Cook Children’s Physician Network has earned silver recognition in 2025 from the American Medical Association (AMA) as a Joy in Medicine® organization.

The prestigious recognition from the country’s leading physician’s association honors health systems, hospitals, and medical groups that prioritize proven methods to reduce burnout and enhance the professional fulfillment of doctors that comes from patient care. Organizations that meet the rigorous criteria of the Joy in Medicine Health System Recognition Program are leaders in the national effort to transform health care work systems and address the root causes of burnout among care teams.

Cook Children's Office of Physician Well-being was established in January 2022 by system leadership to address physician burnout and promote professional satisfaction and well-being. Kirk Pinto, M.D., a CCPN pediatric urologist, and Sara Garza, M.D., a CCPN primary care physician, serve as Physician Well-being Advocates focus on this work.

“In the physician wellness space, the efforts and offerings of the AMA are invaluable,” said Dr. Pinto. “We have matured our program quickly using their resources. The Joy program is a national recognition of our efforts but, more important, it is an expert measurement and endorsement of our progress.”

Drs. Pinto and Garza were guests on an April 2024 episode of the Raising Joy podcast, and spoke about the signs and symptoms of burnout, its impact on doctors, families, and patient care, and strategies for prevention and management. They also sat down for an episode on the Untold: The Stories of Cook Children's podcast. Watch and listen here.

AMA Joy In Medicine

Burnout among U.S. physicians peaked at 62.8% in 2021 during the Covid pandemic, according to research. But thanks to strides made to address burnout at the system level, the national physician burnout rate ebbed to 45.2% in 2023. Despite improvements, physician burnout levels remain much higher than other U.S. workers. Continued efforts are essential to ensure doctors receive the support they need to thrive and achieve national health goals.

“Joy in Medicine recognized organizations are leading the gains made against the physician burnout crisis and help clinicians rediscover the deep rewards and joy that comes from helping patients,” said AMA President Bobby Mukkamala, M.D. “The AMA distinction honors each organization’s commitment to not only the health and well-being of the care team, but also to patients. Quality care ultimately originates from a positive and purposeful work culture where health care professionals can flourish both mentally and physically.”

Since its inception in 2019, the AMA Joy in Medicine Health System Recognition Program has recognized more than 200 organizations across the country. Recognition levels are valid for two years. This year, a total of 109 health organizations nationwide earned recognition with documented efforts to reduce system-level drivers of work-related burnout and demonstrated competencies in commitment, assessment, leadership, efficiency of practice environment, teamwork, and support. Organizations that earned 2025-2026 recognition join a strong group of currently recognized organizations from the 2024-2025 program, bringing the currently recognized cohort to 164 recognized organizations.

Learn more about the AMA Joy in Medicine Health System Recognition Program at ama-assn.org/joyinmedicine.

Announcing Cook Children’s Well-Being Month

Taking care of ourselves is a necessity to keeping our Promise, treating each other like family, and thriving at work and home. Some days balancing everything in our lives can be challenging. When we take time for personal and professional well-being it’s easier to find the energy and motivation to show up as our best selves each day.

We’re launching an annual tradition dedicated to helping you be your best-self at work and home. August will be Cook Children’s Well-Being Month. We’ve brought together multiple teams to promote self-care and connect our 10,000 employees to the programs, benefits, and resources offered to enjoy life and thrive at work and home. 

According to Gallup’s research, well-being is all the things that are important to how we think about and experience our lives. This month we'll talk about the importance of self-care and how teamwork, connections with colleagues, and peer support boost well-being. Lastly, we’ll connect you to the many resources at Cook Children’s to support your well-being.  

What’s Happening This Month

Well-being Month Page on the new CookNet: visit this page to learn about events, classes, and activities planned for August.

Some of the highlights are:

• Look for the Cook Children’s University & Healthy Me virtual self-care class schedule and register through links on that page.
• Learn more about the Virgin Pulse app and how it can help with your well-being goals.
• Connect with your colleagues and teams at Beat the Heat Treat (see in-person schedule and IDT information for off-site and remote teams)
• Take part in Well-Bingo for a variety of well-being activities and the chance to win a gift card.  

