Showing papers on "Culture change published in 2015"
Book•
01 Jan 2015
134 citations
TL;DR: In this paper, the authors focus on peer mentoring circles for women STEM faculty at a large, midwestern research university and find that participants reported diverse, context-dependent mentoring needs and expressed interest in communicating issues raised in the circles to administrative leaders.
Abstract: Higher education institutions often use mentoring to socialize faculty members into their academic disciplines and to retain them. Mentoring can also be used to change organizational culture to meet the needs of historically marginalized faculty members. In this article we focus on peer mentoring circles for women STEM faculty at a large, midwestern research university. Participants reported diverse, context-dependent mentoring needs and expressed interest in communicating issues raised in the circles to administrative leaders. A workshop for circle participants and administrators led subsequently to college-wide teams that addressed problems identified in the circles. We conclude that peer mentoring as a means to facilitate institutional change has great potential.
111 citations
TL;DR: Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges, which require reframing of norms and expectations, and the development of novel and flexible solutions.
Abstract: Purpose of the Study:
To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care.
81 citations
TL;DR: In this paper, the authors call for future work in behavior analysis, emphasizing the importance of organizational leaders' decision-making behaviors in establishing organizational practices that support prosocial behavior and eliminate aversive conditions within cultural systems.
Abstract: Social responsibility looms as a key feature of leadership decision making and citizenship behavior as the world’s resources are depleted, health and education crises increase, and communities, societies, and cultures adapt to a new context shaped by emerging technologies, political upheavals, global warming, and other drivers of behavior change In this article we call for future work in behavior analysis, emphasizing the importance of organizational leaders’ decision-making behaviors in establishing organizational practices that support prosocial behavior and eliminate aversive conditions within cultural systems The discussion expands on recent behavior analytic literature on cultural change and leadership behavior by first providing a summary of popular definitions of human well-being and relating this concept to prosocial behavior By drawing upon these definitions, we then summarize the behavior analytic concepts of metacontingencies and macrocontingencies as a framework from which behavior analysts
53 citations
TL;DR: In this article, an integrative approach to managing safety has been proposed which is based on a combination of the behavior change and culture change approach to safety, and the key features are a data-based and participatory problem-solving process and an explicit culture change process.
41 citations
TL;DR: In this paper, a pragmatic research philosophy and corresponding grounded theory methodology were used to generate a practically-meaningful model of this culture change process from the perspective of UK-based professional team managers.
37 citations
TL;DR: Findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust to predict better social integration and mental and functional health outcomes for nursing homes residents.
Abstract: Objectives. T esting a model based on past research and theory, this study assessed relationships between facility char acteristics (i.e., culture change efforts, social workers) and residents’ social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Methods. Data were collected at nursing homes using a planned missing data design with random sampling tech niques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. Results. The best fitting multile vel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents’ social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes.
34 citations
Journal Article•
TL;DR: In this paper, a new business model for advancing NASA human health and performance innovations is described, including the adoption and results of open innovation initiatives, the challenges of culture change and the development of a knowledge management tool to educate and engage the workforce in the new strategy and promote culture change.
Abstract: OVERVIEW:This paper describes a new business model for advancing NASA human health and performance innovations and demonstrates how open innovation, including the use of crowdsourcing and technology solution sourcing services, shaped its development. A 45 percent research and technology development budget reduction drove formulation of a strategic plan grounded in collaboration. We describe the strategy execution, including adoption and results of open innovation initiatives, the challenges of culture change, and the development of a knowledge management tool to educate and engage the workforce in the new strategy and promote culture change.
33 citations
TL;DR: A literature review was conducted to critique conceptual and methodological understandings of consistent assignment to advance the state of the science of research on consistent assignment and inform current practice and policy.
