This page introduces resiliency concepts and contains articles, tools, personal resilience resources, and guides for organizational programming. These resources have been selected to help health centers and Primary Care Associations, as well as individuals employed in these organizations, practice strength, compassion, and mindfulness as they build resiliency skills.
Also explore the CHAMPS Dimensions of Wellness Resources webpage.
If you utilize a resiliency resource appropriate for health center staff that is not listed on these webpages, please contact the CHAMPS Programs Coordinator, Population Health.
Please click or scroll down for:
Introduction
Articles and Reports
Personal Resources
Organizational Resources
Education and Training
Other Resources
INTRODUCTION
The American Psychological Association (APA) considers resilience to be the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant sources of stress.
The health care field presents a unique set of challenges for health care workers of all types, from providers to non-clinical health care staff. As a result, burnout has become pervasive. Resilience is fundamental to enhancing quality of care and sustainability of the health care workforce.
Staff at Region VIII health centers also express feelings of burnout as seen in data collected by CHAMPS and state Primary Care Association (PCAs) partners. Some highlights from the 2019 Region VIII Health Center Recruitment & Retention Survey Report are below. The survey asks respondents to identify “factors influencing job satisfaction and engagement at work” including items related to resiliency and burnout, such as workload, scope of practice, panel size, available administrative time, team-based care environment, resiliency activities/programs, organizational capacity for change, etc.
- Over 35 percent of respondents who indicated they planned to leave their job within a few years selected “feelings of burnout” as part of the reason for their planned departure.
- Among physicians who were planning to leave their job within three years, over 53 percent indicated “feelings of burnout.”
- Among Physician Assistants who were planning to leave their job within three years, almost 82 percent indicated “feelings of burnout.”
In addition, according to Region VIII Health Center Training & Technical Assistance Needs Assessments:
- “Burnout” consistently ranks in the top five challenges/ concerns for health centers.
- “Burnout Prevention” consistently ranks as a high-need topic for health center support.
American Psychological Association (APA)
Building Your Resilience
Information including background on what resilience is.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
The Impact of “Physician Burnout”
Introductory information on what physician burnout is, its impact in health care, and some possible solutions to end it.
National Institute of Mental Health (NIMH)
5 Things You Should Know About Stress
Five quick facts about stress and information on addressing it.
ARTICLES AND REPORTS
Academic Medicine
Physician Resilience: What It Means, Why It Matters, and How to Promote It
Commentary that proposes methods for enhancing individuals’ resilience while building community, as well as directions for future interventions, research, and institutional involvement. (March 2013)
Annals of Family Medicine
In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices
Highlights primary care innovations gathered from high-functioning primary care practices believed to facilitate joy in practice and mitigate physician burnout. (May/June 2013)
Community Health Association of Mountain/Plains States (CHAMPS)
Region VIII Health Center Recruitment & Retention Survey Report
Information vital to strengthening and enhancing successful recruitment and retention strategies already in place, and to developing new and innovative ways to support successful recruitment and retention of staff in an era of dynamic program expectations and ongoing challenges in finding, and keeping, highly qualified employees. (2020)
Evergreen Health
Wellness Articles
List of articles that address physician wellness and offer insights and suggestions that may be useful.
Harvard Business Review
Burnout is About Your Workplace, Not Your People
Article on the organizational responsibility to address burnout. (December 2019)
National Academy of Medicine (NAM)
Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care
Discussion paper on the extent of burnout among health care professionals, why the health care community should be concerned, and how to address the problem. (July 2017)
Burnout and Job Career Satisfaction in the Physician Assistant Profession: A Review of the Literature
Discussion paper exploring the literature that relates specifically to PA burnout and career and job satisfaction. (December 2018)
Gender-Based Differences in Burnout: Issues Faced by Women Physicians
Discussion paper that reviews the prevalence of burnout in women physicians and contributing factors to burnout that are specific for women physicians. (May 2019)
Implementing Optimal Team-Based Care to Reduce Clinician Burnout
Paper which describes key features of successful health care teams, reviews existing evidence that links high-functioning teams to increased clinician well-being, and recommends strategies to overcome key environmental and organizational barriers to optimal team-based care in order to promote clinician and patient well-being. (September 2018)
Nurse Suicide: Breaking the Silence
Discussion paper describing an initial exploration to uncover what is known about the prevalence of nurse suicide in the United States with the goal of breaking through the culture of silence regarding suicide among nurses. (January 2019)
Organizational Evidence-Based and Promising Practices for Improving Clinician Wellbeing
Discussion paper describing six steps health care organizations should take to advance their clinicians’ resiliency. (November 2020)
The New Yorker
How People Learn to Become Resilient
Article on the origins of studying resiliency and ways people can learn to be resilient. (February 2016)
STAT
Medical Education Needs to Stop Burning Out Students — Now
Article about how medical education creates exhausted and unhappy students who become interns, residents, and physicians at increased risk of depression and burnout. It also addresses what medical schools should do to address this. (August 2019)
The Wall Street Journal
Physician Burnout is Widespread, Especially Among Those in Midcareer
Article on the higher rates of burnout experienced by physicians between the ages of 40 and 54. (January 2020)
PERSONAL RESOURCES
Accreditation Council for Graduate Medical Education (ACGME)
Tools and Resources for Resident and Faculty Member Well-Being
Page which includes tools and resources to support institutional and program efforts to improve faculty member, resident, and fellow well-being. This includes a suite of new ACGME-created resources and a compendium of materials compiled by the ACGME’s Task Force on Physician Well-Being Tools and Resources Subcommittee.
