Uh, okay. Um, so here we go. Uh, you know, the reality is stress is a huge part of healthcare, um, for some of us more than others. And, uh, good for you if, if you're on the end of less stress, um, and for, for others who are on the end of it's higher stress, just because you've tried some things doesn't mean, you know, there aren't other opportunities for us. Now we have made an intentional effort at Johns Hopkins medicine to make our employees more aware of the value and worthwhile, uh, worthiness of taking a healthy breath and the context of helping to lower our stress level. When we are stressed, we tend to hold our breath. So, so we are making an intentional effort to, um, be sure that, uh, our employees are aware and beginning to practice the art of taking a healthy breath. And what you're seeing is one type of breathing pattern, the four, seven, eight breathing technique, which we have, um, both increased awareness of in our workplace as well as caused, um, our, or trained our employees on how to do. There are other breathing patterns or even just taking a deep breath can help lower that stress level. And we're going one step further and we're making an intentional effort to make this breathing pattern a norm at Johns Hopkins medicine. And I'm going to explain what that looks like. So this specific graphic is available to our employees as an ID card. We actually, you know, we have to carry, uh, an ID card on the lanyard and behind that, um, ID card, we have the option for our employees to place another card, same size, same material so that they can have those instructions there whenever they want to refer to them until they've learned it, um, up here. Now in our facilities, we often have to swipe our badges in order to get through, um, secure doors. And as a result, when we have to swipe our ID badge, it's an opportunity every time for us to have to move this card away, but it's a reminder. And it's not that you're going to see our employees stopping at every door to do this exercise, but it's a constant reminder throughout the day. We also have this image on our screensavers at our clinical stations. We have it on our led screens, which are positioned in our hallways across our facilities. We've had this image, um, placed on posters in the past. Um, we teach this 478 breathing during orientation. Um, and, and there's several other ways, um, that I am going to give you a methodical list on how to approach. Now on slide or on page five of your worksheet, you have a list of culture connection points with definitions and the definite, I'm sorry, the culture connection points on this screen. Some of them have a check mark in front of them. And those are the ones that we're using to help make healthy breathing a norm at Johns Hopkins medicine with the goal of helping to bring the stress level down throughout the day. Now I'm just going to run through these pink ones first, uh, first impressions and orientation. I mentioned that our new employees, we teach them this, we do a group exercise and I've done this group exercise virtually. And I've done it in person with, you know, large audiences, as many as 300 people. Um, it's not difficult to learn. Um, and because it's part of orientation, it makes an impression, you know, uh, you know, love at first sight and, um, you know, you only get a chance to make a first impression once learning and training. Uh, I mentioned that, uh, we do this during orientation. We also do it for new managers. We teach new managers because not only do we want them to have their stress lowered, but we also need to know that this is available to their teams. And we have the possibility of someone from our wellness team to go into another team to train those employees on how to do this breathing, uh, exercise, uh, rewards and recognition. Um, we do include, uh, mindfulness, which includes breathing in a rewards program that we have. Now I'm fully aware that many of you may not have rewards programs. It doesn't have to be a financial reward. This connection point is about, um, reinforcing behaviors that you want to see. Sometimes we focus on the behaviors we don't want to see. We have to remember that when we praise, recognize, uh, reward those behaviors that we want to see, including stress management techniques that reinforces, and we'll see those patterns more often. I talked to you about the communication strategies we've used to help broaden the message of 478 breathing resource commitments. Um, this is any act of the organization, uh, committing money or people to help support wellbeing. So in this case, it could be just the money and the distribution of these 478 breathing cars that go behind our lanyards. We actually have a certified mindfulness instructor on our team. I don't expect that of most employers. We have close to 40,000 employees. So it makes sense that we would be able to allocate the budget, but is it possible to have like someone in your office be like 0.25 that depending on the size of your office to be committed to looking at this bigger picture, or does it be maybe you have someone in human resources already, or, you know, just think about what resource commitment are you making? Not just for these culture connection points, but for everything that we're talking about today, uh, role modeling, our, uh, president of our health system introduced our mindfulness instructor at a town hall meeting. And, uh, she led this 478 breathing in front of the audience, as well as all the other affiliates where this was piped through on a televideo conference. Um, let me just run through the other ones. Um, listen, you don't have to use every culture connection point. Every time you're trying to create a new norm. In fact, I wouldn't, I would advise against it. I would choose four to six. It's about the right number of culture connection points to come at the problem from a different angle. If you use too many, first of all, you're going to get exhausted. And then each individual, um, culture connection point is probably going to get watered down because, you know, it's probably better. It's better to do a few things. Well, then try doing all of these. Let me, uh, go to number three. Um, and you can, you'll tell me if we have any comments or questions along the way, right? In