New recommendations offer best practices for hospitalist wellness
The CARES framework (checklist, assessment, relationship, evaluation, safety) provides guidance for hospitals on optimizing their interventions to support clinicians' well-being.
A work group of hospitalists recently developed a list of best practices to address their colleagues' well-being, based on a survey of practices at institutions across the country during the pandemic.
Between May 2020 and October 2021, the Hospital Medicine Reengineering Network (HOMERuN) surveyed its 50 sites and received information about wellness offerings from 26 (52% response rate). They found wide adoption of interventions and guidelines to meet safety and basic operational needs, such as patient triage and personal protective equipment (PPE), but lower reported rates of inpatient telehealth, redeployment of nonhospitalist physicians, and ancillary or consult service support. The availability of emotional support strategy wellness varied among the hospitals, and the survey found particularly low rates of child/elder care offerings (55%), support for families of caregivers (26%), and direct assessment of stressors and/or wellness needs (31%).
Based on these findings and subsequent focus groups, the HOMERuN wellness work group developed a list of best practices for hospital medicine programs, summarized by the acronym CARES. The following recommendations (as well as the survey findings) were published in a concise research report by the Journal of General Internal Medicine on Feb. 9.
- Checklist: Utilize a structured framework (such as the Press Ganey Wellness Checklist) to help organize wellness interventions.
- Assessment: Survey clinicians to identify primary stressors and wellness needs and use the results to target wellness offerings.
- Relationship: Ensure wellness offerings address the needs of clinicians who are also primary caregivers, including child and elder care and counseling and support to families.
- Evaluation: Evaluate the utilization and impact of wellness offerings to assess efficacy and need for improvement.
- Safety: Ensure “safety musts” are provided, including 100% access to basic needs such as adequate personal protective equipment and mental health care.