American Psychological Association (APA)
Building Your Resilience
Roadmap for adapting to life-changing situations, and emerging even stronger than before.
The Atlantic
How to Build a Life
Column about pointing yourself toward happiness.
Bobby Berk
Mental Health & Wellness: The Best Apps & resources for Self Care
Compilation of resources to help individuals expand their existing wellness and mental health practices or get folks started.
Brené Brown
Unlocking Us Podcast
Conversations that unlock the deeply human part of who we are, so that we can live, love, parent, and lead with more courage and heart.
Chris Germer
The Mindful Path to Self-Compassion
Book that illuminates the power of self-compassion and offers creative, scientifically grounded strategies for putting it into action. This website also includes free audio downloads of the meditation exercises.
Community Health Association of Mountain/Plains States (CHAMPS)
Patient Education Handouts
Handouts available in English and Spanish including those on Deep Breathing, Guided Imagery, Mindful Meditation, Stress, and the Tense and Relax Method.
Community Health Association of Mountain/Plains States (CHAMPS)/Western Montana Area Health Education Center (WMT AHEC)
Building Resiliency Skills Learning Community: Walking Together Towards Healing in a Time of Collective Loss
This learning community sponsored by the Rocky Mountain Public Health Training Center (RMPHTC), provided health centers and Primary Care Associations (PCAs) in Region VIII (CO, MT, ND, SD, UT, WY), as well as other healthcare organizations in Montana, access to four, 60-minute interactive learning sessions focused on building individual resiliency skills. Recordings of the didactic portion of each session are available below.
Understanding the Impact of Collective Loss
Mary-Ann Bowman, PhD, Associate Professor, School of Social Work, University of Montana
Click HERE to access the online archive recording for this event.
Click HERE to download the slides.
Trauma and Resiliency
Molly M. Molloy, LCSW, Director, Western Montana AHEC
Click HERE to access the online archive recording for this event.
Click HERE to download the slides.
The Mindful Present
Gina Pate-Terry, LCSW, LAC, Integrated Behavioral Health Lead, Montana Primary Care Association
Click HERE to access the online archive recording for this event.
Click HERE to download the slides.
Positive Psychology in Difficult Times
John Sommers-Flanagan, PhD, Professor, Department of Counseling Education, University of Montana
Click HERE to access the online archive recording for this event.
Click HERE to download the slides.
Community Health Centers, Inc.
Dr. Jay’s Peaceful Abiding
Meditation and mindfulness for healthcare providers in English and Spanish.
Dr. Kristen Race
Free Mindfulness Practices
Scripts and audio files of free mindfulness practices.
Gaiam
Five Yoga Poses to Relieve Stress
Five poses that can be done individually or in a sequence that can help calm both the body and the mind.
Meditation 101: Techniques, Benefits, and a Beginner’s How-To
Guide that walks through the benefits and the how-tos of meditation as well as some tips on how to get started.
Greater Good Magazine
Mindfulness: Articles & More
List of articles, podcasts, resources, and more to help build individual, familial, and community resiliency.
Tips for Keeping a Gratitude Journal
Article with tips from Robert Emmons on how to reap the greatest psychological rewards from a gratitude journal.
Why Gratitude is Good
Article on why gratitude is good four the body, the mind, and relationships.
