Joy In Medicine

BronzeSilverGold(need 5/6 criteria)( 5/6 Bronze criteria)( 5/6 Silver and Bronze criteria)Assessment of all unit leaders usingthe Mayo Leadership Index or similarinstrument, with feedback to leaderwithin the last three years.ORAppoint staff person to beresponsible for leading andcompleting query to de-implementoutdated or unnecessaryadministrative burdens withinthe next six months. (See “Deimplementation checklist”document for suggestions.)LeadershipTeamworkSupportAnnual assessment of all unit leadersusing the Mayo Leadership Index, orsimilar instrument.ANDImplement a leader developmentprogram that includes training intransformational leadership, ability tofoster productive work environmentand guide physicians’ careers.Share an example of how yourorganization has tailored itsleadership program in response tothe gaps identified in leadershipassessment.ANDActively dismantle administrativeburdens identified in your originalquery.ANDQuery physicians and staff aboutadministrative burdens thatcontribute little or no value to care,impede the work of clinicians, andwaste time/resources. (See StepsForward module for additionalinformation.)Supporting documentation: Enter instrument that yourorganization uses for leadershipassessment Provide name of individual andjob description for personresponsible for leading queryto de-implement unnecessaryadministrative burdens.Supporting documentation: P rovide findings from yourorganization’s last two consecutiveannual leadership assessments R elevant written materials onprogram and curriculum P rovide narrative on your approachto querying for unnecessaryadministrative burdens within yourorganizationSupporting documentation: W ritten example on how yourorganization has tailored itsleadership program in responseto gaps P rovide narrative on your approachto addressing administrativeburdens that provide little value toyour organizationTeamwork measured within thelast three years in at least fourdepartments2 i using the AHRQTeamStepps Teamwork PerceptionsSurvey, Safety Attitudes Questionnaire,PeaceHealth’s Team DevelopmentMeasure Survey, or similar instrument3for select specialties.Teamwork for orders (TWORD)3measured in select specialties viaEHR audit.Demonstrate how your organizationhas developed an intervention toimprove teamwork based on resultsfrom survey and/or EHR audit.Supporting documentation: Provide name of instrument ormethodology used to assessteamworkSupporting documentation: N arrative statement summarizingthe TWORD data is reportedconfidentially to the AMA S hare methodology forcalculating teamwork Meeting minutes/agendaSupporting documentation: R oot cause analysis andimplementation planPeer support program that supportsdealing with adverse clinical events.(Note: an Employee AssistanceProgram is not sufficient to meetthis criterion.)Peer support program aimed atbroader issues of physician supportbeyond adverse events and couldinclude proactive planning forsupport during crisis.Structured program that activelyengages physicians to cultivatecommunity at work (Mayo COMPASSphysician dinners, peerRXMED,physician lounges, monthly wellnessmeetings, etc.).Supporting documentation: Narrative descriptionSupporting documentation: Description, web linkSupporting documentation: Description of how your organizationactively engage physicians tocultivate community at work (Pleaseprovide specific information in yoursupporting documents.)ANDTeamwork results reported toorganization leadership/board.1. WOW represents after-hours work on EHR. A surrogate of this measure is provided by some vendors. The optimal method of tracking WOW is to normalizethis to 8 hours of patient scheduled time. Organizations with a data base analyst should be able to determine WOW8 by combining vendor derived EHR-usedata with scheduling data. For example, in Epic WOW8 can be calculated using this formula:'Time Outside Scheduled Hours' (min)/60 min (Signal) 'Time on Unscheduled Days' (min )/60 min (Signal)WOW8 *8Scheduled Hours (Clarity)Cerner also has an after-hours measure currently determined by clock time (from e.g., 5:30 p.m. to 7 a.m.). The optimal method of tracking WOW is to normalizethis to 8 hours of patient scheduled hours. See Metrics for Assessing Physician Activity for more information.2. For example, family medicine, internal medicine, pediatrics and at least one subspecialty department.3. Alternative questions that could be used to assess teamwork could include the two following questions: (1) Which statement best describes the consistency ofyour care team in the ambulatory setting? (a) I typically work with the same clinical support staff (MAs, LPNs, RNs) every day I am in clinic (except for illness orvacation) OR (b) I typically work with individuals from a pool of clinical support staff but the individuals on the team in any given day varies; (2) During a typicalambulatory clinic day, what amount of time do you spend on other tasks that do not require the unique skills of a physician (e.g., order entry, forms completion,processing prescription renewals, visit note documentation) that could be performed by others? (a) less than 60 minutes (b) 1-2 hours (c) 2-3 hours (d) 3-4hours) (e) more than 4 hours. See Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace as a helpful resource.4. Teamwork for orders can be measured by the percentage of orders that have team contribution. See Metrics for Assessing Physician Activity for moreinformation.Additional resources to consider:National Academy of Medicine discussion paper: Organizational Evidence-Based and Promising Practices for Clinician Well-Being

Application processOrganizational self-assessment B ased on the outlined criteria, evaluate the current efforts of your organizationto determine your level of recognition. Supporting documentation is requiredwith your application.Apply for the Joy in Medicine Health System Recognition Program A leadership designee from your organization must complete and submit yourapplication. Applications will open on March 1 and will close on May 21.Review process A review committee composed of recognized national leaders in physician wellbeing will review all applications to affirm an appropriate recognition level.Recognition O rganizations meeting the criteria for a designated level will be recognizedfor their achievement. Recognized organizations will be highlighted in pressreleases, on the AMA website, and spotlighted through AMA podcasts, videosand news stories.Recognition status R ecognition is valid for two years. After two years each organization mustresubmit an updated application for review. Organizations may re-apply eachyear to achieve higher levels of achievement.The AMA practice transformation journeyMoving together toward impactHelping health systems and clinical practices succeed intheir practice transformation journey is critical to the AMA.That’s why we offer evidence-based, field-tested solutionsto guide physicians and care teams each step of the way.Increasing efficiencies, improving patient care andenhancing professional satisfaction—these are what increaseJoy in Medicine and make the journey worthwhile. 2021 American Medical Association. All rights reserved. 21-522388:4/21

1. WOW represents after-hours work on EHR. A surrogate of this measure is provided by some vendors. The optimal method of tracking WOW is to normalize this to 8 hours of patient scheduled time. Organizations with a data base analyst should be able to determine WOW 8 by combining vendor deriv