Creating a National Program to Address Clinician Burnout
Creating a National Program to Address Clinician Burnout
How to turn a successful pilot project addressing clinician burnout into a national program
Burnout among clinicians can compromise patient care by having a negative effect on health care organizations, including absenteeism, attrition, worker shortages, lower productivity and substance abuse. For the Veterans Health Administration (VHA), which operates the nation’s largest integrated health care system, burnout became a strategic issue. A VHA task force recommendation prompted the VHA Governance Board to expand a Chief Well-Being Officer (CWO) pilot into a national program. The CWO is the only VHA role dedicated to mitigating the systemic drivers of burnout among clinicians.
Challenge
Training, strategic communications, and change and program management were needed to transition the pilot project to a permanent program
The VHA Office of Patient-Centered Care and Cultural Transformation (OPCC&CT) team was working with Aptive on an 18-month pilot project for CWO candidates when, in August 2022, the VHA Governance Board signed an Executive Decision Memorandum (EDM) for a small-scale implementation of the CWO role. The EDM specified that each of the 18 Veterans Integrated Services Networks would select a facility to implement the CWO role in FY23. Along with the 18 EDM sites, several “early adopter” facilities were also hiring CWOs. VHA needed a national program to train CWOs as strategic leaders and advocates for clinician well-being. In addition to the training component, the OPCC&CT team needed change management, program management and strategic communications assistance to support newly hired CWOs. VHA determined they were inadequately staffed to expand the pilot into a full program.
Solutions
VHA partnered with Aptive to supplement the OPCC&CT staff and provide project and change management, administration, strategic communications and education/training support in transitioning from a pilot focused on CWO candidates to a full program for VHA CWOs.
Pilot Support and Closeout
While the Aptive team worked on creating the new program, they also continued providing pilot project support. Once the pilot concluded, Aptive managed the closeout, documenting lessons learned and executing a sustainment plan with continued opportunities to engage CWO candidates. In addition, Aptive oversaw partnership efforts with VHA Health Systems Research and Development (HSR&D) to evaluate the impact of the 18-month pilot.
Program Management
Aptive assisted the CWO program with strategic program management support. To increase knowledge sharing and peer support, the Aptive team designed, planned and facilitated weekly meetings with CWOs and interested stakeholders (including education calls, community calls, and knowledge network calls). In addition, the team:
- Designed, developed, launched and facilitated annual three-day CWO Program Strategic Planning Summits in a hybrid format. For the FY24 summit, deliverables included an agenda, a facilitator’s guide, workshops and more than 100 facilitation slides developed in just three weeks.
- Developed a CWO program change management plan to guide organizational change in hiring CWOs and supporting adoption of the role.
- Oversaw partnership efforts with HSR&D to evaluate the impact of the pilot, as well as leading evaluations to advance VA’s Response to National Priorities (LEARN) Evidence-Based Policy Evaluation Center to develop a three-year evaluation proposal on CWO role readiness.
- Facilitated recruitment calls with VA senior leadership to support hiring CWOs based on national recommendations.
- Coordinated with key stakeholders such as VHA program offices, the Reduce Employee Burnout and Optimize Organizational Thriving (REBOOT) Task Force and Employee Whole Health.
Education and Training
Aptive supported VHA in developing training and education for CWOs, including interventions at the field level. Work in this area included (but was not limited to):
- Designing a curriculum framework and guide to support the development of CWOs as strategic leaders and advocates for clinician well-being, including on-demand learning, virtual workshops and weekly coaching.
- Developing, launching and facilitating the CWO Fundamentals Conference for new CWOs, which included education and training on the Stanford Model of Professional Fulfillment, the Listen-Sort-Empower model, strategic planning, leadership, stakeholder engagement, change management and clinician burnout. Since the launch of the CWO program, there have been four CWO Fundamentals Conferences (formats have included in-person, hybrid and fully virtual).
- Incorporating change management principles into training and properly storing documentation on VA systems to be accessible to all internal stakeholders.
Strategic Communications
Aptive co-developed a strategic communications plan for development, implementation and expansion, and communication campaign plans for specific program projects and initiatives, including Senior Leader Engagement Sessions and the CWO Experience. In addition, the team:
- Oversaw the design and development of the VHA CWO program SharePoint site.
- Designed, developed and launched the CWO Communications Toolkit
- Developed many senior-level briefing slide decks, fact sheets, frequently asked question documents and talking points
- Designed, developed and published the CWO Newsletter
Results
Exceptional contractor performance contributes to the program’s continued growth
With Aptive support, VHA successfully transitioned the pilot project into a fully operational program by establishing a comprehensive organizational structure to support the program’s long-term goals.
A significant milestone for Aptive was helping to develop the background content for the EDM, which was instrumental in securing buy-in from key stakeholders. This critical step ensured broad organizational support and enabled the program’s expansion. Aptive’s efforts facilitated remarkable growth in the program’s capacity: 32 CWOs in March 2024, up from only two in October 2022. This expansion is a testament to the success of the CWO program and the effectiveness of Aptive’s recruitment and development strategies.
Furthermore, Aptive, along with VHA education subject matter experts, created the CWO Program Education Framework, a comprehensive educational blueprint designed to ensure CWOs have the necessary knowledge and skills to excel in their roles. This initiative culminated in the launch of the CWO Fundamentals Conference, a key educational event that has become a cornerstone of CWO professional development. Through these strategic interventions, Aptive elevated the CWO program from its nascent stages to a model of operational excellence and laid a solid foundation for its continued growth and success.
The Aptive team received exceptional Contractor Performance Assessment Reporting System ratings for 2023 in quality, schedule, cost control and management. The CWO program government leads noted “the efficiency and management of the [Aptive] team contributes to the continued growth and success of the CWO program.”