the chat box. Absolutely. Okay. Um, pushback. Um, listen, when, uh, you see something that's not okay, we need to speak up and that's pretty common in patient care, right? We're about to see something happen. That's going to be detrimental to our patient then. Yeah. We're going to stop it. Right. You know, it's great when we can catch each other about to make a, an error of delivering care. We also need to be thinking about this in the context of our employees. You know, if we see someone in the office or here are some of the office, you know, taking a jab at someone who's trying to meditate off in a quiet room, you know, that they're making fun of them being a yogi or something like that. I think we need to not let that continue. It doesn't mean we're going to publicly humiliate the person who's, you know, potentially causing some, you know, negative consequences. Just take them to the side and say, Hey, you know what? I think it's great that Jennifer is trying to meditate and I know you might be playing with her, but let's not take any chance on her feeling uncomfortable because we want everyone to feel relaxed. That includes you too. Um, sometimes we need to push back against, um, unwanted words and behaviors that sometimes most, you know, I don't, yeah, it would be an exception not to push back. I think recruitment and selection when you're hiring people, I know it's a tight labor market. So you might be like, I don't want to put one more thing that I'm looking for because I can't eliminate everybody. But really, if you have the option of two people, you know, think about how you're assessing that potential new employee on, um, the, the, their ability to not only be well themselves, but, you know, how are they going to contribute or take away from the wellbeing of our team? Now, is this person smiling all the time? Uh, that is a positive, you know, that's positive energy. That's energy. That's great for her or him. And it's positive energy. I'd love to see on our team. Now you can't go and ask people, you know, a question like, you know, how many donuts do eat each day? That's not what I'm talking about. Uh, when I'm, you know, we're not going to get into their personal behaviors as much as we're going to try to weave through the answers they're giving you. And maybe even ask some questions directly like, Hey, in our workplace, um, we support each other's wellbeing. Can you give me an example of how you've supported your coworkers, uh, at your, at your current place of employment? Um, it's just think about how we're leveraging that opportunity. Now, of course, there's always even just getting the people to apply. So just getting the attention of people, um, one, if you know, you may want to ask if you're probably already thought of this, the people in your office to be asking around, and they're much more likely to ask their friends and family members when they are feeling like they have a good employer, but in your advertisements and your postings, are you saying anything that might help the candidates think that they're headed towards something that's going to be supportive of their health and wellbeing or their, um, or better work-life balance. There was a time where we would have our job postings. And at the bottom, we would say, uh, something like Johns Hopkins medicine offers a smoke-free campus. And it's both the way to say, Hey, we value like not having smoke around, but it was also kind of like, Hey, if you are a smoker, you better, you know, you need to think about this because you're about to get into a situation where you're not going to be able to smoke on our campus. Um, number five built environment. Are there physical cues that would, um, help improve health and wellbeing? I mentioned some of them earlier, you know, physical paint, physical pictures on the walls. Um, is there, you know, there's a break room. Is it cluttered and it's kind of dirty or is it, you know, not cluttered. And there's some, um, I don't know, a Rubik's cube on the table, but our built environment will influence our health and wellbeing traditions and symbols. Some places will bring donuts on Monday morning, which is kind of nice in a lot of ways, right? Maybe it's increasing camaraderie. It's, uh, maybe, you know, it's Monday and we know that people would rather, you know, still be weekend. But on the other hand, um, after that sugar high, what does it do to our energy level and our mood? Uh, what about the people in the office who have diabetes and maybe they love donuts and it's hard for them to say no. Is there another, uh, tradition that we could put in place? Um, so that maybe it's, um, supportive of everybody and not some people, uh, relationship development. Uh, we, we talked about peer support, uh, a culture connection point in the context of relationship development is a intentional effort by the employer to, um, uh, improve or foster healthy relationships. So an example would be like a secret Santa. Um, if people remember what that is, it's been a while since I've participated. You get the name of someone on the team and they don't know you're their secret Santa and they leave little gifts for you. It's a, it's a proactive way and not just leaving it to chance that, um, employees would be, uh, building, um, the relationships and then policies. Dr. Jamal mentioned earlier about a policy about not eating in the workstation. That's a great example about how to use policies to shape a norm. Um, I'm gonna, uh, uh, just highlight, uh, this recruitment and selection. I went through it kind of quickly, but I want to pause there because of, um, how important it is, uh, in this tight labor market that we get the attention of candidates and, um, and, and help bring those, uh, on who are going to not only do a great job, but be a great teammates when it comes to supporting the health and wellbeing of those around us. Um, anybody have any strategies for how they're, um, uh, going, undergoing, uh, engaging in recruitment that, uh, might reflect on this idea that work-life balance and wellbeing is important? That's a reminder. You can raise your hands and we can open your line, or you can feel free to use the chat. Okay, let me go to the next slide then. So in your worksheet on page, what is it, page, bottom of page