What the data says about wellness initiatives

Wellness offerings continue to evolve as both employers and employees understand more about the benefits and look for more meaningful options.

For employees to get the greatest benefit from well-being programs, employers should address such seemingly disparate things as stress, flu shots, workplace fatigue, job security and overtime management, alongside program staples like fitness and nutrition, according to a report from the Campbell Institute, an organization affiliated with the National Safety Council.

As the definition of wellness as an employee benefit takes on broader meaning, traditional programs are often evolving into well-being programs that reflect a holistic approach to employees' overall happiness and prosperity. As such, the concept of wellness is no longer just about healthy eating, physical fitness, weight control and smoking cessation. It has expanded to include more personalized offerings, such as mental health services, financial education, stress management, diabetes control and back-pain management.

Employers can make their well-being programs more personalized by adding benefits that help employees control major stressors in their lives and at work. HR departments looking to transform their wellness programs into well-being formats can start by gathering data on what workers need and want.

Well-being continues to emerge as the key word for employers looking to improve employee health and reduce health costs. Providing holistic health experiences that account for behavioral, mental and physical health have been proven to reduce health costs considerably in the long run, even if they take higher investment in the short-term.

Financial wellness is also part of well-being, particularly retirement savings and money management skills. Employers know that financial problems can cause undue stress and anxiety for workers. Therefore, they’ve added help with financial matters to their wellness services.

As employees become increasingly interested in wellness, employers are working to ensure that workplace benefits and amenities meet that demand. Wellness is now part of office design planning, and some have gone so far as to include vegetable gardens and walking trails, design experts have told HR Dive. Employers must have a plan in place to assess the ROI of these types of offerings, but experts say such amenities can result in improved attendance, productivity and retention.

It is also important that employers watch for a disconnect between their own perception of wellness offerings and how employees see those programs. In a Willis Towers Watson (WTW) survey upwards of 61% of employees said their employers' well-being initiatives don't meet their needs. The "2017 Global Benefits Attitudes Survey" also found that 81% of employers believe they do, while only 66% of employees agree.

To increase support for employee well-being, employers told WTW that during the next three years, they plan to focus on four components of well-being: physical, social, emotional and financial. Following physical well-being, WTW said emotional well-being is evolving as the number-one priority.

The study also shows that 84% of employers plan to improve employees’ physical well-being over the next three years, up from the current level of 27%; 66% plan to increase their support for financial well-being, compared to the current level of 16%; and 49% hope to improve social well-being, up from the current level of 12%.

The results point to a recurrent disconnect between what employers think they're offering in benefits and what employees say they need. But instead of employers and workers talking to each other through surveys, employers need to solicit feedback — and workers need to be empowered to tell employers what they need.

Another WTW statistic suggests an unsettled debate about how involved employers should be in encouraging workers to make healthier lifestyle changes. Most employers (87%) say they should be involved, but only slightly more than half of workers (54%) agree. There seems to be little doubt, however, about whether wellness programs require behavioral change.

Even with a broader definition of “wellness” in the workplace, there is good news for employers that get it right. Most employees — a full 68% — said they think "work perks" are just as important as health coverage, life insurance and other traditional benefits, according to a survey of 600 small and midsize businesses conducted by Zenefits. Small businesses without big-company resources can build an advantage and compete for talent in the tight labor market by offering popular fringe benefits that don't cost much to provide.

Respondents identified wellness programs as the most important perk, followed by education programs, financial wellness programs, free meals or snacks and commuter benefits.

The data indicates wellness programs continue to be a priority for employers and a welcome perk for employees. But it is still important for employers to offer initiatives that employees find beneficial, not just the offerings they think will resonate. With better mapped wellness programs, both employers and employees are better positioned to benefit from these offerings.

Article top image credit: Flickr; Tulane Public Relations

To connect with millennials and Gen Z, know their story

Employers can't afford to overlook the unique requirements and inclinations of key segments of the workforce when it comes to both traditional benefits and wellness offerings and how they are defined and administered.

HR conferences host a wide range of discussions on how to hire, support and retain younger workers — often reflexively referred to as millennials — and one critical component of these efforts is benefits. Employers can't afford to overlook the unique requirements and inclinations of key segments of the multigenerational workforce when it comes to the benefits offered and how they are administered.