Note: The self-care class schedule, details on Beat the Heat Treat, Virgin Pulse info sheet and the Well-Bingo card are in the top right corner of this page to download and print.

Destigmatizing Self-Care

We hope the message from Mr. Merrill inspires you to focus on self-care and learn what’s important to your well-being.

What is Self-Care?

Taking care of yourself is essential for maintaining overall well-being and allows you to be better at everything you do, at work and at home. Self-care involves self-awareness and intentional activities that reduce stress, replenish mental and physical resources and help you enjoy life. Self-care is not selfish; rather, it is necessary for maintaining balance and ensuring your needs are met.

According to the National Institute for Occupational Safety and Health (NIOSH), self-care is the process by which people at least temporarily reduce the demands they are experiencing and replenish spent resources. Since a wide variety of activities can be considered self-care, two things to keep in mind when thinking about self-care activities:

• Add restorative activities to your days
• Reduce your demands by identifying and minimizing stressors

Research shows that certain activities are more restorative than others. Use these five points as a guide to help you think about what self-care activities you should choose.

1. Focus on something that helps you stop thinking about your demands
2. Have a choice about when, how, and what you do to recover
3. Do anything that helps you relax physically and mentally 
4. Engage in activities that challenge you or help you acquire new skills 
5. Build connections and spend time with others (family, friends, colleagues)

Self-care is very personal - it varies from person to person. It’s about finding what works for you and making it a regular part of your routine. By prioritizing self-care, you can improve your overall quality of life.

During Well-being Month, there are a variety of self-care classes and activities in August to help you take care of yourself. To learn more, click here to go to the Well-being Month page on CookNet.

VIDEO: Introducing Kristin Burrow, Chaplain of Well-being

Did you know there is a Chaplain dedicated to employee well-being? In July 2023 a new role was created to provide support to employees on patient units and partner with leaders for team interventions. We want to introduce you to Kristin Burrow, Chaplain of Well-being. She works to create safe spaces where employees can acknowledge difficult things and resume focus on their work’s purpose, hope and joy. Please watch Kristin’s important message about self-care in the video below.

By Kaley Johnson

Kristin Burrow, Chaplain of Well-Being in the Spiritual Care Department, and Jennifer Hayes, the Director of Spiritual Care, have long seen the need for Cook Children’s staff to have emotional and spiritual support. In July 2023, Burrow started in her new position after working at Cook Children’s for five years.

Since then, she has focused on extending resources for staff well-being through empowerment, new programs and emphasis on listening.

In July 2023, Kristin moved into the newly created role as Chaplain of Well-Being. While traditional hospital chaplain roles are connected to patients, Kristin focuses on staff. As a former PRN and NICU chaplain she saw firsthand the burnout and emotional strain that can accumulate for people in the medical field. Her hope is through education and access to resources, staff will not only help themselves, but also help one another.

One such initiative Kristin has tackled is creating QPR workshops for staff. Similar to CPR, QPR -- which stands for Question, Persuade, Refer -- teaches people to help peers who are in a medical emergency. Staff learn how to talk to someone in a mental health crisis, urge them to seek help and refer them to mental health resources at Cook Children’s.

Each QPR training lasts one hour and can be taken during work time.  Participants will learn the warning signs of a suicide crisis, know what to say to someone who might be at risk for suicide and how to how to get help. The training will be available in English and Spanish and there is no cost to employees.

Staff at the Medical Center-Fort Worth will be able to sign up to take part in the training via ULearn here. Leaders can also reach out to Kristin to schedule a time to learn more about scheduling a training time that works for their team.

Kristin has also focused on peer-to-peer conversations, which are an integral piece of mental health wellbeing in the workplace. To create the space for more of those peer-to-peer connections, Kristin and the Spiritual Care Department increased the amount of debriefs that departments and individuals participate in after an emotional event or case. In 2024 so far, the department has helped coordinate 99 debriefs with 701 total staff members.

