Creating work spaces that foster resiliency and wellbeing is critical to building and retaining a strong, compassionate workforce. The fourth season of the STAR² Center Talks Workforce Success podcast focuses on the ways organizations support their employees and empower them to address and prevent the challenges of compassion fatigue and burnout. In this episode, ACU’s Alex Rohlwing interviews Sarah Macrander, senior health operations manager at the Colorado Community Health Network, about organizational approaches to examining, prioritizing, and investing in staff wellness to create an organizational culture of wellness.

Transcript by Amberscript

Alex Rohlwing: Welcome to the first episode of the STAR Center Talks Workforce Success Podcast Season 4. I’m today’s host, Alex Rohlwing, training specialist at the Association of Clinicians for the Underserved. In our fourth season, we will be focusing on ways organizations support their employees and empower them to address and prevent the challenges of compassion fatigue and burnout. Creating workspaces that foster resiliency and wellbeing is critical to building and retaining a strong compassionate workforce, and we’re going to hear about a variety of approaches for doing that. Today I’m speaking with Sarah Macrander, Senior Health Operations Manager at the Colorado Community Health Network. Sarah, thank you so much for being here today.

Sarah Macrander: Happy to be here, Alex.

Alex Rohlwing: If you don’t mind, could you tell us a little bit more about yourself and your role and your organization?

Sarah Macrander: Certainly. As Alex mentioned, my name is Sarah Macrander. I’m the Senior Health Center Operations Manager at Colorado Committee Health Network, the Colorado Primary Care Association. Like many folks at the PCAs, I wear a lot of hats, one of which is to help lead the wellness team that is internal to our Primary Care Association. I also do a number of other things related to projects centered on workforce, and our purchasing program as well as a number of other things.

Alex Rohlwing: Excellent. What workforce challenges are you seeing, especially when it comes to burnout, compassion fatigue or people’s general struggles to maintain wellness. Especially as we come out of the bulk of the initial COVID response and adapt to the new post-COVID world or the new “COVID is everywhere” world.

Sarah Macrander: I will start by saying I’ll provide a Primary Care Association workforce perspective and then kind of more of the greater environment and what I’m seeing at clinics. Primary Care Association, I think actually applies to both what we’re seeing in the workforce, what we’re seeing generally across all industries as it relates to workforce. You’re seeing high levels of turnover, people re-evaluating what their values are in terms of work, increases in hybrid and remote work options, which I think is interesting development. More specific to clinics, you do see burnout and compassion fatigue, which of course ultimately leads to burnout. You’re also seeing organizations invest more heavily in wellness, which I think is really interesting and exciting development to this post initial wave era that we are in.

Sarah Macrander: Generally, also to clinics in particular, I would say this is also reflected at the PCA to a degree, is people are being asked to do more with less, mainly less staff. That’s hard, that also relates to burnout and compassion fatigue. That’s what I would say are the top workforce challenges and also, of course, recruitment. It’s a super competitive market these days, from entry level positions all the way out to providers. I think unlike before the pandemic where you saw recruitment issues being primarily top heavy, so provider level staff, advanced practice provider level staff. Now you’re seeing it across the board, but more acutely in those support staff roles or entry level roles.

Sarah Macrander: I think that people have a lot more career options than they maybe did before the pandemic and pay is really competitive across multiple industries. I know here in Colorado we hear that Amazon; Starbucks can offer employment package that’s very enticing and very competitive to what the health centers offer. Also, I think another important thing to mention here is that we’ve seen a lot more leadership turnover in the last two years than I feel like I have seen in the previous five years that I’ve been with the Primary Care Association, so that’s a lot. I think you’re seeing that reverberated across workforce generally, but it’s specifically in healthcare.

Alex Rohlwing: That sounds very true and, unfortunately, a very common story of people coping with some of the stresses of their previous jobs by moving on seeking different opportunities. Seeing that change, is there anything that you and other leadership have done or that you’ve seen leadership do to help combat their stresses and provide an environment where people don’t feel that they need to leave to seek other opportunities or better wellness opportunities?

Sarah Macrander: A few things in terms of Primary Care Association perspective, I know we do a lot around wellness and creating a culture of gratitude and trying to focus in on things and in moments that we are grateful for with both our work in our personal life. CCHN as an organization offers a flexible work schedule, we’re seeing that also at the clinic level as well. They offer us remote work or hybrid work too, which is another benefit that I think is helpful in the new era, I guess, is what we’ll call it. You’re seeing that also at the clinic level, where you’re having increased reports of offering hybrid work models, increased flexibility, in part driven by staff, and then the organizational response to what the staff needs are. Also, I think you’re seeing an increased investment in benefit packages. What are those benefits tangible or intangible that staff are going to value? I have already mentioned, like hybrid work and flexible work. Also, your health insurance cover, what are the benefits under that. Also, an investment in programs that will really focus on staff wellness.