The so-called millennial generation (defined as those born between 1981 and 1996) is now the largest segment of the U.S. workforce, according to the Pew Research Center. The needs of millennial employees are also generally shared by their colleagues born after 1996, known by the “Gen Z” moniker. But these two generations are more than curiosities — they are a growing force to be reckoned with. Experts are advising employers to re-evaluate their employee benefits strategies accordingly.

A world of difference

No two generations experience the same life events in the same order. That applies when speaking of the differences between the lifespans of, say, the generation called either traditionalists or the silent generation (born before 1946) and Gen Xers (defined as those born between 1965 and about 1980). HR should apply this same thinking to their younger peers, said John MacPhee, CEO and executive director of The Jed Foundation, a nonprofit focusing on the mental health of young adults.

“It’s important that we understand that things are changing fast, and the world that emerging adults are growing up in today is quite different than even 10 years ago, arguably more than five years ago,” MacPhee said during a webinar presented by the Disability Management Employer Coalition. “There’s heightened risks around sustainable employment [and] the gig economy — it feels less settled.”

This changing landscape has revealed key differences in how millennials select and consume employee benefits, Emily Bailey, principal at OneDigital, told HR Dive in an interview.

“It really does cause us to take a step back and better assess how we're putting information out there,” Bailey said. “[Younger generations] may not put as much value on certain benefits that the boomers and other generations that have been in the workforce for a while do.”

Younger workers are particularly likely to forgo voluntary benefits like life insurance and disability insurance regardless of sagacity, Bailey explained, in favor of options that meet immediate concerns, like tuition reimbursement and commuter benefit plans.

Their preferences are also likely to impact delivery. Purchasing benefits, in the eyes of recent grads, will be held to the same standards set by e-commerce applications like Amazon, Bailey said. In short, millennials feel comfortable in a system that offers choice while allowing for a thorough evaluation of each option.

“That's not traditionally how we've presented employee benefit programs," Bailey said. "It's been kind of a one-size-fits-all approach, and I think that's going to have to change and that's what we're working to really do.”

Employers can’t afford to throw out a slew of options that don’t stick, though. Offering decision-making tools is part of making the process easy to understand and user-friendly, particularly for younger workers who bring personal devices to work on the regular, Bailey said.

No time to save?

Financial experts recommend that millennials set aside between 15% and 22% of their pre-tax salary, according to Jennifer Brown, manager of research for the National Institute on Retirement Security (NIRS), who spoke as part of a panel at the NIRS’ annual Retirement Policy Conference. But many younger employees are struggling to save even a single dollar. Literally. An NIRS report authored by Brown found that two-thirds of working U.S. millennials (birth years 1981-1991) failed to save for their retirement. A mere 34.3% participated in their employer’s retirement plan.

Breaking down the results of the report, the panel listed a variety of causes for millennials’ lack of retirement plan uptake, ranging from low wages and part-time/gig work situations to lack of trust in the financial services industry. A lack of proper financial education also plays a role.

“Part of this participation rate is the lack of education and knowledge,” said panel participant and Pershing LLC VP Kathleen Johnson, “and that’s where you have a great opportunity here.”

But by far, the biggest obstacle appeared to be a lack of access; 40.2% of millennial workers in the report cited eligibility reasons for their non-participation, usually due to a lack of requisite hours or tenure length, Brown added. A silver lining: millennials who were eligible for a retirement plan, and had that plan offered to them by their employer, showed a 93% take-up rate of said plans.

Mental health considerations are key

Wellness program popularity, combined with the industry standard of employee assistance programs (EAPs), have given HR a potent tool to combat stress, fatigue and other common mental health issues in the workplace. Millennials may be in particular need of this care.

“People are leaving home later than they used to be,” MacPhee said. “They’re financially independent later. And as a result, adolescence is stretching out.” MacPhee said there are even empirical findings that support a type of “quarter-life crisis,” which results from the financial and social pressures younger workers face.

“When we look at populations of employed individuals, we definitely see an increasing need for information and programs to support health and well-being,” Bailey added. “There's a marked increase in the results showing that employees and younger generations are looking for things like wellness programs or wellness incentives.”

Well-being programs have generally grown to be more holistic, embracing basic physical fitness in addition to financial, mental and emotional health. And the trend isn’t just impacting younger workers’ lives.

“It starts with leadership declaring that this is a priority,” MacPhee said, adding that all relevant departments and constituencies need to have established policy in place to promote these programs.

Article top image credit: Kendall Davis/HR Dive

Mental wellness in the workplace

As mental health garners more attention as a workplace issue, not just a personal one, employers are finding considerable barriers may remain to implementing strong policies.