“Our Promise starts with knowing that every child’s life is sacred’, and knowing that, we promise to ‘improve the well-being of every child in our care’. Our employees work so hard to live into that promise, and it takes a toll on the mind, body and spirit. I am grateful this role reminds us that our lives are also sacred, and our well-being is connected to our patients’ well-being,” she said.  

Kristin, a Fort Worth native, obtained a degree in Political Science before going to seminary school at 35. Even before then, she took part in various nonprofits which heavily influenced her approach to wellness care.

Locally and abroad, she worked with farmers through the organization Growing Hope, which helps people develop sustainable farming practices. Rather than a one-size-fits-all approach, Kristin and her work at Growing Hope focused on what individual communities already knew and had access to and helped create a unique farming plan tailored to the community.

That approach gave her the foundation to how she approaches spiritual care now, in which she empowers people to discover solutions instead of just telling them what to do.

“If you stop and you listen to somebody, they have their own solution in them,” she said. “I'm not the solution, but helping them find the solution for themselves, or helping them find and connect to the resources that we have, I think that that's really important.”

As she continues in her role, Kristin hopes to continue to facilitate peer-to-peer support programs, increase support for staff who experience workplace violence and coordinate more debriefs for Cook Children’s staff.

You can contact Kristin at StaffCare@cookchildrens.org or call Spiritual Care office (682) 885-4030 during business hours. If you need to reach a chaplain after hours please call (682) 885-4000 and page the chaplain on call.

Self-Care Resources for You

At Cook Children’s we have many resources dedicated to supporting you. Click the links below to learn more.

Mental Health Resources: Contacts for EAP, counseling, Spiritual Care and other resources to support you.

Healthy Me: A voluntary health and wellness program for employees. Links to Virgin Pulse, CareATC, Uprise Health, Fidelity and many more.

Occupational Health: Learn about health and safety at work.

Spiritual Care: This team provides staff care through counseling, resource referrals, debriefings and more.

Benefits: Learn more about 2024-25 benefits updates and open enrollment as well as information and contacts for your current benefits providers.

Cook Children’s University: Learn about and register for classes to enhance your personal and professional well-being.

Wherever you work across the System, we hope you’ll take part in Well-being Month! We want to enable you to have the emotional and physical energy and motivation to be your best. Begin with you and be well!

Questions about Well-being Month? Email teamexperience@cookchildrens.org

It's National Suicide Awareness Month and we at Cook Children’s are not immune to the devastation, pain, and uncertainty that accompanies our friends, family, and co-workers who experience suicidal thoughts or die by suicide. 

Simple, real conversations that create space for an individual to express suicidal thoughts can be the difference between life and death. 
How do you start these types of conversations?

Question, Persuade, Refer

Cook Children's is offering an evidence-based suicide prevention training that teaches staff how to engage, interpret, and respond to peers experiencing suicidal ideations. It's called Question, Persuade, Refer Training, or QPR for short. QPR teaches three steps that anyone can take to help save a life from suicide.  QPR training is being introduced first to employees at Cook Children's Medical Center-Fort Worth this fall, and will expand to additional locations starting next year.

QPR is an emergency mental health intervention for suicidal persons created in 1995. The intent is to identify and interrupt the crisis and direct that person to the proper care. Just as people trained in CPR help save thousands of lives each year, people trained in QPR help save lives as they learn how to recognize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help. 

QPR Training Through Cook Children's

Mental health and suicide can be challenging topics to address with colleagues.  It is important to reduce the stigma that surrounds suicide and self-harm, and instead normalizes these conversations. That's why we are making this training available to our employees.

Each QPR training lasts one hour and can be taken during work time.  Participants will learn the warning signs of a suicide crisis, know what to say to someone who might be at risk for suicide, and how to how to get help.
The training will be offered in-person and through Zoom with a live trainer. The training will be available in English and Spanish and there is no cost to employees. 

You'll notice that the last step in QPR is to Refer, and a multidisciplinary team has been working on a referral process that guides staff when an on-shift colleague needs help. That's why the initial QPR training opportunities will be available for employees who work at the Medical Center-Fort Worth, and will coincide with a mental health crisis response plan specifically designed for Medical Center-Fort Worth  staff. Staff at the Medical Center-Fort Worth will be able to sign up to take part in the training via ULearn here.  