Alex Rohlwing: You know I’d be curious to hear a little bit more about what types of programs focus specifically on staff wellness. You’ve talked a lot about the benefits and things that more classic attractors to a job. Have you seen or used anything else you mentioned to expand that culture of well-being?

Sarah Macrander: Yes, at the PCA level we have EAP programs that we have access to– I think a key difference is we do have a team internally to focus on wellness for our staff. Through that group we are often on agendas to do wellness activity and it can range anything from breath work. Taking a collective breath together at the start of the meeting, to encourage staff to go on wellness walks during their work days just to get out from in front of their computers. We’ll do things like physical activity. We just had our staff get together last week and I led a warm up, a traditional exercise warm up. All of these things are optional, people aren’t required to participate. It’s really what’s going to work best for you. I always try to remind folks at the start of the activity, that it’s the case. I think sometimes you have that collective pressure of, well everyone else is doing and I guess I have to do it too. We don’t always have to meet people’s needs. I really want to encourage folks to find something that resonates with them and to make it a habit, that’s a huge game changer.

Sarah Macrander: Now at the health center level, what we’ve seen is offering things like ski passes as part of benefits packages. Encourage or pay a stipend for having a gym membership, those types of things. Also having teams internally dedicated to staff wellness, who identify “what do staff want in terms of wellness” type of thing. They communicate often with leadership teams to help implement those things. Another shift that I would identify that speaks to an increased focus on wellness. We’ve started hearing rumbling at the health center level of moving away from just an employee engagement survey or an opinion survey to doing more of a cultural assessment. They’re looking at organizational culture and seeing and trying to identify: what are those drivers of an organizational culture? How is that impacting to workforce experience? Is that leading to retention or turnover? I’m just starting to hear rumblings about it, but personally it makes me excited because I think that it is important, organizational cultural is vital to keeping staff. Also, two, it’s just something new. You’re taking an age-old practice of employee engagement, employee opinion, which can be a hit or miss if we’re honest, and flipping it on its head and looking at culture instead, which I think is cool.

Alex Rohlwing: I really like that. That’s fantastic. Especially, like you said, providing lots of opportunities to engage in wellness activities, but at the discretion of the person as far as being able to be like, ‘Oh, this is something that will help me. I can do this’ or ‘no, this isn’t what I need right now’, and not having that pressure to engage and making stuff habits. I think that’s really awesome because, if you don’t make it a habit then when you’re really stressed out, you’re not going to revert to those wellness practices, you’re just going to revert to the old routine. I guess talking about that, how can you use organizational change to improve staff well-being? Especially in light of these cultural assessment perspectives that you’re going to be using. How is that going to inform organizational change for you?

Sarah Macrander: As I mentioned, the cultural assessment is brand-new so I don’t know if I can speak to that. I’ll learn more in September from one of our health centers, so I can’t really speak exactly to that at this point. In terms of organizational support for wellness, I think it’s what you’re asking. What I’ve seen at CCHN, is a few things. I think, first and foremost, having a leadership team that priorities wellness. What that looks like is not only them practicing their own wellness, but demonstrating what wellness looks like or means to them. Also encouraging staff to do the same, which can look like holding space at the start of meetings for wellness activity, sending reminders about benefits and programs that staff have access to. The language that we use is also really important. When you see someone struggling, we’re all human, it’s okay to say, ”Hey, are you okay? How can I support you?”

Sarah Macrander: I know for me what I’ve seen organizationally is that type of interaction even happening at the supervisor level. I think so often we find ourselves spinning in this cultural productivity, but is going to be easy to forget to ask. One thing that I really value here, is having a supervisor that will look at me and say, ”Hey, how are you doing”, and be willing to talk about my workload if needed. If it’s like too much or too trustful or adjust deadlines as needed. It’s a little different at the health center level. I think that their work cadence is just so different from what we get at the Primary Care Association that can be a bit difficult, but also just carving out for staff if they so choose to connect around what’s weighing on them.

Alex Rohlwing: It sounds like you’re doing a lot of really good work. Just the idea of breaking away from, or at least expanding past just the culture of productivity to building a culture of asking how people are doing, I think, is one of the coolest things. It’s not just, do wellness stuff on your own for yourself, but engage with other people in the wellness space. As an organization providing the space to do that and modeling it. Just to wrap-up a couple of things. One is, do you have any advice or strategies, tips that you would give to other health centers or PCAs that were curious about starting or expanding on these kinds of programs?