By all accounts, Dennis Miller, CEO of an eponymous company that provides leadership coaching and executive search consulting, has had a successful career. He's served in executive positions across several non-profit organizations and is now a published author and speaker. He's also been enabled to do his work thanks to therapy for mental illness.

But it's only in recent decades that he has been able to openly address his experience, or even say that he first sought therapy when he was 20 years old.

"I talk about this deep secret I kept because I was so ashamed of it," he said. "I was a president of a major medical center but I still felt stigma."

As companies are pressed to push down healthcare costs, wellness programs have resurged as a way to encourage employee health, reduce claims and improve a company's recruitment brand. The market has responded in turn — meaning mental health may finally be emerging from the shadows.

"We're seeing this as a tipping point right now," Meena Ramachandran told HR Dive while serving as senior director of product management at Castlight (she has since moved on to a new role with another organization). "For the first time we are seeing huge demand for this type of support for employees and seeing support in ways that weren't talked about before."

Employers still face considerable challenges, particularly the specter of stigma and problems tracking utilization. But benefits platforms like Castlight and YourNurse are emerging to guide employers toward a more holistic wellness — and create a better atmosphere for employees in all walks of life.

"We are at a point in our culture and history that we can open up about emotional stuff, and it is not soft stuff," Miller said. "It's business."

Breaking through stigma

Blood pressure, diabetes and cholesterol screenings are all considered the norm. So are smoking cessation programs — set to cease a habit that was at one time considered normal. Openness about physical health, including cancer and diabetes, has improved over decades. But for many, mental wellness remains a topic fraught with shame and stigma.

"The business just kind of sees it as a labor issue only, without realizing that the whole organization will do better when people are healthier," Miller said.

Ramachandran said her company spent close to a year speaking with users and combing the literature to distill the stigma issue down to four facets that employers can help tackle.

1. For employers, the first step is to encourage openness and instill awareness. Many employees do not realize they are struggling or experiencing symptoms of a mental illness. Finding ways to subtly encourage them to seek help, either through education programs or access to personalized healthcare platforms, is key.

2. Others are concerned that care won't actually be effective for their problems, Ramachandran said, tying directly into stigma and a belief that there isn’t an illness at fault but rather a personal flaw.

3. Cost (or the perception of cost) can be a barrier. Some do not realize that there is high-value care for mental health.

4. Perception of access can also be an issue.

YourNurse, a call service that guides employees through health benefits, tackles awareness through its one-point call system. Nurses respond to calls from employees and guide them toward the care that they need, rather than having an employee figure out on their own which service to call. Jamie Marcellus, RN, President of First Health Care, noted that nursing is a "trusted profession." Employees feel more willing to open up to someone they believe is truly listening to them.

Often, the reason for calling is the "tip of the iceberg," he added. The nurses can then arrange for the employee to receive the care they need for all facets of their health.

"As stigma starts to erode and as people become more aware of mental health challenges among the broader population, more employers are figuring out how to support employees during a time of need," Marcellus said.

Many employers already have Employee Assistant Programs and other support programs in place for this purpose. But due to the fragmented nature of these programs — a different program for every need, be it physical, mental or financial health — employers are consistently concerned about the actual value they are receiving.

Breaking out of silos

Despite an increased interest in holistic wellness from employers, the health and wellness industry still tends to operate in silos, Marcellus said. Typically, organizations will sign with an EAP for mental health, a health assessment service for physical health, and so on. Inevitably, employers have challenges in maximizing use of these services while also addressing the complex, multifaceted issues employees face.

In response, the industry is shifting. Both YourNurse and Castlight provide a single touchpoint that employees can use to overview their benefits, easing confusion and encouraging engagement. YourNurse provides a single number that employees can call when they require assistance, while Castlight’s platform gives employees an overview of providers they can compare on cost and quality.

Breaking down reporting

But the current siloed state of wellness has led to another issue in the industry, particularly with mental health initiatives: reporting results and the end value of such services.

“Organizations will have five to six services they purchased and they have no idea of knowing what that’s worth,” Marcellus said. “It’s difficult for organizations to really understand what employees are using, how, and if they are seeing value for that use.”

Additionally, employees often have their own apps and devices they use to track their wellness that do not get reported to an employer, Ramachandran said. An aggregator has yet to emerge that safely tracks such wellness forms.