Rest assured, we did not forget about those of you who work in our other facilities. The more people trained in QPR, the more lives saved. We want to do right by every employee, ensuring we are able to work with each site’s leadership to develop a mental health crisis response plan that is mindful of the context and available resources at each location. 

Why Are We Offering this Training?
In short, we are offering this training because you matter. You are a sacred being who is full of value and worth. 
We want you and our entire community to connect in meaningful ways that bring about hope, eliminates stigma, fosters resiliency, and positively impacts the people in our lives—in and outside of Cook Children’s. 

 Cook Children's has many mental health resources available for employees. Click here on CookNet to learn more. 

 Results Sharing

To date all executives and their leadership teams have received results for their direct reports. Most department leaders have also shared results with their teams with some remaining departments finishing up by the end of this month.

If you have questions about next steps after rolling out results to your team, please reach out to one of our Leadership Coaches for support:

Jeremy Jameson, Jeremy.Jameson@cookchildrens.org

Kim Hampton, Kim.Hampton@cookchildrens.org

Physician Results Sharing

The physician wellness advocates, Sara Garza, M.D.,  and Kirk Pinto, M.D.,  are nearing the end of the physician survey results reporting and listening rounds with clinics and departments within the Physician Network. If any physician missed their department’s results meeting, they can reach out to Kim Swain in CCPN Administration to set up a meeting to review survey results.

As part of their results reporting meetings, they’ve asked physicians to serve as wellness champions and have had almost 20 primary care and specialty care physicians express interest. This group will work together on a framework for addressing physician feedback from the survey. 

Focus Groups

As we mentioned in the last burnout survey communication, 68 departments were identified as priority areas that need additional support. The Team Experience & Organizational Development team will begin focus groups with teams in May and these will run through the summer. Focus groups allow for open discussions about the survey’s findings and help us learn about any changes that have occurred over the past few months. Most importantly, agreed-upon initiatives and next steps will be established to ensure the most meaningful change for each team.

New Burnout Resources for Leaders

Since you’ve had your initial conversation with your team about the survey results, you may want help with having additional conversations about next steps or opportunities to work on. Here are two resources that can assist you:        

• The Leader’s Guide 
• Additional Resources for Leaders Guide.  

These guides will bring more clarity on understanding, addressing and preventing burnout and touch on:

• Leader support throughout the upcoming focus groups, but also, for other similar activities leaders might be interested in initiating within their teams to collect feedback and address opportunities.
• Overview of key measures of the burnout survey.
• Tips on taking in feedback and creating psychological safety for people to share feedback.
•  How to take action on your team’s feedback to improve their work life.
• Following up on your team’s progress for meaningful change to their work life.

We look forward to sharing updates on our progress addressing and preventing burnout here at Cook Children’s.

For current resources to support your well-being, click here.

Please share these resources – available in English and Spanish – with friends, family, colleagues and neighbors. And be sure to check back often for new information.

The New Year is a great time to jumpstart your healthy lifestyle goals as part of improving your wellbeing, managing stress and safeguarding your overall quality of life.

But making changes with an eye toward slimming down is easier said than done. That’s why providers at CareATC want to help Cook Children’s employees achieve and maintain a healthy lifestyle and body mass index through potential behavioral changes and health maintenance strategies.

Cook Children’s partners with CareATC to offer enhanced primary care services at multiple locations with quick accessibility. Shital Chavda, M.D., and Cassandra Muff, FNP-BC, provide care at the CareATC Health & Wellness Center at 500 S. Henderson St., less than a mile from Cook Children’s Medical Center- Fort Worth.

Patients can come to CareATC for advice about good nutrition, water consumption, avoiding processed foods, exercise and other lifestyle habits that affect the weight we carry.

“It’s not new information. We all know what we’re supposed to be doing,” Cassandra said. “But people get frustrated when they’re trying to do it and the results are not working as well as they would like.”