Health Outreach Partners (HOP)
The COVID-19 Pandemic and What it Taught Us: Collective Trauma and Moving Forward
In this eight-episode podcast series, the impact of the COVID-19 pandemic on mental health and wellbeing is explored.
Institute for Healthcare Improvement (IHI)
Using the Psychology of Change to Enhance Joy in Work
Information on a team that employed the psychology of change to improve their joy in work.
Matthew S. Bennet
Self-Care in the Struggle
Article including a training regimen for self-care during the “revolution” of caring and advocating for the underserved.
The Mayo Clinic
Meditation: A Simple, Fast Way to Reduce Stress
Information to help individuals understand meditation and its benefits, the types and elements of meditation, and skills for everyday practice.
Mindful.org
Five Steps to Mindfulness
Article on mindfulness with information on exercises such as mindful breathing, concentration, awareness of your body, and more.
Mindful Life Today
Mindfulness Techniques
Step-by-step, simple, brain-based Mindfulness techniques guided by Dr. Kristen Race to help you flourish in our stressed-out, fast-paced world.
Mind Tools
Avoiding Burnout: Maintaining a Healthy, Successful Career
Toolkit that walks through an overview of the signs and consequences of burnout and how to avoid burnout in professional life.
Recovering from Burnout: Finding Passion for Your Role Again
Toolkit that describes the effects of burnout and details steps and strategies to begin recovering from burnout.
National Academy of Medicine (NAM)
Individual Strategies to Promote Well-Being
Information on strategies like mindfulness, meditation, and strengthening one’s own skills and abilities to promote well-being.
National Association of Community Health Centers (NACHC)
Self-Care Resources
Resources including pre-taped virtual yoga classes, guided meditation moments, and tips on healthy eating from a licensed dietitian.
Nine Types Co.
Nine Types of Rest
Article describing nine types of rest and how rest may be more easily accessible with a little bit of intention and planning.
On Being
A Care Package for Uncertain Times
Collection of podcasts, poetry, meditations and reflection for processing uncertainty.
Project Happiness Global
Home Page
Resources designed to help empower people to create greater happiness within themselves and the world.
Salem Publishing Solutions
Recapturing Joy in Medicine
Book containing a prescription for physicians who are practicing medicine during a time of crisis in the healthcare industry; one that is fueling an epidemic of physician burnout.
Self Compassion – Dr. Kristin Neff
Home Page
Information and resources to help individuals build on self-compassion.
Ten Percent Happier
Home Page
Mobile app to help people learn to meditate to be happier and healthier.
Thrive Global
Wellbeing
Resources focused on well-being for first responders and useful for others.
University of California, Berkeley
Mindful Moments
Information on the benefits of mindfulness as well as a scripted mindfulness exercise for individuals or to start meetings.
Women’s Health
The 12 Best Meditation Apps for 2020
List of meditation apps with information on each one.
Yoga with Adriene
Yoga with Adriene
Free online guided meditation and yoga videos.
Zenful Spirit
Meditation for Beginners: A Comprehensive Guide
A guide intended to introduce meditation in a way that is accessible to everyone, so that all can explore this gratifying practice in a way that will nurture their life and connect them to others.
ORGANIZATIONAL RESOURCES
Well-being is the ability of individuals to address normal stresses, work productively, and realize one’s highest potential. According to the Centers for Disease Control and Prevention (CDC) Engaging Employees in Their Health and Wellness webpage, “employees in good health are more likely to deliver optimal performance in the workplace.” These employees also have increased work productivity and are more likely to contribute to their communities. A work environment that puts focus on wellness can also build resilience within the staff.
Incorporating wellness activities into daily staff routines can build a strong and resilient workforce. An official staff wellness program, usually offered through the workplace, is intended to improve and promote health and fitness and can include wellness events, services, and resources. Staff wellness programs can help improve employee relationships, increase connections to corporate values, and promote leadership. Active engagement and participation from all staff is needed to make these programs beneficial. For more information, including ways to engage employees in elements of a comprehensive worksite wellness program, visit the CDC’s Engaging Employees in Their Health and Wellness webpage.
Click or scroll for:
Sample Staff Wellness Plans/Policies
Additional Organizational Resources
Sample Staff Wellness Plans/Policies
Centers for Disease Control and Prevention (CDC)
Current Practices in Worksite Wellness Initiatives
Highlights efforts by six state health departments to create healthier community environments through worksite wellness initiatives.