Abstract: Many national organizations consider consistent assignment of nursing staff to residents in nursing homes an important strategy for improving quality of care and quality of life for residents (Advancing Excellence, 2012; American Health Care Association, 2012; Koren, 2010b; Leavitt, 2006; Pioneer Network, 2011; Quality Partners of Rhode Island, 2004), and some states have even included consistent assignment as target goals in their pay for performance programs (Colorado Department of Health Care Policy and Financing, 2011; Commonwealth of Massachusetts Office of Health and Human Services, 2012). Furthermore, consistent assignment is a central strategy in the culture change movement, a national effort to improve nursing home environments by transforming traditional, institutional culture to one that is home like, where residents are able to receive person-centered care according to their preferences and customary routines (Doty, Koren, & Sturla, 2008; Koren, 2010a; Pioneer Network, 2011). Culture change advocates believe consistent assignment fosters strong, trusting relationships between staff and residents and enhances ability of staff to better “know” residents, their needs and preferences, and to provide care in meaningful and person-centered ways (Advancing Excellence, 2012; Koren, 2010a; Pioneer Network, 2011).
The practice of consistent assignment of nursing staff to residents has intuitive appeal, and anecdotal reports suggest that it leads to better quality of care outcomes, stronger relationships between staff and residents, and a more stable and committed workforce (Albright, 2009; Farrell & Frank, 2007; Farrell, Frank, Brady, McLaughlin, & Gray, 2006; Kaldy, 2011; Rahman, Straker, & Manning, 2009). However, research demonstrates an inconsistent link between consistent assignment and outcomes, with studies demonstrating improvements, as well as not changing, and even worsening outcomes. A recent review of consistent assignment outcomes noted methodological limitations may be influencing this inconsistency (Rahman et al., 2009). In order to explore reasons for varied results and advance the state of the science, it is necessary to have a thorough understanding of conceptual and methodological inconsistencies found in this research. The purpose of this review is to summarize and critique the conceptual and methodological inconsistencies in research on consistent assignment. This review will answer two questions:
1. How has consistent assignment been conceptualized and defined in research?
2. What are the methodological limitations in current research on consistent assignment that may contribute to inconsistencies in outcomes?
30 citations
TL;DR: The authors examined the assumptions of culture homogeneity within nations and its stability in the current global context by using a sample of 720 respondents (207 in Canada, 263 in the US) and found that the assumption of homogeneity was false.
Abstract: This study intends to examine the assumptions of culture homogeneity within nations and its stability in the current global context. First, by using a sample of 720 respondents (207 in Canada, 263 ...
28 citations
TL;DR: In this article, the authors describe a long-term intervention aimed at creating a winning culture in a national orienteering team that took place as an integrated part of the athletes' training and competition environment.
Abstract: Organizational culture is an emerging topic in sport psychology and recent literature has argued that creating and maintaining high-performance cultures is a key function of the sport psychologist. This article describes a long-term intervention aimed at creating a winning culture in a national orienteering team that took place as an integrated part of the athletes’ training and competition environment. The intervention involves three stages: unfreeze (creating survival anxiety and motivation for change), learning (designing new values and strategies), and refreeze (implementing these values in the identity of the team). The case study may produce a much-needed set of guidelines to inform the process of culture change.
TL;DR: In this paper, the authors examined the incompatible aspects of the declared and actual organizational norms as cultural aspects and concluded that organizations should make a substantial effort to instil their desired vision and norms among their members.
Abstract: This study examines the incompatible aspects of the declared and actual organizational norms as cultural aspects. Data were drawn from a performance evaluation conducted in a large multinational pharmaceutical organization. The selected evaluation dimensions are based on the publicly articulated behavioral norms stated by top level management. The empirical model partially supported the hypothesis. Two predictors, intrinsic normative motivation dimensions and professional behaviors, showed some overlap between the declared and the actual evaluative behavior norms. One implication of this study is that organizations should make a substantial effort to instil their desired vision and norms among their members.
Book•
24 Nov 2015
TL;DR: The Diversity Scorecard as discussed by the authors is designed to provide step-by-step instructions, worksheets and examples to help diversity executives and managers analyze and track the impact of their diversity initiatives to mobilize the organization for strategic culture change.