Stress eating, convenience foods and lack of time/energy to exercise can all play a role in weight gain. Sweet treats, fast food and overeating can be temptations when people work long shifts, night shifts and stressful jobs. Thyroid problems, hormone imbalance and some medications also affect appetite and weight. But your health care providers can team up with you to help set goals for improving your diet and exercise habits.  

“People feel good when they’re able to set aside some time for a walk or to go to the gym,” Dr. Chavda said. “When they’re just too busy and stressed to make that time a priority, in combination with other habits, it can lead to unwanted side effects like weight gain.”

CareATC provides enhanced access to primary care services for no charge or a reduced cost. Dr. Chavda and Cassandra are accepting new patients, and they specialize in seeing Cook Children’s employees and their covered family members ages 18 and older. Members also have access to four other CareATC locations across the DFW Metroplex.

Visits are 100% covered by Cook Children’s when enrolled in the HRA or EPO plans. For people enrolled in the HSA1 and HSA2 plans, the cost for a diagnostic visit is only $10. Employees not enrolled in a Cook Children’s medical plan have access to acute medical care for $10 per visit.

You can make an appointments on the CareATC mobile app, the Patient Portal at www.careatc.com/patients, or by calling 1-800-993-8244. 

Go to CookNet to learn more about the Cook Children’s HealthyMe wellness initiative, which includes:

·         Discounts for joining Weight Watchers or other recognized weight loss programs 

·         Wondr Health online behavioral counseling program that includes lessons for weight loss and eating tips for preventing heart disease and diabetes

·         Free access to the Wellness Zone workout facility

·         Screening of weight, BMI and other biometrics through Quest Diagnostics

As director of Spiritual Care, Jennifer Hayes spends much of her time at Cook Children’s serving as a confidant to you, our employees.

She talks to us enough to understand how burnout has impacted so many of our lives.

“We hear about it every day … multiple times a day … and yet, here we are … still burned out … surrounded by good, even great intentions, but still burned out,” Jennifer said.

Jennifer understands that an upcoming survey to address burnout may be met with skepticism, since, after all, lots of us don’t need a survey to let us know we are burned out.

So, why do we bother taking a survey at all?

The survey results and findings will give us a detailed snapshot of where we are at this moment in time in regard to burnout throughout the entire system. It will allow leadership to gain an idea of the scope of the issue and prioritize targeted initiatives.

Simply put, we need to hear from our employees to know how big the problem is and what areas are currently the most impacted by burnout.

This issue is prevalent throughout not only Cook Children’s, but health care organizations across the country. The survey is the first step in addressing burnout in a systematic, meaningful way.

“The thing is, we realize that what we have been doing is not enough. The good news is there are many people across the system who are working together to improve wellbeing ….and we are deeply invested in working with you to create a better workplace. Because we can do better as a system. We have to.”

But to get better, we have to first learn more about the issue at hand.

Please take the time to complete the survey.

On Aug. 23, all employees hired by June 30, received an invitation to complete a burnout survey. The survey is available to complete from now to Sept. 13. Please read below to learn more.

As you may recall, this survey was initially planned to launch earlier in the year, but we postponed it due to several factors including rising COVID numbers, the Joint Commission visit, and staffing issues. We care about you and your well-being and we feel we can no longer delay this important survey.

Strengthening the health of our workforce is certainly a concern and a priority at Cook Children’s, which is why we have made it a strategic goal. To achieve this goal though, we first need to hear from you.

Why do we need a survey?

For most of us, this is a time of extraordinary struggle and upheaval. Health care is changing rapidly, creating stress and, ultimately, burnout for employees at all levels and across all functions. The pandemic has accelerated the problem.

You may be wondering, “Why do we need to complete a survey when everyone knows we are experiencing burnout?”

While completing the survey is voluntary, your feedback is critical. The survey results and findings will give us a detailed snapshot of where we are at this present moment in regards to burnout within the system, and will help us prioritize and implement targeted initiatives. Simply put, we need to hear from our employees to know how big the problem is and what areas are currently the most impacted by burnout.

