Pilgrims together: leveraging community partnerships to enhance workplace resilience

Many of today’s healthcare personnel find themselves in a double-bind. The question is: How to remain connected, caring and compassionate with patients, while mitigating the impact of chronic workplace stress? Mindfulness is emerging as a means for addressing this dilemma as it has the potential to both reduce workplace stress and boost employee resilience, while enhancing the patient experience. This article describes the development of a unique collaboration between local hospitals, primary care teams and a university, aimed at bringing mindfulness to life in healthcare. This is a conventional story of program development and evaluation, as well as an unconventional story of personal discovery, community-building, and organizational transformation. Each section of the paper highlights a critical success factor that we have uncovered in our journey, and poses a series of questions for contemplation.  This paper aims to fill a gap in the literature by describing the key ingredients for developing and sustaining a community-wide collaboration aimed at integrating mindfulness into the healthcare system.  

Beyond stress reduction: A conceptual model of intrapersonal transformation through mindfulness interventions

Mindfulness-based programs are becoming increasingly common in workplace settings as a means to manage worker stress and enhance resilience.The healthcare sector has been an early-adopter of mindfulness as a means to mitigate workers’ exposure to trauma and high levels of stress, which can result in fatigue, burnout and sub-optimal patient care. In spite of the avalanche of new empirical and theoretical studies of mindfulness programs published over the past ten years, there remains a relative dearth of high-quality qualitative research describing the process and outcomes of programs from the perspective of participants, including their longitudinal impacts. This paper describes qualitative findings of an evaluation of two workplace mindfulness programs involving over 190 healthcare workers, using pre- and post-intervention qualitative surveys as well as focus groups. The study explores participant experiences, described in their own words, and the impact of these programs one year after completion. We draw on the stories gathered from participants to craft an inductive model of mindfulness and its impacts on the lives of novice practitioners. Using metaphor as a method to elucidate this model, we describe the transformative impacts of mindfulness for workers, including impacts on stress, resilience, insight and well-being.We also discuss how qualitative research methods can inform efforts to enhance the quality and evaluate the impact of mindfulness programs in the workplace.

Partnering to develop resilience in health professionals and faculty through mindfulness-based education

Given the pressures that exist in our health care system, health care professionals often are under significant stress to provide both quality clinical care to patients and quality teaching to their learners. We present an innovative program to develop faculty and health professional  skills in reflective practice and resilience, which strengthen participants' ability to act as effective clinicians, educators, role models, and leaders. The basis of the curriculum  rests in the neuroscience of mindfulness  and its applications. This program was enabled through a unique partnership between acute care hospitals (Hamilton Health Sciences and St Joseph's Healthcare Hamilton), Family Health Teams (McMaster Family Health Team and Hamilton Family Health Team) and the McMaster Faculty of Health Sciences Program for Faculty Development (PFD), with additional funding support in 2013 from the Ontario Ministry of Health and Long Term Care (MOH-LTC). Data from 2013 course participants (validated measurement  tools and qualitative feedback) was analyzed to evaluate the effectiveness of this initiative. This poster outlines the journey of this work and a summary of the data gathered to inform further education.

Engaging heARTS: Developing an arts-based curriculum to enhance compassion and creativity in healthcare

In 2014-15 Hamilton Health Sciences (HHS), with supportive funding from the Ontario Arts Council, partnered with a local group of professional artists to develop a curriculum called Awakening Your Creative Power: a seminar series on creativity, compassion and play. In order to understand the feasibility and impact of this arts-based curriculum for healthcare personnel working within a hospital, HHS undertook a comprehensive program evaluation. Input from participants who attended the course was obtained in three ways: (1) weekly evaluation forms at the end of each session (2) a final evaluation that asked questions about the overall seminar series, and (3) a focus group discussion held 2 weeks after the seminar series ended. This paper reports on the outcomes of the evaluation and the evolution of the curriculum over the past 3 years, including its impacts on both participants and the arts partners. The evaluation data demonstrate that the course was successful in meeting its stated objectives which include: enhancing interpersonal skills, fostering self-reflection, deepening compassion, cultivating resilience, recognizing creative potential, applying intention and coping with daily stresses through the power of play. In addition, the course also: increased self-awareness, fostered a sense of community, emphasized the value of creativity for its own sake, empowered participants, provided participants with a sense of accomplishment and made participants feel valued by the institution. The paper concludes with some reflections on the potential of engaging arts professionals in health professional education.

Matters of principle: Agency, practice and identity in clinical bioethics

This project is an ethnographic investigation of the practices and professional identities of clinical bioethicists working in Canadian and American hospitals. Data collected over a three-year period (September 2000--February 2004) included participant-observation, interviews and the author's own experience working as a clinical bioethicist. Specifically, the author queries the tropes conventionally utilized by clinical bioethicists to describe their emergent profession. Chapter Two examines the trope of the ethics consultant as the paradigmatic moral agent within health care institutions by conceptualizing clinical bioethics as a form of labor, and its practitioners as subjects situated within particular institutions, political economies, social norms and culturally-marked bodies. Chapter Three examines the trope of the clinical bioethicist as an "ethics facilitator" in the practice of ethics consultation through analysis of the emerging standards in ethics consultation, and the opening statements of actual consults. Chapter Four queries the trope of the clinical bioethicist as "cultural broker" by examining the tension between pluralism and normativity in both the clinical bioethics literature and the discourse of ethics consultations. By documenting and analyzing the work of clinical bioethicists ethnographically, this project renders a phenomenology of this emergent profession, as well as a meditation on moral agency within institutional contexts