Abstract: 'The Diversity Scorecard' is designed to provide step-by-step instructions, worksheets and examples to help diversity executives and managers analyze and track the impact of their diversity initiatives to mobilize the organization for strategic culture change. Diversity is not a program; it is a systemic process of organizational change that requires measurement for organizational improvement and success.Measuring the progress and results of diversity initiatives is a key strategic requirement to demonstrate its contribution to organizational performance. Diversity executives, professionals and managers know they must begin to show how diversity is linked to the bottom-line in hard numbers or they will have difficulty maintaining funds, gaining support, and obtaining resources to generate progress.Many organizations collect some type of diversity-related data today, even if it focuses only on Affirmative Action statistics. "The Diversity Scorecard" focuses on tools and techniques to make sure diversity professionals are collecting and measuring the right type of data that will help ensure the organization"s success both now and in the future. This book helps the reader spend some time thinking about what they currently measure and adding new measures to a database to track progress towards their diversity vision. The basic premises of this book are that it is important to develop measures that focus on the past, present, and future; and that measures need to consider the needs of the organization"s diverse workforce, its work climate, diverse customers, the community, and shareholders. Part I of "The Diversity Scorecard" identifies the need for diversity measurement highlighting a business case for diversity and providing an introduction to diversity measurement. Part II of the book outlines the diversity return on investment (DROI) process taking you through step-by-step processes and techniques. Part III teaches you how to use measures in six key categories - Diversity Leadership Commitment, Workforce Profile Representation, Workplace Climate, Learning & Growth, Diverse Customer / Community Partnerships, and Financial Impact - to build a diversity scorecard that is aligned and linked with the business strategy of the organization. Finally, in Part IV, Dr. Hubbard discusses implementation issues involving strategic change procedures and techniques to avoid the pitfalls inherent in a diversity-based cultural transition process.
01 Dec 2015
TL;DR: A new person-centered care model is described, DementiAbility Methods: The Montessori Way, which focuses on the abilities, needs, interests, and strengths of the person and creating worthwhile and meaningful roles, routines, and activities for the person within a supportive physical environment.
Abstract: Efforts to improve the quality of life of persons with dementia in long-term care through the implementation of various approaches to person-centered care have been underway for the past two decades. Studies have yielded conflicting reports evaluating the evidence for these approaches. The purpose of this article is to outline the findings of several systematic reviews of this literature, highlighting the areas of improvement needs, and to describe a new person-centered care model, DementiAbility Methods: The Montessori Way. This model focuses on the abilities, needs, interests, and strengths of the person and creating worthwhile and meaningful roles, routines, and activities for the person within a supportive physical environment. This is accomplished through gaining the commitment of the facility's leaders, training staff, and monitoring program implementation. The potential for a culture change in long-term care environments is dependent on the development and rigorous evaluation of person-centered care approaches.
TL;DR: Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher environmental culture change implementation.
Abstract: Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices.
01 Jan 2015
TL;DR: This case study was a case study of a pioneering hospital-based PPACA-compliant initiative and answered the research question of how Wallace’s revitalization movement theory (RMT)—a rapid culture change model—could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital- based programs.
Abstract: The Center for Total Health: Healthcare Reform in Cook County, Illinois by James L. Miles, Sr. DMin, Virginia Union University, 2002 MDiv, Virginia Union University, 1996 BS, Park University, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University December 2015 Abstract The Patient Protection and Affordable Care Act (PPACA) of 2010 requires hospital systems in the United States to shift the culture of patient care from a focus on sick-care to a focus on prevention and wellness care. Little is known about how hospital systems will make this culture shift while retaining quality patient care. The purpose of this case study of a pioneering hospital-based PPACA-compliant initiative was to answer the research question of how Wallace’s revitalization movement theory (RMT)—a rapid culture change model—could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital-based programs. Kingdon’s policy streams theory provided a conceptual framework. Data analysis included iterative, thematic coding of interviews with 3 primary stakeholders responsible for developing the policy, planning, and program implementation strategies of the Center for Total Health (CTH). Nineteen extensive primary source documents were included in the analysis as well. Findings supported the utility of