It’s vital in helping us make very important decisions to assist you and everyone else at Cook Children’s. 

What exactly is burnout?

Burnout is a state of physical and emotional exhaustion. It can occur when you experience long-term stress in your job, or when you have worked in a physically or emotionally draining role for a long time. Burnout does not refer to experiences in other areas of life, only in your work life.

What help is available to me now?

While we look forward to seeing the results of the survey, many of us are struggling right now.

Please know we have built an initial set of resources to help you through a difficult time. Click here to review the resources available to you now. Many are no cost to you and are confidential. According to the survey results, we will continuously work on developing these resources to better meet our employees’ needs.

Please focus on your wellbeing and take this time to care for yourself!

How will the survey work?

We will use the Maslach Burnout Inventory (MBI) & Areas of Worklife Survey (AWS) – the gold standard for measuring burnout.

●        The confidential survey will be sent from Mind Garden, a third party vendor, as an External Email with a green approved vendor tag on the invitation.

●        It takes approximately 20 minutes to complete and does not have to be done all at once.

●        You can work on the survey, save your progress and return to it when you have the time.

●        The survey will be open 24/7 until September 13^th at 11:59 PM.

Who will see the results?

The survey will provide each participant a confidential personal report about their own situation. Each person will receive this individualized report in their email shortly after completing the online survey. Nobody else will receive your individual report, and the report is not accessible to anyone but you. Cook Children’s is highly committed to preserving confidentiality in all aspects of this data collection process. After the survey closes, executive leaders will receive a de-identified summary of the combined results for their area.

What are we going to do with the results?

Cook Children’s is making serious efforts to make our chosen careers in health care the rewarding endeavor we all envisioned and not the frustrating challenge that, for far too many, it has become. The results of the survey will be used to build data-driven strategies and associated interventions aimed at preventing and addressing burnout at the individual, team and organizational level.

Please take this opportunity to help Cook Children’s improve your experience.

Please take the survey as soon as it is emailed to you. We encourage you to respond with honest answers. Your participation will help gauge the level of burnout among Cook Children’s employees and identify areas of strength or weakness within our organization that may be contributing to burnout

If you need support, please consult the following resources and find the one that responds to your needs:

Uprise Health

You’ll receive confidential advice, support and practical solutions to real-life issues. Life presents us with challenges at work and at home on a daily basis. You don’t need to face these challenges alone.

Our EAP benefits are available to all employees and their families at no cost to you.

• Confidential counseling: Up to six face-to-face, video or phone counseling sessions per issue (for relationship and family issues, stress, anxiety and other common challenges).
• 24-hour crisis help: Toll-free access for you or a family member experiencing a crisis.
• Peer support groups: Online support groups for addiction, depression, bipolar, anxiety, parenting, LGBTQ+, front-line workers and grief.
• Coaching: Up to three sessions with a coach to help develop resilience, stress management and mental fitness.

Free and confidential help available at 24/7 800-395-1616

uprisehealth.com/members

• Access code: cook

Our EAP also provides a wide range of work-life balance services to help you achieve a better balance between work and family to help make your life easier:

• Child care services: Information and support on parenting, school issues, adoption, college planning, teenager challenges, summer camps, daycare and other important issues.
• Adult and elder care services: Information and services including transportation, meals, activities, prescription drug information, in-home care, daytime care and housing.
• Legal services: Access a free, half-hour consultation, by phone or in person, for any non-work-related issue, followed with a 25% discount in legal fees. Create online legal forms including wills, contracts and leases.
• Financial help: 30 consecutive days of free phone consultations for debt counseling, budgeting, college/ retirement planning and taxes, including 25% off certified public accountant services for tax preparation.
• Mediation services: Free consultations for personal, family and non-work-related issues.

As part of EAP,  Tess, a well-being chatbot, is a different type of immediate resource available:

• Tess is  available 24/7, that provides emotional support and check-ins to boost your wellness.
  • Tess follows up with reminders and check-ins to reinforce use of skills learned in previous conversations.
• Chat with Tess for unbiased emotional support in the moment you need it the most.
• Build resilience and self-awareness by practicing coping skills at your convenience.