Current utilization calculations don’t help, either. Many providers capture every interaction with an employee and charge that back as utilization, regardless of whether value was gained from it by the employee.

“We force organizations to take a pause to look at who is accessing services,” Marcellus said. In some cases, there may be a difference between actual utilization and what is recorded – a particular problem if actual utilization is higher than expected. If one in four employees are accessing services, for example, there may be a bigger workplace problem that needs to be addressed, he added.

In all, organizations should take care to better observe their utilization and find ways to optimize tracking of value added.

What employers can do now

As holistic wellness garners attention, mental health initiatives will continue — because, in many cases, employers are already "paying for it" in lost productivity, Miller said. Such initiatives can scale appropriately.

Castlight made headlines recently due to its ability to track employees' behavior on their platform and to push information when it senses an employee searching about a relevant topic. Technology will likely continue to play a large role in making wellness more rounded overall.

"The technology will evolve around those pain points that are being talked about by employers and employees," Ramachandran said. That includes combinations of telemedicine and behavioral health, as well as computerized cognitive therapy and other tech-enabled solutions.

"I would utilize the free expertise that you can get from associations, the county government and behavioral health organizations," Miller added. "Invite them in to talk to you. Start a campaign."

Frontline HR managers should be educated on how to recognize a potential mental health problem and how to approach someone about that problem.

"Understand that you can be a good employer and a good business person, too," Miller added. "The good news is that you can get treatment. I did. You have to envision the kind of life you want to have and treat people the way you want to be treated."

Article top image credit: Getty Images

How spending more on behavioral health can bring wellness savings

More employers are embracing the adage that sometimes you have to give a little to get a lot.

Donna Sexton, the ‎director of employee benefits at Costco Wholesale, speaking on a panel at the National Business Group on Health conference, remembered how she felt when she looked into the data on her employees' mental wellness.

The data revealed an average of two suicides a month over an 18 month period.

Her immediate reaction: "I don't know what we're going to do."

Suicide not only deeply, irreversibly affects families, but it filters through the whole ecosystem of the workplace, pushing the emotional, social and monetary cost of a single death "way beyond" other problems.

The mental health crisis is a "real thing employers are facing," noted Dr. Steven Serra, senior medical director at Aetna. The delivery systems remain fragmented. Even at organizations like Aetna with large networks at their disposal, many employees face six months of wait time before they can meet with a psychiatrist, Serra added. When employees do not receive treatment, it drags down the entire organization on every wellness front.

The problem: mental and behavioral health issues often appear alongside other chronic problems, including cardiovascular health issues, injury and the like — and equally as often, employees are unaware of the impact of these "comorbidities," especially on their day-to-day work performance.

That means employers may need to consider spending more to save more. This technique involves what Dr. Reena Pande, Chief Medical Officer of AbleTo, calls "good utilization," and it requires solid investment — and commitment — by employers in order to create positive outcomes.

Where behavioral health saps money

Depression and its ilk are difficult enough on their own, but they also exacerbate other health problems and make recovery more difficult. Since 50% of Americans deal with some type of chronic health condition, according to Serra, this is no small problem for American employers.

Handling such a problem relies on an employer investing money in the right tools and programs that reach workers — meaning an employer must first have a key understanding of company culture.

Sexton noted that Costco has "high company trust" from employees and focuses on reinforcing a "cost/value conscious culture."

"We don't feel super innovative, but we focus on culture to choose what to take risks on," she added. To maintain that company trust, she knew that meant getting to the bottom of their mental health crisis. Major depression causes a 46.9% loss of productivity dollars per year. Even worse, "presenteeism," also known as "working while sick," causes losses that reach as high as $78.7 billion a year.

"We tip-toe around mental health all the time, but it really matters," Pande said.

Luckily, a focus on holistic wellness, something many employers are looking at, is already a step in the right direction. AbleTo's approach — the approach that Costco bought into — sees behavioral health recovery as part of any health recovery process, and its program includes guidance in social support, exercise, nutrition and sleep.

"Good utilization" comes in when employers are willing to increase their spend on programs that are proactive and seek out employees who may be struggling. Spend on behavioral health goes up, but in turn, employers save on other aspects of employee health due to behavioral health's wide impact. In this example, Serra said, behavioral healthcare was bolted directly onto Costco's health plan and includes active outreach to those most at risk.