the RMT structure and definitions in the identification of culture change dynamics in CTH. Additionally, this structure served as a scaffolding for grouping individual and institutional rapid culture change dynamics into stages that could be evaluated in terms of PPACA compliance. These stages effectively identified a Kingdon policy window in which PPACA mandates could be expected to result in culture change in multiple streams of public policy development, not only in wellness and sickness prevention, but also in local, state, and national health cost-saving initiatives in food-as-medicine, community identity, public health support networks. It could also reduce chronic disease and the rising institutional care delivery costs.The Patient Protection and Affordable Care Act (PPACA) of 2010 requires hospital systems in the United States to shift the culture of patient care from a focus on sick-care to a focus on prevention and wellness care. Little is known about how hospital systems will make this culture shift while retaining quality patient care. The purpose of this case study of a pioneering hospital-based PPACA-compliant initiative was to answer the research question of how Wallace’s revitalization movement theory (RMT)—a rapid culture change model—could serve as a transferable evaluation framework for PPACA prevention and wellness care compliance in hospital-based programs. Kingdon’s policy streams theory provided a conceptual framework. Data analysis included iterative, thematic coding of interviews with 3 primary stakeholders responsible for developing the policy, planning, and program implementation strategies of the Center for Total Health (CTH). Nineteen extensive primary source documents were included in the analysis as well. Findings supported the utility of the RMT structure and definitions in the identification of culture change dynamics in CTH. Additionally, this structure served as a scaffolding for grouping individual and institutional rapid culture change dynamics into stages that could be evaluated in terms of PPACA compliance. These stages effectively identified a Kingdon policy window in which PPACA mandates could be expected to result in culture change in multiple streams of public policy development, not only in wellness and sickness prevention, but also in local, state, and national health cost-saving initiatives in food-as-medicine, community identity, public health support networks. It could also reduce chronic disease and the rising institutional care delivery costs. The Center for Total Health: Healthcare Reform in Cook County Illinois by James L. Miles, Sr. DMin, Virginia Union University, 2002 MDiv, Virginia Union University, 1996 BS, Park University, 1989 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University December 2015 Dedication With a grateful heart, I dedicate this dissertation to my parents, Harold and Evelyn, and to my children, Princess and JL. Acknowledgments First and foremost I thank Dr. Bethe Hagens, my dissertation Chair, for her amazing guidance, corrections, and support without which I would not have reached this academic milestone. A special thanks to Dr. Eliesh Lane who presented finely tuned public policy perspectives that strengthened my dissertation research and writing. To Dr. Terry Mason, I am eternally grateful for the, life transforming, invitation to participate in his vision for a revitalized 21st century food is medicine movement. There were others among Walden University faculty leadership, my family, friends, students, and colleagues who shared just the right encouragement, at the right times, solidifying my resolve to complete this academic goal. To all, I say thank you for believing in me and my potential to make a difference with this scholarship.
TL;DR: Drawing from data gathered throughout the PAR process, the challenges experienced by participants working together to guide culture change within their respective care settings are unpacked and the potential for appreciative inquiry (AI) to be integrated with PAR is highlighted to guide a process whereby participants involved in culture change initiatives can develop strategies to mitigate challenges they experience.
TL;DR: Throughout the institutional change and shift to the European model of employment relations system, change in management practices has preceded changes in safety culture which according to theoretical argument is supposed to follow culture change.
Abstract: This article focuses on employee direct participation in occupational health and safety (OHS) management. The article explains what determines employee opportunities to participate in OHS management. The explanatory framework focuses on safety culture and safety management at workplaces. The framework is empirically tested using Estonian cross-sectional, multilevel data of organizations and their employees. The analysis indicates that differences in employee participation in OHS management in the Estonian case could be explained by differences in OHS management practices rather than differences in safety culture. This indicates that throughout the institutional change and shift to the European model of employment relations system, change in management practices has preceded changes in safety culture which according to theoretical argument is supposed to follow culture change.
Dissertation•
29 Apr 2015
TL;DR: In this article, a new concept called culture change management (CCM) is presented that will strengthen the total organization's capability and willingness to accept and prosper in a rapidly changing worldwide environment.