Text “Hi” to 650-825-9634 to get started.

Responder Health

As a front-line  worker, what happens when your personal life and/or career are out of balance?

Responder Health provides confidential and full-service solutions that support front-line workers through stress and traumatic events.

The confidential crisis hotline, made for frontline workers and answered by front-line workers, is available 24/7.

• Responder Health can help you find a vetted counselor and/or treatment facility that are in-network.
• Cook Children’s peer support program can help you overcome the challenges of being a front-line worker.

If you are in crisis, or just need to talk, call 206-459-3020, 24 hours a day, 7 days a week.

Responder Health App (available on Google Play or Apple App Store).

The app helps front-line workers and their families learn skills and habits for dealing with life’s daily stressors. Three minutes a day can help you become happier, more resilient and lead a more fulfilling life.

Unlock Code: COOK21

TRAUMA | RELATIONSHIPS | FINANCES

PTSD | SUBSTANCE ABUSE

CareATC/EAP in-person services

When it comes to whole-family health care, we’re all in it together. Every day, Cook Children’s employees work to improve the well-being of every child in our care and our communities.

But we can only take care of others when we take care of ourselves.

To make sure that happens, Cook Children’s has partnered with CareATC to provide an additional benefit to help care for health care professionals who have dedicated their lives to taking care of others.

CareATC offers the best care when you need it most. Appointments are required and can be made on the CareATC mobile app, the Patient Portal at www.careatc.com/patients, or over the phone by calling 1-800-993-8244. 

Appointments with our EAP therapist can be scheduled separately by calling the EAP main phone number, 1-800-395-1616. We will have much more information on this service in the upcoming weeks.

You can schedule in-person visits, or after becoming an established patient, you can schedule virtual visits through your computer or phone. Same-day appointments are available on a first-come, first-serve basis and must be scheduled over the phone.

To get started, activate your CareATC patient account by visiting www.careatc.com/activate or downloading the CareATC app and following the prompts. It's important that each eligible member aged 18 and older creates his or her own account.  For more information, visit careatc.com/cc.

To learn more about CareATC and its providers, click here.

For most of us, this is a time of extraordinary struggle and upheaval. Health care is changing rapidly, creating stress and, ultimately, burnout for health care professionals, at all levels and across functions. The pandemic has sped up the problem. At Cook Children’s, we truly care about you and your teams, and we are determined to prevent and address burnout.

What exactly is burnout?  The World Health Organization defines burnout as resulting from chronic workplace stress that has not been successfully managed. It is characterized by:

• Feelings of low energy or exhaustion
• Feelings of detachment, negativism or cynicism related to one's job
• Reduced professional efficacy

Burnout does not refer to experiences in other areas of life, only in your work life.

What are we going to do about it?  We’re conducting a system-wide burnout assessment survey to learn about our exposure to burnout, and identify potential workplace burnout triggers. The survey will: 

• Explore individual perceptions of work-related stressors
• Identify key areas of strength or weakness in the workplace that may cause and/or trigger burnout
• Build data-driven solutions to prevent and address burnout at both individual and organizational level

How are we going to do it?  We will use the Maslach Burnout Inventory (MBI) & Areas of Worklife Survey (AWS) – the gold standard for measuring burnout. Each individual will be invited via email to complete an assessment in April that will measure:

• Exhaustion - feelings of being overextended and exhausted by one's work.
• Depersonalization or Cynicism -indifference or a distant attitude toward your work and/or patients
• Professional Accomplishment/Efficacy - satisfaction with past and present accomplishments, assesses an individual's expectations of continued effectiveness at work

What about the results?  Each person will receive their individualized report in their email shortly after completing the online survey. Nobody else will receive the individual report. Cook Children’s is highly committed to preserving confidentiality in all aspects of this data collection process. Leaders will receive a de-identified area summary and aggregated data will be used to develop strategies to address burnout.

Q: Why do we want or need to do a burnout survey?