five, oh I'm sorry, yeah, I think it's the bottom of page five. You'll see the, you have some space at the bottom of that page if you wanted to take any notes about your previous identified unhealthy behaviors. But if you go to the top of page six, you know, hey Kristen, can you help me out here because I have an access problem to page five electronically. Oh, there we go. Sorry folks, just catching up. Okay, top of page five and at the bottom we're, we've got some norms. If you can write in there which norms you want to shape and then take a few minutes to use those culture connection points that are defined on page five to figure out how you're going to shape that norm. Just as a recap, previously, you know, we spent a little time on breaks. We spent a little time on work-life balance. I'm going to zip my lip and give you guys a little time to take some notes. If you are done, if you want to put your favorite fruit or vegetable emoji into the chat box, that would be fine. We'd love to see your favorite fruits and vegetables. And if anyone has any questions, like the instructions sheet or my verbal instructions aren't clear, I'd be happy to answer them. So just to recap, one of the norms that we're shaping at Hopkins, the norm that we wanted to shape is for our employees to take a breath to help lower their stress levels. In particular, the norm was to make it acceptable and a normal practice to do the 4-7-8 breathing exercise. And then the four to six culture connection points I shared with you, they were the ones that had a pink check mark to the left of the list of 12. Okay so I'm going to assume that we have enough time. So would someone be willing to share what norm you want to shape or anybody, you could all type your norms and it might be interesting for each other to see what norms you're all working on. It might be very helpful for each other. That would be good peer support, by the way. You're going for gold there, Dr. Jamal, one hour lunch break rather than 30 minutes. Anybody else? If not, I think we're going to go with the idea of how can we use the norms, I'm sorry, how can we use the culture connection points to shape the norm of taking a lunch break? And let's not define the number of minutes because everyone might have a different goal of the number of minutes, if that's okay. Now Dr. Jamal, you shared the idea of using a policy to help. I'm wondering if anybody else could share an example of a culture connection point to help shape this. You allow me to elaborate on the lunch time. I understand that there is legalities to how many minutes here and there in terms of us being in California. Our legal limit is 30 minutes. We came to realization a while ago that the 30 minutes is really not enough for an employee to take a breath. By the time they heat up their food and they start eating, it will be done. So realize that really we have to shape our whole operation about giving them more leverage to go out, at least maybe drive or go about what they need to do in that hour and come back. And we have seen more productivity and more compliance with that whole hour that's given to all our staff. That's great. That's great. I'm glad to hear you're having a positive experience as you move toward that. I'm going to stay with the idea of how do we make it more normal to get a break. Now we could assume, we could say it's either a lunch break, it doesn't matter the amount of time, it might take 30 minutes, 60 minutes, I don't want us as individuals to get caught up in the amount of time, but you could also think about if there's other appropriate times the day to take a break. To your point, Dr. Rich, if you look at Melanie in the chat, she kind of talks about that. Let me see if I can find that. She says some of our staff choose to alternate coming in 30 minutes early and getting to leave 30 minutes earlier. Ah, okay. That's great. I hope that you're getting the outcome that you're looking for. If you don't know, it would be great if there was a way to get anonymous feedback. Why do I specifically say anonymous? It goes back to one of the earliest slides. We don't know exactly what's on our employees' minds, and they're not likely to share everything with their managers. It's just human nature that unless we have a very trusting relationship, we're probably not going to know everything that is on our employees' minds. I'm going to look at the culture connection point list, and I'm going to go down the list as it comes to breaks. I'm going to do the first one, and then I'd like people to chime in. This is a brainstorming exercise. As we're thinking about how we're going to recruit new employees, what are we doing to create a first impression to ... I'm sorry, that's the ... I'm going to start with recruitment and selection. I'm sorry. What are we doing in our recruitment and selection to help send the message to potential candidates what we're doing in the space of breaks? One obvious way is to literally tell them during an interview, this is part of the deal. Does anybody have any other ways that we should be ... What should we do in recruitment and selection to help our potential future staff know about what we're doing to support breaks I mentioned we're going to communicate verbally. I mentioned that you could put something in your job posting. When they come in for an interview, assuming it's not virtual, maybe show them where the breaks are. Maybe at that point, you can not only show them the physical room, but are there any ... This may sound corny, but microwave, refrigerator, linger on that for maybe more than a second or two to emphasize the point. Or if there's some employees who have a certain ritual at lunchtime, maybe someone goes out for a walk at lunch. Maybe highlight those practices during the interview process so that the candidate gets an idea, okay, it's not just a break room and it's not just a policy, but these are the ways that the people here are actually living this. Any other thoughts on that one? Does anyone have any other ideas using the culture connection points other than recruitment selection? We talked about communication and we talked about policies. That's three. This is probably a cheap one, but built environments, if you don't have a break room, you're not really