Siouxland District Health Department
Sample Policies for Worksite Wellness
Sample policies for general wellness, tobacco free workplace, and breastfeeding that can be modified to fit an organization’s worksite needs.
Workable
Employee Wellness Program Policy
Employee wellness program policy that is ready to be tailored to an organization’s needs.
Additional Organizational Resources
American Hospital Association
The Clinician Well-Being Playbook
Playbook on well-being tailored specifically for health system leaders to address burnout in their organizations. It contains seven key steps for success and provides real-world case examples of successful interventions deployed in various health system settings to illustrate the steps. (May 2019)
British Medical Journal
How to Have Joy at Work
Podcast featuring two experts discussing joy at work – what the concept means, and practically how organizations can start implementing it.
Centers for Disease Control and Prevention (CDC)
Engaging Employees in Their Health and Wellness
Webpage with information on achieving wellness program engagement including opportunities and resources.
Health Outreach Partners (HOP)
Self-Care: Taking Care of Ourselves So We Can Take Care of Others
Resource with self-care practices, its benefits, and strategies to build a culture of self-care that supports staff health and well-being and helps health centers recruit, motivate, support, and retain staff.
Health Resources & Services Administration (HRSA)
Improving Well-Being Among Primary Care Trainees, Faculty, and Clinicians: Optimizing Systems to Mitigate Burnout, Promote Resilience, and Drive Quality of Care
List of recommendations to aid in improving well-being and resiliency for primary care staff.
Special Edition Digest – Workforce Engagement & Well-Being, Vol. 1
Special edition of the Primary Health Care Digest that provides health centers with tools and resources, including promising practices, to promote a healthy and engaged workforce. (May 2019)
Special Edition Digest – Workforce Engagement & Well-Being, Vol. 2
Special edition of the Primary Health Care Digest that provides health centers with tools and resources, including promising practices, to promote a healthy and engaged workforce. (May 2019)
Institute for Healthcare Improvement (IHI)
Why Is “Psychological PPE” Important for the Health Care Workforce?
Recommended evidence-based “psychological PPE”— individual and system-level actions to safeguard and support the mental health and well-being of the health care workforce.
Minnesota Department of Health
COVID-19 and Healthcare Responder Stress
Information on healthcare responder stress, the stress cycle, stress reactions, and tips for personal stress management that can be applied beyond the COVID-19 pandemic.
National Academy of Medicine (NAM), Action Collaborative on Clinician Well-Being and Resilience
Home Page
Network of more than 60 organizations committed to reversing trends in clinician burnout composed of six working groups. The group meets to identify evidence-based strategies to improve clinician well-being at both the individual and systems levels.
Action Collaborative on Clinician Well-Being and Resilience – Video Recordings and Presentations
Recordings and resources from a public meeting which featured expert panels on issues related to redesigning the clinical learning environment.
Utilizing a Systems and Design Thinking Approach for Improving Well-Being within Health Professions’ Education and Health Care
Paper highlighting two approaches—design thinking and systems thinking—that could be used for developing strategies to address stress and burnout and to improve the well-being of students, trainees, faculty, and health care professionals.
Valid and Reliable Survey Instruments to Measure Burnout, Well-Being, and Other Work-Related Dimensions
Summary of established tools to measure work-related dimensions of well-being.
Office of the United States Surgeon General
Consequences of Health Worker Burnout Graphic
This webpage contains an infographic that details how health worker burnout negatively impacts health workers, patients, health care systems, and communities.
Factors Associated with Health Worker Burnout Graphic
Infographic detailing what systems-level factors contribute to health worker burnout.
Solutions to Health Worker Burnout Graphic
This webpage contains a graphic that details the ways individuals, communities, and organizations can work together to reduce health worker burnout.
Surgeon General’s Advisory Addressing Health Worker Burnout
A short video capturing the urgency and toll of health worker burnout by the U.S. Surgeon General.
STAR² Center
Burnout Assessment
Tool meant to help organizations identify strategies that may improve success with provider retention. Using responses, the tool will provide brief recommendations.
Workforce Self-Care Resources
This resource repository is meant to serve as a starting point for organizations to grow their support of self-care of their workforce and includes an ever-growing clearinghouse of resources for individuals to engage in self-care.
Student Training and Education in Public Service
Mental Health and Wellness Guide for Public Service Professionals
Health care worker specific information and general information for public servants.
