-promoting initiatives by recovering their own energy and clarifying their personal vision of health.

This final article of the series looks at how conversations with your colleagues can help your organization gain momentum toward greater health. And since I’ve the honor of talking with those of you attending the ACEP17 Wellness Section meeting in DC (October 30, 2017), I’m eager to hear what you make of these ideas when we’re together.

Why Conversations?

If you've been doing some thinking, envisioning what a healthier emergency medicine practice might look like for you and your team, the next step is to engage your colleagues in the conversation in a thoughtful, systematic and ongoing way.

Conversations about healthy work are a first, essential step toward increasing work system (and physician!) health. They help you expand your own understanding of healthy work. They also serve to deepen your trust between you and your colleagues. As importantly, you develop a shared language with which to talk more precisely about work.

These conversations, themselves, are a powerful intervention.

A group's culture is the psychological and social environment people experience. It is shaped by a set of unwritten values about what behaviors are acceptable and rewarded, as well as what people shouldn’t do and talk about when they are together.

Meta-conversations about healthy work are seldom part of an organization's culture. Most of us are overwhelmed with transactional, how-to conversations about work. This is why the very act of talking about healthy work systems is the first step toward greater health. Taking the time to talk about something that is usually never spoken about communicates what you value. When others become engaged, the conversations, themselves, become a change initiative.

Why it feels strange

Talking about work with colleagues can feel strange. This may be especially true for emergency medicine physicians.

For one thing, part of an emergency physician’s role is to stay calm and embody order in the midst of crisis. The leadership you share with your patients and your team helps others cope with their emotions.

What’s more, healthcare often depends upon a hierarchical communication style that runs counter to the exploratory and non-transactional conversations needed to seed an organization change movement. While a checklist may help you more effectively communicate a diagnosis with a patient, for example, it is the antithesis of the open-ended and exploratory exchange that will help you talk about healthy work systems with your colleagues. After all, we're not trying to communicate an answer. Instead, we are trying to constructively engage people in a set of questions. And these are questions you, yourself, are unlikely to have the answers to – at least, at first.

In meta-conversations about work, it is not only the new content (healthy work) that might feel unnatural, you may also be revealing a more vulnerable side of your personality.

Why it works

The good news is that physicians have an important skill set that lends itself to these culture-transforming conversations. You interview your patients and their families all day. You know how to ask the right questions and how to listen closely without interrupting or judging. Your keen and quick observations are sometimes literally a matter of life and death.

The focused attention you bring to your patients, your ability to be fully present and integrate seemingly divergent information is a huge asset in seeding change initiatives with colleagues.

What’s more, everyone is interested in healthy work for themselves. We all want to experience work that is engaging and life affirming. I’ve yet to meet the person who doesn’t want this. People might have given up on their early dreams as naïve, but they never intended to feel perpetually exhausted by their careers.

So, let’s start from that common ground: the knowledge that we all want to live healthy, productive and enlivening working lives.

Starting meaningful conversations about work

I usually give a homework assignment to my group program participants. I ask them to interview a colleague or friend about healthy work. If they feel awkward asking colleagues for a chat about work, I suggest they say, “I have a homework assignment to interview somebody about this subject.”

Another option is to say something like, “I’ve been doing some reading about health-promoting work and I’m starting to think about it myself. I’m still learning and I’d love to hear how you think about it.”

Or, you might watch a video about healthy work and talk about it together. I’ve created some free videos to help spark conversations. (The one about workload uses emergency medicine as an example.) These videos also give you a feel for the conversation I’ll be having with those of you who attend the annual wellness meeting in DC on October 30th.

Bringing it all together

When you meet, remember that the point is to cultivate relationships and build trust while you share ideas about what a healthier work system would look like. It’s not to make a list of what’s wrong with the current system. That sort of negative-focus can depress you both, and make you feel hopeless. That’s not the intention.

Focus on the motivators
Instead, we have to focus on empowering people with concepts and language that can shift your profession toward health. The first newsletter article in this series talks about motivators and dissatisfiers.

Ask your colleague about more than just what causes stress or dis-satisfaction in their work. Give equal time to what feels right and good about work and how those things can be enhanced or rebuilt. That would be a great place to start.

Tune in
Revisit the second newsletter article and think about the work you've been doing to take better care of yourself, to cultivate a breathing space. Remind yourself that you don’t have to solve any problems in a 45-minute coffee conversation. You’re building a foundation for movement together.

For now, just ask. Listen. Share. You are building momentum toward health, one conversation at a time.

It’s been a pleasure to write for your newsletter this year. If you’ve time to write and tell me how it’s going, I’d love to hear from you.

Take good care, Kathy

Resources for your group
See my site for my healthy work framework and free videos on individual topics you can use to start a conversation with your colleagues.

Katherine Sanders, PhD
Human Factors & Work Systems Engineer

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