sending a great message. That's four. Does the break room though, is it inviting? Is it clean or is it cluttered? Is it used partially as a storage room? Is there a window? If there's a problem with the physical structure of your break room, maybe you think about whether or not you can change things out with another room. I'm not saying spend $20,000 on a remodeling job, but maybe it just requires a little bit of thinking to make it a more inviting place to take that break. Any others before we move on? Okay. I'm going to move on then. Hey, with a show of hands, how many of you realize that Indeed, which is a job posting site, includes some ratings by employees that include work-life balance and culture? Could I see with a show of hands using the hand feature? Okay, so we have a couple people. Okay. All right, well, thank you for raising your hands. You can put them down. Yeah, I mean, this is the new reality. This is the new norm, actually. It's not just Indeed. I think it's also a site called Comparably. More and more of these employment-related sites are offering both quantitative and qualitative information for candidates. So you are now similar to restaurants. People are rating you on Yelp, like it or not, and 70% of Americans now use Indeed for their job search, and that's how important this has become. And this is just an example. I don't know if anyone's here from Kaiser. I didn't see. You don't have to tell me. I didn't look at the list of people, but I had to choose some healthcare organization. We talked about recruitment and selection and attracting and attaining talent, but how do we keep them? We've sprinkled in different messages and important nuances about how do we keep our talent. And I've been looking at, I mentioned at the introductions, I've been looking at this idea between retention and well-being, and there's a lot of information out there. There's also one more piece here. It's a report from the Surgeon General about mental health in the workplace and came out a few months ago. You know, depending on your level of interest, you might Google Surgeon General and mental health in the workplace. Excuse me. In that report, the Surgeon General calls out work-life balance as one of the most important factors. And it makes sense, especially given some of the previous data we saw. I'm thinking about the one where it was the second highest rated item that candidates look for in their future job. It's also makes sense when we all recognize that 60% of employees say the biggest stressor in their life is their job and that many people would be willing to take a pay cut in order to have better mental health. Now the Surgeon General has a framework for work-life balance, and it includes three ingredients. Many workers are, and I'm going to put all of them up there through this. Many workers are subject to variable and unpredictable work hours, and some of you may have more predictable work hours than others, but it is health care. We do have times where things aren't going as scheduled. And in the meantime, we've got life going on around us. Some of us are taking care of young kids. Some of us are taking care of elderly adults. Some of us have cars that need to go into the shop. And so it's really tricky to keep calm and support our well-being while trying to address the things going on inside the workplace as well as those outside of the workplace. Now I heard some contributions to our conversation earlier. Someone's offering that closes on Fridays at two. Someone's got a four-day work week. Those are examples of flexibility in the scheduling. There's other ways. It's a little bit more challenging, in my opinion, in health care to have flexible scheduling than it is in an office job, like an accounting firm, let's say. One of our colleagues today offered that they offer maybe a hybrid, like some day or days they're able to work remotely, probably not doing colonoscopies remotely. Think about how you're offering flexibility to your employees, obviously without harming the quality of the patient care, but if you're going to be able to close, if one practice is able to figure out how to close at two o'clock on Fridays, is there another practice that's able to have a four-and-a-half-day work week where different employees have different half days off? And maybe that half day is the half day that they're able to do their errands. Maybe it means staying an extra hour one day. I don't know, but if we can offer flexibility, it lowers the stress level and helps us manage the other parts of our life more easily. And thank you, John, for sharing your comments in the chat box. Okay. Sorry. Okay. The second block from the Surgeon General is about respecting work-life boundaries. I don't know about you, but many of us have done patient notes, electronic medical record, either a little bit earlier in the morning than we wanted to or late into the evening. There are definitely challenges for getting texts at home or emails at night. There are definitely challenges with separation, and it's not just physical separation. It's also psychological separation. I had one finance person contact me when she realized this was too much. She contacted me a day or two after doing laundry at like 10 o'clock at night and thinking about a spreadsheet. We have to be able to psychologically separate from work as well. It's not always easy. I mean, obviously, if something goes wrong with a patient one day, it's not going to ask me to brush that off. But are there things that we can do to help our colleagues psychologically separate from work? I mean, one might say that emailing in the evening is a physical connection to work, but I'd also say it's psychological because if you and your colleagues are in the habit of emailing each other work stuff in the evening, psychologically, you're thinking like, what's on my phone right now? So we need to figure out how to have separation so that when we're not working, we actually can be rejuvenating. We can actually get in both physical and mental rest. Thank you for sharing your different work schedules and compensation to tie to it. This is helping colleagues who are also tuned in today get new ideas. OK, last ingredient, autonomy over how and where we get work done. The where we talked a little