Sarah Macrander: Certainly, I think the first piece of advice or where I would recommend any organization to start, is examine how you’re investing in wellness. It doesn’t mean fiscally; it can mean time. Time is an investment; energy is an investment. I think so often we get stuck in those financial ways, because money matters that we forget that there are these other ways to invest, including human investment. Do you have a wellness team? Do you have someone who’s thinking about wellness at your organization and tasked with doing something about it? Investment is where I would start. Strategies, never forget the human element that we’re all humans showing up as messy as we are. Also, I think creating, shared language about wellness, whether allowing for human check-ins to happen. What are some tips or tricks or even canned language that people can turn to learn how to talk about wellness, I think, is another strategy. I already mentioned the investment of time, but that is a piece of it. If people don’t feel like they have the time, they’re not going to do it.

Sarah Macrander: I even know just from our internal wellness team, for a while we’re putting wellness breaks on people’s calendars. Nine times out of 10 people, including myself, would just blow through that. You have to still make time; you also have to show that people can do that. Having a shared language around that can help. Sometimes acknowledging the problem, that one could be another one like saying ”Hey, I see that everyone’s been working really long hours, what’s going on? People are maybe feeling a little burnt out, how is everybody doing?” Acknowledging the problem, I think is a big one too. You can’t really deal with a beast until you know its name. Examine benefits and compensation. I think that’s always a major thing to do, but I think if you’re not doing it or if you haven’t looked at it in a while and you’re seeing turnover, especially people leaving to go to different organizations or outside industries then taking a look at your benefits package and compensation package is always a great place to start as well.

Sarah Macrander: Beyond that, I think a piece of advice that I would give is, ”Wellness this looks different for everyone”. Trying to make a one-size-fits-all wellness program, you’re going to miss people. If you let staff drive their own wellness, figure out what works for them, maybe it is that wellness walk. Maybe it’s that they take a lunch and go outside or maybe they want to do yoga. Who knows? It looks different for everybody. I think so often we get trapped in this, wellness looks this way or it means this thing. If we can open our definition as to what wellness looks like, I think that will be better off in the long term.

Alex Rohlwing: If you don’t mind, I’d like to follow-up just a little bit real quick on the shared language of wellness. That is a really excellent idea that I had not heard articulated before, that you need that common vocabulary. If you can share a little bit more about what that looks. Maybe what would be some shared terms that either you use or working with staff to implement?

Sarah Macrander: It’s going to look different at every organization, because cultures are different across organizations. Here at CCHN a shared language peace that I would call out, is asking for gratitude. Whether it’s at the start or end of a meeting, when we do large staff events, we always know that there is going to be gratitude sharing element to it. In my vocabulary of wellness here at CCHN, gratitude is at the center. That’s an example of what it might look like. Once again, wellness is different for everyone and every organization. What works for one person like that work for the next person. What I suspect is something that we might learn from the cultural assessment, is what is that shared language around wellness for an individual organization. Did I answer your question?

Alex Rohlwing: Yes, absolutely. I really like using the cultural assessment to find what language already exists around it. You’re not just creating this artificial template, of here’s the words we’re going to use, but actually looking at what are people already using as a language around wellness. I think that’s really fantastic.

Sarah Macrander: I’m just trying to wrap my brain, if there is anything else I would add or emphasize. Too often something I see not just in healthcare, when I talk to friends who are in other industries is wellness is a one size fits all approach. It’s not. That’s the beginning, the middle, and end to it. To figure out what works for folks, you have to ask. Some people they won’t want to tell you, and that’s okay too. If you want to start doing wellness within your organization as a leadership team, people need to see investment. They also need to see that you are asking them what works well for them and that they have the flexibility needed to engage with whatever it looks like. There are confined to that too, understandably, but I think to a certain extent sometimes staff just want to be heard by their leadership team, by the people who run an organization. That can be sometimes achieved, though a wellness team. It can be achieved through just asking questions.

Alex Rohlwing: Thank you, Sarah. I think just the idea that we could all do a little bit better job listening to each other is a fantastic point to wrap-up on today. Thank you so much for being with us. Thank you all for listening in today. I hope you found Sarah’s discussion as helpful as I did, either learning some new techniques or confirming some good practices you already do. Be sure to check out all of our free workforce tools and resources, found at our website chcworkforce.org, and join us for the rest of season four of the STAR Center Talks Workforce Success Podcast. Have a wonderful day.