Abstract: A lot of brilliant work has been done to develop methodologies and approaches to apply change management concepts to managing the development and implementation of projects and programs. This has resulted in major improvements in success rates, delays, and the total effectiveness of these projects and programs. Unfortunately, these endeavors have not resulted in the desired improvement in the organization’s ability to endure the constant change activities that the environment, technology, customer, and international competition have placed upon the organization. This technical paper presents a new concept called Culture Change Management (CCM) that will strengthen the total organization’s capability and willingness to accept and prosper in a rapidly changing worldwide environment. It will require a major change in the way organizational change management has been structured, minimizing the focus on projects and programs and maximizing the focus on organizational operations.
TL;DR: In this paper, the role played by a Human Resources (HR) department orchestrating culture change during the merger of two large State departments with dissimilar cultures was explored, and a 2-year case study determined what HR strategies were having the greatest impact on embedding new organisational values to produce a more flexible culture and how these practices could be accelerated.
Abstract: This paper explores the role played by a Human Resources (HR) department orchestrating culture change during the merger of two large State departments with dissimilar cultures. A 2-year case study determined what HR strategies were having the greatest impact on embedding new organisational values to produce a more flexible culture and how these practices could be accelerated. This paper indicates how a more strategic approach by HR departments can support and develop relational managing capability that accelerates cultures change towards a more flexible work environment. This paper describes the context of the change process, the relevant literature, and outlines the research process. The findings from the phases of the data collection are summarised revealing the traumatic perceptions of the change process, but also the instrumental actions of some managers, working creatively with their teams to tackle new tasks and projects. The evidence suggests that these informal practices of task allocation were at the core of change agency in this case study and put the new flexible organisational values into action. The findings illustrate how the organisation moves from valuing managers for their technical competence to valuing managers for their relational competence. The paper then discusses what strategic HR actions were accelerating this process and illuminates the critical role of building managers as change agents. The paper concludes by confirming the need for a strategic approach by HR during organisational change. Building manager capability and supporting informal change agency practices is presented as a core focus for HR during such organisational cultural change programmes.
01 Jan 2015
TL;DR: This study supports the benefits of value-based programs by describing the experiences of nurses during the process of exploring their values and developing these into a shared vision at both an individual level and as a team.
Abstract: Objective The ‘Essentials of Care’ (EoC) program seeks to develop a shared vision amongst nurses within particular workplace teams. The purpose of this study was to describe the experiences of nurses during the process of exploring their values and developing these into a shared vision at both an individual level and as a team. Design A qualitative, focus group design was used to provide an accurate representation of the nurses experiences in reflecting on their values and developing these into individual ward/unit vision statements. Six focus groups were conducted by independent researchers. The focus group discussions were recorded and transcribed by an independent researcher. The transcription provided the data for thematic analysis. Setting This study was conducted in two tertiary hospitals from the same Local Health District in New South Wales, Australia. Subjects Forty‐two nurses from fourteen hospital wards or units participated in the study. Seventeen were facilitators of the program and the remainder were nursing staff who had undertaken the program. Main outcome measures The authors independently interpreted the transcripts using inductive qualitative analysis, reaching consensus on emergent themes. Representative quotations were chosen for each theme. Results Six themes emerged which describe the experiences of nurses during the exploration of individual and team workplace values which were then developed into shared visions. The emergent themes were: shared values and commitment to patient care; empowerment and ownership for cultural change; real and observable outcomes; the meaning of the team; different active learning approaches equalling the same outcome; and culture change results in new perspectives. Conclusion This study supports the benefits of value-based programs. Exploring values led to new perspectives on clinical practice, both individually and collectively by the nursing teams. ACKNOWLEDGEMENTS The authors would like to thank all nurses who participated in the study and to the interviewer for all focus groups.
TL;DR: Underreporting of errors in health care is better understood, a model of change that increases voluntary error reporting is presented, and the role nurse executives play in creating a culture of safety is discussed.