bit about, if there's people in the office who are able to work remote for a half a day or a day, that's an example of that. Now, autonomy, people wanna have control. We all wanna be able to make our decisions, right? I mean, we all wanna be able to decide, do I want dessert or don't I want dessert? Telling someone every day, you can't eat dessert, you can't eat dessert, that's a recipe for a problem. When it comes to autonomy in our work in healthcare, some things are maybe negotiable and other things are not, right? It's not negotiable to use a clean needle, we have to use a clean needle, that is not negotiable. But what is negotiable? What can we give the people we work with control over so that they can have a say in how they do their work? When people have an input into their day, it helps bring their stress level down, it helps them feel more valued, it makes them feel more connected and respected. All of these things are helpful for their wellbeing. Any thoughts or questions about this? One of the things that we learned, especially after COVID for what you're saying is to give some of our employees that have the capability to have autonomy on what they're doing and when to do it, as long as they are performing and doing the job is to offer an open Saturday for administration. So, and that's by choice, completely by choice and flexibility. And so, what we do, we offer that Saturday to whoever has administrative work that they can catch up on and do whatever they need to if they need to take off during the week. So, they come to the office and we don't put a timeline on when they have to be, we give them the whole flexibility from seven o'clock in the morning until seven o'clock in the evening to go and perform whatever they need to perform and whatever hours they need to stay as long as they don't overstay, definitely. That has helped a lot of employees in taking off during the week when they need to, definitely not affecting our clinical flow. Yeah, that's a great example. I see how that ties across all three. You're showing flexibility, you're giving them some autonomy. I'm assuming that if someone's doing this like every other day, they maybe have a conversation with them. You're showing flexibility, autonomy, and you're respecting that there's things going on outside of their life where they need that time. I love that example. How big is your organization? So, we are three doctors and four mid-level providers in terms of providers. In terms of employees, we do have now 14 full-time employees and additional four that are part-time. We do have two offices in two different counties and a surgery center and a remote location. So, Dr. Martin, hey, we'll all go by first names today, if that's okay. John, I'm Rich. If you want me to call you Doc, just let me know through the chat box. John asked a question that, how do we see that this is being distributed fairly among members of the team? And if anybody wants to answer, John, either through the chat box, thank you, or take themselves off mute, I'm happy to. But in the meantime, there might be the technical ways of distribution fairly, and then there's the not-so-technical, psychological aspect of fairness. Now, fairness is important in our wellbeing and for some people it's more important than other people, but generally speaking, most employees want to feel as if they're being treated fairly. So this is an important issue. When people don't feel like they're being treated fairly, they become disenfranchised, less engaged, and more likely to be open to the possibility of working elsewhere, especially when they see this as a pattern. So if there's a favorite employee who seems to be getting special treatment, that might be great if you're trying to keep that person, but you might inadvertently be trying to, you might inadvertently be pushing other employees away. So for the sake of time, because we have a few more slides to get to, when you choose something like, can you take a half a day off during the week so that you can address family issues and then come in on Saturday, just make sure that you are communicating it to everybody and that if it seems that this person or persons are taking advantage of it, make sure that you address it, make sure people know your decision processes. What unfortunately happens is that people have the best intention, they think they're being fair and it's really a matter of communication. That is something that we should all be aware of. Okay, polling question. Advanced slide, Rich. Okay, Eden, can we get that up there? Okay, which one of these is your organization's biggest problem for work-life balance? Making scheduling flexible when possible, respecting boundaries between work and non-work or something else. And please vote. And depending on the votes, the outcome of this vote will... Okay, wow, okay. Which one of these organization's biggest problem is respecting boundaries between work and non-work? Would someone be willing to share what that means to you? Because I gave a couple of examples, but I don't know, be curious. Okay, actually, Eden, if you don't tell me there's anything, I'm going to go, we're going to go to the next activity. If you could turn to work-life balance activity on top of page six. You're going to write down the topic we just chose to work on. So the answer was separating the boundaries between work and non-work. So if you didn't answer the polling question and you're thinking of something else differently as a work-life balance problem, that's fine, you can put yours in. But just know that we're going to be expanding on this. Okay, so I'm wondering, can we get some ideas looking at the culture connection points, which means we might have to flashback a page. Can you think about how to use the culture connection points to better separate between work and non-work? And remember, it doesn't just have to be physical separation, it can also be psychological separation. So I will tell you what our team does. Not that you have to do this. We have hours before which we should not be emailing and hours after which we should not be emailing. And if someone's working, they should be working on their own and not letting other people know they're working. And part of that's not emailing. And it's worked