Imagine: An initiative to support the wellbeing of staff at Bulli District Hospital

This is a staff-based wellbeing initiative program; designed to demonstrate an increase in staff satisfaction and workplace engagement.

Aim

To increase staff mindfulness, engagement, and workplace wellness by at least 80% by June 2018, as measured by specific indicators based on the People Matter Employee Survey questions.¹

Goals specifically included:

• to support staff wellbeing: as well as sessions on mindfulness, staff learned strategies such as breathing techniques, gratitude, and exploring self-care options, to support their well-being
• to support patient and carer wellbeing: throughout the program, participants were also encouraged to ‘imagine’ how the care environment could be enhanced to support the wellbeing of all patients, carers and staff, not just those in the program.

Benefits

The expected benefits include:

• reduced stress at work
• higher self-awareness
• enhanced communication
• deeper workplace engagement
• increased job commitment
• increased use of innovative and supportive organisational systems
• increased authenticity when working with others, in respect of others’ values and beliefs.

Background

Working in aged care is known to be physically and psychologically demanding, as well as stressful; which can lead to staff burnout. This can result in reduced job satisfaction, and may be detrimental to care delivery.

To address these issues, staff at Bulli District Hospital, a 52 bed sub–acute geriatric hospital, initiated a program to improve staff support and wellbeing. The program was designed to address some of the issues identified in the People Matter Employee Survey: A NSW public sector employee survey.² In the staff feedback session that followed the survey, wellbeing was identified as an area that needed to be addressed.

Implementation

The project team engaged the staff (made up of nursing, allied health, managers, health, and security staff) to co-design the self-care program. The project team, led by a wellness expert from the University of Wollongong, then developed an eight week wellbeing program for 11 staff at Bulli District Hospital.

• The program delivered weekly one-hour sessions that became known as Wellness Wednesday.
• As well as sessions on mindfulness, staff learned strategies such as breathing techniques, gratitude, and exploring self-care options, to support their wellbeing.
• Eleven participants were recruited to participate in the program’s first cohort.
• Throughout the program participants were also encouraged to ‘imagine’ how the care environment could be enhanced to support the wellbeing of all patients, carers and staff, not just those in the program.

From here, the next steps are as follows.

• Funding has also been applied for, and accepted, to support the rollout of the following research process.
• Ideas generated from the imagine process will be distributed to all staff for critical discussion. Patients and their carers will also be invited to participate and help to refine the ideas.
• Key priorities and initiatives will be implemented through an action plan with inbuilt evaluation.

The scope for implementation is significant for the following reasons.

• There will be a translation of key findings, with the study’s processes to be shared with other workplaces.
• The pilot study will also be shared across the immediate local district and with other local health districts. This will be done through publications and conferences, such as the NSW Health Innovation Showcase.
• The University of Wollongong has accepted this program to be included in its Nursing Undergraduate course content.
• This program has been accepted for the Enhancing Practice conference in Basel, Switzerland.
• This program has been submitted to the NSW Health Workforce Forum for consideration.

A wellness expert from University of Wollongong supported this project, in collaboration with the Illawarra Shoalhaven Local Health District Nursing and Midwifery Research Unit.

The program also engaged a local yoga instructor, Sue Brittain, to run the yoga component.

Status

Implementation - The initiative is ready for implementation, is currently being implemented, piloted or tested.

Key dates

• 4 October 2017: first project team meeting
• 29 November 2017: expression of interest sent to all staff inviting them to participate in the program
• 21 February 2018: first session started
• 13 April 2018: certificates were presented to all participants, and the Chief Executive was in attendance
• 2 May 2018: second cohort began, with 12 participants involved
• 30 June 2018: second cohort was completed

Implementation site

Bulli District Hospital, Illawarra Shoalhaven Local Health District

Results

To assess the program’s effectiveness, pre and post data from the People Matters Employee Survey were collated. Program evaluation data was also captured at the end of each focus group session. Lastly, a focus group, made up of the program’s first participant cohort, was carried out at the completion of the program to identify opportunities to refine the program.

Results include:

• positive initial focus group results, with the first cohort showing an increase in ‘job satisfaction’ of up to 23%, and a reduction in ‘intention to quit’ of up to 50%. Other well-being indicators also showed an improvement
• a mid-point progress snapshot from the People Matters Employee Survey was also completed.

Lessons learnt

• The impact on staff rostering: staff participation in all of the one-hour sessions across eight weeks impacted on rostering requirements. This was more acutely experienced if staff had booked annual leave, or taken sick leave. This is because the remaining participating staff were unable to attend a program session at that time.
• The impact on the allocation of staff time: in taking time out during work hours to undertake the project interventions, it could impact work commitments outside of the program. Some staff were willing to take part in the program in their own time.
• The challenge in scheduling presenters: Availability of the presenters was a challenge due to competing work commitments.

References

1. NSW Public Service Commission. People Matter Employee Survey
2. NSW Public Service Commission. People Matter Employee Survey 2017: NSW Public Sector Employee Survey - Agency report: Illawarra Shoalhaven Local Health District. Sydney: PSC; 2017.

Further reading

• Cohen-Katz J, Wiley S, Capuano T, et al. The Effects of Mindfulness-Based Stress Reduction on Nurse Stress and Burnout, Part I. Holistic Nursing Practice. 2004:18;302-308.
• Cohen-Katz J, Wiley S, Capuano T, et al. The Effects of Mindfulness-Based Stress Reduction on Nurse Stress and Burnout: A Qualitative and Quantitative Study, Part III. Holistic Nursing Practice. 2005a:19;78-86.
• Cohen-Katz J, Wiley S, Capuano T, et al. The Effects of Mindfulness-Based Stress Reduction on Nurse Stress and Burnout, Part II: A Quantitative and Qualitative Study. Holistic Nursing Practice. 2005b:19;26-35.
• Davies N. Learning Self-Compassion. Diabetes Self-Management. 2012:29;58-61.
• Erogul M, Singer G, Mcintyre T, Stefanov D. Abridged Mindfulness Intervention to Support Wellness in First-Year Medical Students. Teaching and Learning in Medicine. 2014:26;350-356.
• Hunter L. Making time and space: the impact of mindfulness training on nursing and midwifery practice. A critical interpretative synthesis. Journal of Clinical Nursing. 2016:25;918-929.
• Paatalo K, Kyngas H. Measuring hospital nurses’ well-being at work – psychometric testing of the scale. Contemporary Nurse. 2016:52(6).
• South Eastern Sydney Local Health District, Louisa Hope Fund for Nurses. Nursewell. [App]. Sydney: Inky Smudge; 2017.

Contact

Marie Tobin
Deputy Director of Nursing
Bulli District Hospital
Illawarra Shoalhaven Local Health District
Phone: 02 4283 0602
marie.tobin@health.nsw.gov.au