Abstract: According to the Institute of Medicine (IOM, 1999, p 1), "Medical errors can be defined as the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim" The current health care culture is disjointed, as evidenced by a lack of consistent reporting standards for all providers; provider licensing pays little attention to errors, and there are no financial incentives to improve safety (IOM, 1999) Many errors in health care are preventable "Near misses" and adverse events that do occur can offer insight on how to improve practice and prevent future events The aim of this article is to better understand underreporting of errors in health care, to present a model of change that increases voluntary error reporting, and to discuss the role nurse executives play in creating a culture of safety This article explores how high reliability organizations such as aviation improve safety through enhanced error reporting, culture change, and teamwork
TL;DR: The authors Reflective PRACTICE The Boys and Men of Color Framework: A Model for Community and Systems Change Marc Part, M.P.A., M.H., and Judith Bell The authors distill key lessons from this work.
Abstract: REFLECTIVE PRACTICE The Boys and Men of Color Framework: A Model for Community and Systems Change Marc Philpart, M.P.A., M.P.H., Boys and Men of Color initiatives, and Judith Bell, M.P.A, PolicyLink EC TIV Residents and leaders in communities across the nation are spearheading efforts to dismantle the barriers facing young men of color and help them reach their full potential; this article distills key lessons from this work.
TL;DR: In this paper, the authors examine why culture is the cause of such widespread failure in mergers and acquisitions (M&A) and explore ways to improve their success rate and identify some new approaches to improving M&A success rates.
Abstract: Purpose – The purpose of this paper is to examine why culture is the cause of such widespread failure in mergers and acquisitions (M&A) and explore ways to improve their success rate. Design/methodology/approach – Review of some prominent “failed” mergers for evidence of the influence of cultural factors. Findings – It was found that M&A tended to be more successful where cultural factors were made a priority early in the process and where transparent and two-sided dialogue about culture took place up and down both organizations. Originality/value – Although the impact of culture in M&A is a topic that has been covered before, this review identifies some new approaches to improving M&A success rates.
TL;DR: The Association for Behavior Analysis International (ABI) Seminar on Leadership and Culture Change as discussed by the authors was the first one to include a special selection of presentations, beginning the day before the 40th edition.
Abstract: Last May, the Association for Behavior Analysis International hosted the Seminar on Leadership and Culture Change. This special selection of presentations, beginning the day before the 40th annual ...
TL;DR: In this article, the authors explore an initiative to change culture in a low-secure service through the introduction of a self-advocacy group and an independent evaluation was carried out by a university research team.
Abstract: Purpose – Improvements in organisational culture are a common recommendation of enquiries into system failure and an aspiration of policy. The purpose of this paper is to explore an initiative to change culture in a low-secure service through the introduction of a self-advocacy group. Design/methodology/approach – An independent evaluation was carried out by a university research team. A theory-based methodology was deployed with qualitative data gathered through observations, interviews and focus groups. Findings – Culture change was reported by senior managers and clinicians in relation to the transparency of the service, decision making regarding resources, and engagement of patients in redesign. Self-advocacy group members reported a different relationship with senior management which in turn enabled greater influence in the organisation. Achieving these impacts relied on independent and skilled external facilitation, support from senior managers, and a calm and democratic atmosphere in the meetings. ...
TL;DR: Patient and family engagement is no longer a “why,’ “when,” or even “how” conversation; it is a personal level conversation.
Abstract: Patient and family engagement is no longer a "why," "when," or even "how" conversation. So why are many health care organizations still struggling to embrace the patient as a partner? Now is the time to shift the conversation to a personal level.
TL;DR: In this paper, the authors describe a case example of culture change and definitions of wellness at William Beaumont Hospitals, Troy Family Medicine Residency Program, a community-based, university-affiliated program in suburban Detroit, Michigan.
Abstract: Background The existing literature either does not address physician wellness or defines it as a lack of burnout. The goal of this article is to call attention to this important gap in the literature and provide ideas for how to fill it. We need a culture change, and we propose that this change begin within graduate medical education. Methods We describe a case example of culture change and definitions of wellness at William Beaumont Hospitals, Troy Family Medicine Residency Program, a community-based, university-affiliated program in suburban Detroit, Michigan. Results We developed a toolbox of practical steps to create a culture that emphasizes wellness. We present a general timeline illustrating necessary steps toward accomplishing a true cultural change. Discussion The time has come for academic medicine to move beyond a simple discussion of physician burnout. To do this, we must first develop a shared definition of physician wellness followed by interventional strategies to bolster it. The b...