out pretty well. I would say in the past two years, it's happened a couple of times in the last 12 months. And I've spoken to that person separately and it's the same person both times and six months is pretty good run. Great, we have Rula, if I'm saying your name correctly, you have something similar for timing. I don't know if it's policy, but it falls within the same genre. It's a rule, it's something that we ask of. Now, any other thoughts? Okay, we have another comment in the chat. Okay, keep it to Epic. And that way, if you're not logged in, you don't have to do that. You don't have to be exposed to it. I don't know what that means, Rula, personal choice. Oh yeah, yeah, okay. It's, so I wanna talk about personal choice, not just in separation of work and life, but just in general. Personal choice is great. And as we saw, the power of cultures can greatly influence the outcome of things. So someone might say, hey, it's my choice. Rich, if you don't wanna eat that bowl of chocolate, you don't have to eat that bowl of chocolate. And theoretically, that sounds great, but I have a sweet tooth and it's difficult for me. So even though it is my choice, if I have a good relationship with the people I work with, we will figure out a way that chocolate can be made available to people in the office without me having to see that bowl of chocolate. That's just kind of an example that may not be as serious as work-life balance, but for you to know that if we email after hours and we think it's only me doing the work, we may be inadvertently challenging the wellbeing of those we work with, because there may be an unspoken amount of pressure to reply and it may be difficult for some people not to allow these cues around us to impact our wellbeing. Ahmed, do you wanna take yourself off mute and we can explore this more, or I could also just kind of comment about different beliefs, whether they're religious or other practices. Okay. So, you know, there's the law, and then there's how are we working together as a group of people to both have a thriving practice in business, as well as happy and healthy employees who don't wanna leave and more who wanna come. And so different religions have different holidays and practices, and certainly we should be aware if we want to be the best practice and be the best employer, we need to be aware of them. We've all probably known about the importance of diversity and inclusion in our workplace longer than employee health and wellbeing has been respected. The two are intimately tied together. So, you know, it's in the practice's best interest of respecting employees' different religious beliefs, and at the same time, trying to make sure each employee is being treated fairly, which can be a little bit of a tight walk at some times, because let's say that one religion has a request that every month they have the first Wednesday off or something like that. And then another employee is denied every Wednesday off because somebody else is using them. We're not gonna have the answer to every scenario today, but know that one person's religious belief, we wanna try to respect it, and you need to balance that with the needs of the other people in the practice. I need to move forward in order to make sure we get through the... How many of you with a show of hands have ever had a bad boss? And if you could raise your hand, I'm raising my hand, use the feature in the chat to raise your hand. Okay. Anybody? I'm the only one who's ever had a bad boss. Okay, when I do this as a live audience, almost everybody raises their hand. And- You do have some hands raised, Dr. Rich. Yeah, thank you. Okay. When I do this in a live audience, almost everybody raises their hand. And when I say, hey, whoever's hand is raised, put it down. And then you see there's only a few people who've never... Most of us have had a bad boss. And what it comes down to for most people is that bad boss made us feel bad inside. They either didn't recognize us for the contribution we made, they didn't treat us fairly. Whatever it is, it's how we feel inside. And a bad boss can be the difference between going to the gym after work or going home and eating a bag of potato chips. And a bad boss could be the difference between having a good night's sleep and a restless night of sleep. So it's not just about role modeling. It's about how we're making other people feel. Let's take a look at how the people in our life are impacting our mental health. This is a research study from UKG, the HR company. I think I shared a survey question from them earlier today. 2,600 employees, and they can answer more than one person. So relationships and mental health, they could either positively impact mental health or negatively impact these employees' mental health. Half of employees said their doctor impacts their mental health. I hope you're not surprised that the number one answer is a spouse. But what I think will surprise you is that there's a tie. Just as many managers say, I'm sorry, just as many employees say their manager impacts their mental health as much as their spouse. And I found this shocking. I don't think most employees realize this. And I don't think most, sorry, managers realize this. And I don't think managers genuinely want to negatively harm the mental health of those they lead. But I'm pretty sure it's happening because I get most people raising their hand that they had a bad boss. So let's presume this guy in the middle is the boss. You know, what do we see here? He's smiling. Actually, everyone's smiling in this picture. I wanna just remind everyone that the emotions, our emotions impact those people around us. The emotions of the manager, the leader, have an exponential impact on the emotions of those they lead. And so we need to really, it's not just the folks here, we need to talk to our colleagues who are in a leadership position. We have to remind them. We have to make sure that we have our own way of checking in with our own emotions so that our emotions don't negatively impact those we lead or else people are gonna leave. Now, for me, it's a matter of recognizing that my shoulders are tense, my neck muscles are tense, or my eyebrows are furrowed. And then I take a deep breath, honestly, and I try to relax those muscles