Substance Abuse and Mental Health Services Administration (SAMHSA)
24/7 Disaster Distress Hotline: 1-800-985-5990
A Guide to Managing Stress for Disaster Responders and First Responders
Guide that provides tips to help disaster response workers prevent and manage stress while on assignment. It includes strategies to help responders prepare for their assignments, take stress-reducing precautions, and manage stress in the recovery phase.
Thrive Global
Well-Being
Resources focused on well-being for first responders.
U.S. Equal Employment Opportunity Commission (EEOC)
EEOC’s Final Rule on Employer Wellness Programs and the Genetic Information Nondiscrimination Act
Information on the rule that employers may provide limited financial and other inducements (also called incentives) in exchange for an employee’s spouse providing information about his or her current or past health status as part of a wellness program, whether or not the program is part of a group health plan.
EEOC’s Final Rule on Employer Wellness Programs and Title I of the Americans with Disabilities Act
Information on the rule that employers may provide limited financial and other incentives in exchange for an employee answering disability-related questions or taking medical examinations as part of a wellness program, whether or not the program is part of a health plan.
Small Business Fact Sheet: Final Rule on Employer Wellness Programs and Title I of the Americans with Disabilities Act
Information on the amendment to the regulations and interpretive guidance implementing Title I of the ADA as they relate to employer wellness programs.
Small Business Fact Sheet: Final Rule on Employer-Sponsored Wellness Programs and Title II of the Genetic Information Nondiscrimination Act
Information on the amendment to the regulations and interpretive guidance implementing Title II of the Genetic Information Nondiscrimination Act (GINA) as they relate to employer wellness programs.
EDUCATION AND TRAINING
American Medical Association (AMA), Steps Forward
Physician Well-Being: Protect Against Burnout and Encourage Self-Care
Self-paced training with CME available designed to meet the educational needs of practicing physicians, practice administrators, and allied health professionals in addressing burnout.
Community Health Association of Mountain/Plains States (CHAMPS)
Slides
Self-Care Action Plan
Recorded webinar to help Care Coordinators learn strategies to embrace resilience, well-being, and self-care.
Staff Wellness Best Practices Interview Series
Series highlighting interesting and innovative ways that Primary Care Associations (PCAs) and health centers in Region VIII are addressing staff wellness as a component of supporting employee satisfaction, engagement, and retention.
Working on Wellness On-Demand Learning Modules
Pre-recorded modules for health center and primary care association staff to engage with educational content on promoting resiliency and wellness.
Coursera
The Science of Well-Being
19-hour course from Yale University with a free option. In this course, students will engage in a series of challenges designed to increase their own happiness and build more productive habits.
Migrant Clinicians Network (MCN)
Witnessing (Part 1 of 2): Understanding the Effects of Overexposure to Stories of Trauma and What to Do About It
Recorded webinar that provides an overview of empathic stress, moral injury, and microaggressions, and describes coping strategies for both providers and clients. The speaker discusses the role of clinicians, therapists, social workers, and other “witnesses” and “helpers” and the impact that witnessing has on the behavioral health of the witness. (October 2019)
National Academy of Medicine (NAM), Action Collaborative on Clinician Well-Being and Resilience
Meetings and Events
List of past events including case studies and national meetings with links to each events’ page.
Rocky Mountain Public Health Training Center (RMPHTC)
Resilience Toolkit
Online toolkit to help define resilience accurately, explore how stress manifests, and examine how best to exhibit resilience through the effects of stress.
STAR² Center
Administrative Strategies to Reduce Burnout
Five-part webinar series that highlights some common challenges in primary care settings that lead to burnout and identifies areas for intervention and innovation at the personal and organizational levels to reduce burnout and promote retention.
Burnout 201
Six-part webinar series addresses topics such as team-based care and the role of provider satisfaction, clinician experience, and how the physical set up of a space contributes to provider satisfaction and reduces burnout.
OTHER RESOURCES
National Health Care for the Homeless Council (NHCHC)
Provider Burnout
List of resources aimed at addressing the challenges of burnout prevention in the workplace.
STAR² Center
Burnout
List of articles, tools, websites, recorded events, and more that focus on addressing health care provider burnout.
Substance Abuse and Mental Health Services Administration (SAMHSA)
Spotlight: Building Resilient and Trauma-Informed Communities – Tarpon Springs, FL: A Community Journey Towards Resilience
Brochure featuring an asset-based approach to developing trauma-informed care communities.