The trouble with access

In many cases, behavioral health is "almost a prereq" before an employer can aim for other health solutions, experts said. But traditionally, access is a huge problem for behavioral healthcare. To overcome this, AbleTo utilizes remote and telehealth solutions to encourage employees to engage, capitalizing on a strong current trend.

"We make it really hard to get behavioral healthcare at work," Pande said. "We don't want to talk about it." The convenience is a real factor. Being able to obtain treatment at home at any time of the day or week means employees don't have to take time off work or risk "revealing their issues" to anyone, she added. At the end of the day, getting people to treatment is the key.

According to AbleTo, telephonic therapy works just as well, even in randomized trials, as in-person therapy. Evidence also shows strong reductions in medical utilizations after behavioral therapy, including: 31% decrease in hospital admissions, 48% decrease in hospitalization days, 56% decrease in depression symptoms, 61% decrease in absenteeism, 44% decrease in presenteeism and 44% decrease in activity impairment.

Cost is another huge factor. Costco, in a reflection of its values, 100% covers the cost of AbleTo treatment for employees. Sexton said the program has met great success.

"If we can reach 10%, we're happy," she added. "They reached 50% of the women called for post-partum depression." Those who were fine and didn't need treatment were "so grateful" that the company thought to reach out and consider their needs. Those who did need help were caught at a key time, before any problems could get out of hand.

ROI and proof of concept

The struggle to prove ROI in wellness is well-documented and problematic. Many modern healthcare applications have ROI at top-of-mind, and behavioral wellness offerings are no exception.

Employers tend not to have seen ROI with similar programs, Pande noted, so "we knew from the outset that we had to prove that."

Due to the 8-week, telephonic model, AbleTo matches more modern expectations of ROI outcomes and is able to provide ROI in six months versus the old, long-term model of 10 years or more. Part of that involves AbleTo's willingness to direct employees to the treatment they need — even if that ultimately isn't in AbleTo's wheelhouse.

Partnerships are key, Pande said, as their strengths can be optimized by integrating the strengths of other providers when needed. This strategy is similar to how concierge services provide benefits, though AbleTo is built more specifically to handle behavioral health cases. They and other behavioral health providers extend a hand of support in order to address a need, using conversation guides to get to the real issues at hand.

While AbleTo uses claims data and other provided sources in order to reach the appropriate employees through phone, email and even texting in some cases, the key is simple: "We actually do it," Pande said.

"We tend to put the burden on an ill person's shoulders, which is not fair," she said. "We have to reach out proactively."

Article top image credit: Adobe Stock

Case study: Hospitals add C-suite officer to boost staff wellness

Chief wellness officers are becoming more mainstream

As healthcare organizations look for ways to reduce physician burnout, some are placing their bets on a new C-suite role: chief wellness officer.

Hospitals that appoint an executive to oversee wellness anticipate not only happier employees but also improved patient experience and outcomes.

Physician burnout is at an all-time high. In a recent Medscape survey, nearly two-thirds of doctors reported feeling burned out, depressed or both. Worse, 33% of respondents said those feelings impacted their patient interactions. Burnout rates were highest among family physicians, intensivists, internists, neurologists and OB-GYNs, and were higher among women than men.

This epidemic, if you will, comes as the nation faces a growing shortage of doctors. The Association of American Medical Colleges projects the physician shortage could reach 105,000 by 2030.

Among factors fueling burnout are long hours, increasing regulatory and recordkeeping requirements and administrative and computer tasks. An Annals of Family Medicine report found that primary care physicians spend more than half their workday on EHR tasks. But the implications go beyond the looming shortage; physician burnout has been linked to lower productivity and absenteeism, medical errors, poorer outcomes and lack of engagement with patients.

Enter the chief wellness officer, or chief physician wellness officer as the title is sometimes called. The idea is not new, said Linda Komnick, a senior partner and co-leader of the physician integration and leadership practice at Witt/Kieffer. Companies and large organizations have employed them for more than a decade. However, it’s only in the past couple of years that they’ve started cropping up in healthcare.

“I would not call it a ‘trend’ yet,” she told HR Dive’s sister publication Healthcare Dive. “What is a definite trend is that healthcare organizations are trying to be more holistic in supporting employees.”

The idea of CWOs aligns with the shift toward value-based, patient-centric care. Hospitals are trying to differentiate themselves culturally while they manage cost and risk. And there’s growth in self-insured plans and the overall societal thrust toward wellness.