and that actually gets me in a better mood. Now, there are a whole bunch of things leaders can do, but I want you to recognize that it's not just like a leader being a role model of like, hey, I'm gonna go exercise or they come in the next day and say, hey, I went running the last night. That's great, but it's a lot to do with how we lead and how we make other people feel. Sometimes our employees are feeling overwhelmed and they're running from one thing to another which adds stress to our lives. So sometimes it's simple management skills like setting priorities that is the key to making sure that our employees feel that they're cared for and we lower their stress level. If we have too many things on our plate, then that is not good for our mental health. We really need, and many employees feel that they don't have the priorities spelled out to them. I don't know if you're already doing this, but if you're not, making sure that your employees have clarity about what the priorities are because in most practices, people are being pulled in multiple directions. It's like juggling multiple balls. Nobody wants to let any of the balls fall, but we may have to let a ball fall. We may have to take something off the plate. We may not be able to do everything that we want to do in a practice if we want to make sure that we are preserving our workforce. Listen, Michael Jordan was a great basketball player, but he also had a great coach. And it wasn't just because he was a great basketball player. I'm sorry, his coach, Phil, wasn't just a great coach because he won two NBA championships as a player himself. He was able to put himself in his players' shoes because he was a player. That's another piece. We just kind of need to slow down long enough to put ourselves in the shoes of those who we work with because when we can do that, we're better able to understand what they're going through, kind of like that TV show, Undercover Boss. Something to think about. Can we really put ourselves in their place? And that might help give us some insight as to what we could do differently to help them feel more supported. One very important responsibility of a leader is to remove speed bumps that our employees face during the day to their own wellbeing. Sometimes those speed bumps are obvious if the copy machine keeps getting jammed and someone has to take the piece of paper out and then try to find the small piece that got ripped and is still stuck in there. And that's going on for a period of time. That's really an unnecessary stressor, especially in a busy practice. But more often, those speed bumps are not visible. And the way to find those invisible speed bumps is to ask your employees. And when you ask your employees, if you have a good relationship with them, they will probably tell you more. They won't tell you everything, but they're more likely to tell you. And there are some other ways to get more feedback from employees. I mentioned one early, it's anonymity. And having them not have to answer in front of a group of people. If it's just you and that one person, they may be more likely to share that information. Then finally, if there's a peer champion, like a employee representative who could bring you information, that's another way to do that. We really want to get to the crux of the matter. And donuts on Monday morning in one hand is nice, but it may not be the real speed bump to the well-being of a day. Speed bumps, bottom of page six. So essentially thinking about and writing in to your worksheet, what are these speed bumps that are getting in? Maybe it's you. Maybe you could think about yourself for a second. What are your challenges with having a more well day? Because if you are feeling better, it's gonna help those you work with. And then we're not gonna have time to brainstorm this, but it's something that this worksheet, hopefully you're gonna go back to your colleagues and you will continue to expand on this with them so you can come up with a plan. So there is a leadership support section on page seven. And you may wanna be, you should spend some time with this. You can't do everything, but you could take some time out of your day. You're taking the Saturday morning out of your day. Maybe it's the next Saturday morning that you sit down and think about as a leader, what are you doing that you think you should continue doing and what should you stop doing? Because if you do too much, then you yourself, your own wellbeing is in jeopardy. And what is it today that you learned that you wanna start doing? The last building block is shared values. These are the, yeah, like you didn't have enough of seeing my face this morning, now it's on a slide. The shared values are the values that are shared between the employer and the employees. This is important that we recognize that both sides think it's valuable. This is a great book. If you're interested, you don't really have to read it, but I'll just tell you that there's not just this book, but books written on the importance of values. Values are like the lines on the side of the road. They keep us pointed in the right direction. They keep us making sure that our business decisions are made so that everyone's priorities, it's another word, the values or priorities are respected. Kind of like when my wife and I met, my wife, I told you about before, she exercised, I exercised, we both value exercise. That was something that attracted us to each other like two halves of a cookie. My attempt at a sense of humor, but the reality is sometimes the values are determined by the leaders only, or if you're a big organization, the board of directors and not by the employees or the employees don't have input. And unfortunately too often the value of wellbeing is not part of the organization's fabric. So if you are big enough, or even if you're not big, but you have already thought about your values, go back and read them and ask yourself, is our health and wellbeing part of our values? And if not, I would suggest you consider making them part of your values because those organizations that do have wellbeing as a value are much more successful on a variety of levels. The obvious level is that employees feel better about their health and wellbeing being supported, which means organizational success. And organizational success can mean lots of different things, including in that book, he gave a number of examples about the value of the stock prices going up. We're gonna skip through this because of the timing. Actually, does anybody, there's a chat thing, let me just check here. Okay, John commented on multiple fates. Yes, coverage for holidays, I agree. Thank you. So we're gonna go past this, but if anyone has a question or a thought on shared values or has a shared value that they want to put in the chat box for your colleagues, we'd love to see it. So, you know, at the beginning of our time together today, I talked about this culture framework and I spent time going through each of the building blocks. Sometimes I felt like I was going a little fast, I apologize, and we heard the definitions. We tried to understand the power of each of these. It really can't be done thoroughly. Three hours is a long time, but as you can probably get the sense, there's a lot more behind this and there is. I'll tell you in my 25 years in the employee health and wellbeing space, I will tell you the biggest missing piece is the role of leaders at all levels in creating this wellbeing culture. This work cannot be done by any one person alone. Each person plays a role in the health and wellbeing of the people in the workplace. You know, it's a little bit daunting, this idea of changing the way we do business. When I think about some of the things I've come across over the years, for example, in the last six months, I looked at about a half a dozen different core curriculum from MBA programs at highly prestigious institutions. And in the MBA core curriculum is at least shared online. There's courses on accounting and finance and communications. They don't take a course on employee health and wellbeing. And there's a good chance that when you became a doctor or a nurse or a practice leader, you also did not get trained on how to support health and wellbeing. HR, that's, you know, their job is to support the employee experience. If you wanna get certified by SHRM, they suggest you study their workbook. And, you know, diversity and inclusion, equity, that is related to wellbeing, but it is not exactly wellbeing. And yet still, this is not part of their mission either. We, as a country, have come some way. We've kind of been forced into it, accelerated because of the pandemic, even though this work has been going on since the 1950s. So I want you to know that you showing up today is a huge step forward that many people are not taking. We have, I think, one final polling question. Does your organization, this doesn't count, this morning, do you guys train any of your leaders for this idea of supporting wellbeing in your workplace? Okay, so we had a few who said voluntary training. We had no, a few who said no, an equal amount, and one who said yes to mandatory training. Okay, thank you for participating. Let me show you when, probably, it was in the spring, I did a training program for a couple of years. I did a training program in the spring for HR leaders across the country, and this is how they answered. These are HR leaders. Two-thirds offered no training. And you saw that, you know, in our smaller sample, it looked like 37% or something like that. In our smaller training, we had, our smaller sample, we had more of you saying that you offered training. But really, across more organizations, a bigger sample size, only 2% offered mandatory. There's basically, this isn't happening. I'm gonna just kind of skip past this one. It's really about, well, listen, the final message here is, you can't do this alone. Great leaders aren't just great leaders because they are that talented by themselves. Great leaders need to ask for help, and they need to go seek help. And so, if you have multiple leaders in your practice, and here are some ideas. We talked about peer support to build a connection and psychological safety. Choose a peer amongst the workforce who might be your champion. This person can both convey messages, like what are the resources available? What are we trying to achieve? They can also get input. You know, what's the feedback coming from the team or the workforce? Think about what speed bumps are getting in the way of having a well day. Do you have a broken copy machine? This has to do with like practice efficiencies, which I'm sure you guys have been working on. You know, if you're like most practices, you've been working on it. And I just want to respect that this is hard work looking for practice efficiencies, but it's also work that impacts well-being. If you go to YouTube and you search 10-minute well-being tips for managers, and you hyphen Hopkins maybe, you will find 46 episodes on 10-minute well-being tips for managers. I mentioned it earlier. You will see different topics if you're interested to help enhance your understanding of how to create this well-being culture. And then we were quickly trying to work on shaping a norm, a well norm on our teams. And then, yeah, this was some kind of cute message, but given that we're out of time, I'll just leave you with this. If you have any questions you want to ask me outside of this forum, you have my email address here. If you want to read more on my website, there are a bunch of articles there on richardsophere.com. And I post on employee health and well-being a couple of times a week on LinkedIn. I'm going to stop sharing. I'm sorry, the last five, probably 10 slides were a little bit of a rush. And what can I do for you in the last four minutes? So we'll see if any questions come in. Dr. Heikes, would you like to turn on your camera and join us, and do you have any comments to add? Well, thank you so much for your active participation and those insightful discussions. Dr. Sophia, thank you for your expertise. And let's continue to apply what we've learned today to improve practices and patient care. Thanks. Best wishes to each of your own well-being. And I'm sure the healthier and more well you are, the more the people you work with will appreciate you. Have a great day, everybody.

culture of well-being

workplace

leaders

mental health

employees

stress levels

flexible scheduling

work-life boundaries

autonomy

speed bumps

shared values