Last summer, Stanford Medicine became the first academic medical center in the U.S. to designate a CWO, naming Dr. Tait Shanafelt, a hematologist who spearheaded an anti-burnout initiative at the Mayo Clinic.

Creating incentives for wellness

Concerns about chronic disease and rising healthcare costs led the Cleveland Clinic to appoint the C-suite role a decade ago. The question was “could we change the culture and environment of the organization by figuring out incentives to help people stay well and then reward them for staying well?” said CWO Dr. Michael Roizen. “And what would that do to absenteeism and productivity?”

To do that, the clinic asked employees to achieve six “normal” vital signs — blood pressure, fasting blood sugar, body mass index, LDL cholesterol, healthy urine, learn to manage stress and see a primary care physician once a year. Those who meet those targets or are on a clear path to achieving them get the insurance rates and benefits in effect in 2008, when the CWO program took off. Everybody else gets rates in line with the current economy.

Preventing burnout is a big part of Roizen’s role. He said stress levels for healthcare workers were five deviations above the mean in 1983 when the Perceived Stress Scale was developed. To address the problem, the clinic offers an online stress management program. Those who take it see their stress and burnout levels fall by about 75% and 44%, respectively, he said.

The clinic also designated two physicians to work solely on reducing EHR clicks for physicians and uses scribes to assist its primary care practices.

There have been environmental changes as well, such as removing sugary products from vending machines, eliminating fried foods and trans fats in its eateries and making on-campus fitness centers free to employees.

The effort has paid off. In 2008, about 6% of clinic employees had six normal vital signs. Today, 63.8% of employees are in chronic care management programs and 40% have the six normal numbers. “That’s saved us, compared with competitors, $254 million for 101,000 employees in the past three years,” Roizen tells Healthcare Dive.

In addition, absentee rates have dropped from 1.07% to 0.70%. That change alone, if all the clinic did was replace the nurses, saves about $7 million a year, he adds.

It’s a win for employees, too, Roizen notes. The lower insurance rates translate to about $200,000 more in retirement funds, and employees live about eight years younger, meaning their risk of getting a chronic disease is that of someone younger.

A holistic approach

Dr. Edward Ellison, executive medical director and chairman of Southern California Permanente Medical Group, hired a CWO six years ago after physicians ranked the organization “very low” on wellness support in an internal survey. The response stood in contrast to that of managers and other staff.

The survey was trigger of sorts, Ellison said. “I had been a practicing physician and I knew the stresses. I knew the challenges of the electronic health record and how it had made many positive gains for systems of care and caring for patients, but created an added burden for physicians.” The survey was a “data point for me and what really prompted me to appoint a chief physician wellness officer,” he said.

To increase physician satisfaction, the group now offers flexible and alternate work schedules, reduced hours, mental health resources and peer-to-peer support. Specified teams help physicians prioritize administrative tasks so that others can handle the clerical work. There is also a physician concierge to help with non-work life planning, social events aimed at reducing the isolation physicians can feel in their job. Doctors are taught to practice personal preventive care and provided access to workout equipment.

“You have to take a very holistic approach,” Ellison said. “It starts with culture, but it’s also about the practical, tactical time in your day. It’s about reducing the hassle factor and some of the bureaucracy of systems, and it’s about personal care and resilience and connecting people so that they don’t feel isolated.”

SCPMG has repeated the survey that showed physicians did not feel the organization supported their wellness. The response today: double-digit improvements on culture and wellness, Ellison said.

An evolving role

So what qualities does a CWO need? Healthcare organizations are still figuring that out, said Komnick. Some are tacking physician and employee wellness onto medical director, chief human resource officer or chief experience officer roles. For those focused on physician wellness, it helps to have someone with a medical degree or research credentials. Other assets include the ability to lay out a vision for long-term wellness and supportive programs and exceptional collaborative and communication skills to get people on board with new ways of working in organizations that are traditionally resistant to change, she said.

The challenges for CWOs are huge and call for a wide continuum of solutions. “It’s not one size fits all, and we have to do this in the face of enormous change in healthcare, a lot of ongoing changes in reimbursement strategies and systems of care,” said Ellison, noting CWOs have to navigate all of that while focusing on wellness and resilience.

Meanwhile, the problem of burnout is only getting worse. Ellison sees a parallel in airline passengers being told to don their own oxygen mask before helping others. “We need to make sure that our physicians are as healthy as they can be because they are then going to be able to be their for their patients and support them,” he said. “It is in line with taking care of our patients.”

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