A: The need has been identified analyzing different available data points. For example:

• Internal formal data - physician burnout survey in 2019, safety survey, turnover reports, exit interviews, patient experience survey.
• External formal data - burnout-related studies and trends with focus on health care industry.
• Informal data - employee feedback on their work experience that relate to burnout triggers, such as: unsolved work stressors, workload, leadership concerns, compensation and request for different types of organizational support in areas that connect to burnout.

Q: What is the intent or purpose of the survey?

A: Many of us might experience burnout. However, whether or not we do, how and why we experience burnout, and how we can address and prevent it, are questions we still do not have an answer for.

The overarching purpose for burnout interventions is to minimize its occurrence and support a preeminent team experience through an organizational ability and readiness to address and prevent burnout, gain a sense for its predictability and its controllable evolution.

Here are the main ways to achieve this level of maturity in addressing and preventing burnout:

• Establish a solid baseline in terms of organizational diagnostic, inclusive of clinical and non-clinical employees.
• The possibility to build results-driven interventions.
• Create a meaningful cause-effect cycle.
• Monitor progress.

Q: What does it gauge or measure specifically?

A: The Maslach Survey represents the gold standard in measuring burnout. We will use two sets of questions:

1. Maslach Burnout Inventory (MBI): The purpose of this assessment is to discover how our employees view their job and the people with whom they work closely.

The MBI-GS addresses three scales:

• Exhaustion measures feelings of being overextended and exhausted by one's work.
• Cynicism measures an indifference or a distant attitude towards your work.
• Professional Efficacy measures satisfaction with past and present accomplishments and it explicitly assesses an individual's expectations of continued effectiveness at work.

2. Areas of Work Survey (AWS): The purpose of the AWS assessment is to discover potential work-related burnout triggers for our employees.

Q: Why is it important that we know this type of information?

A:  This complete analysis will help us create the cause - effect loop for burnout, indicating not only our burnout status at different levels,  but also what are our opportunities to work on essential workplace components that are responsible for generating burnout, through targeted interventions.

Q: Why is now the right time for us to conduct this survey?

A: The need is here. This survey had been initially scheduled for 2020, but COVID-19 happened and we postponed it. We are not getting better, according to available data. Burnout aggravates in time, it’s not a “time will solve it” type of problem. Twenty minutes of fighting against survey fatigue and competing priorities, and taking the time to participate can have a huge impact on our workplace health and wellbeing.

Q:  What will we do with the information we receive?

• Work on reports, data analytics and findings.
• Communicate results and findings at the system level, and cascade it down to specific groups, as relevant (by company, team, function, etc.).
• Create a system-wide strategy and associated interventions; plan and communicate with/to key constituents for prioritization and implementation.
• Monitor and communicate progress at the required levels

Q: Will there be department specific information?

A: Yes. However, no action is expected from supervisors, managers and directors, other than collaborating for successful implementation, as necessary. 

Q: What else do you want people to know?

A:  Each respondent will receive an individual report with their individual burnout profile and related recommendations. NOBODY ELSE will ever see that report. Its meaning is to increase individual awareness and promote individual care. Based on the results and the findings, we will implement system interventions post-survey. Individual care and system interventions are aimed to go hand-in-hand for the best results.

Resource: Home - Wellness Resource Library - Library Services at Cook Children's Health System (cookchildrens.org)

When you experience burnout problems seem insurmountable, everything looks bleak and it’s difficult to muster up the energy to care, let alone take action to help yourself. But you have a lot more control over stress than you may think. There are positive steps you can take to deal with overwhelming stress and get your life back into balance. One of the most effective is to reach out to others.

Social contact is nature’s antidote to stress and talking face to face with a good listener is one of the fastest ways to calm your nervous system and relieve stress. The person you talk to doesn’t have to be able to “fix” your stressors; they just have to be a good listener, someone who’ll listen attentively without becoming distracted or expressing judgment.

RECOGNIZE – Watch for the warning signs of burnout.

REVERSE – Undo the damage by seeking support and managing stress.

RESILIENCE – Build resilience to stress by taking care of your physical and emotional health.

TURN TO OTHER PEOPLE

• Be more sociable with your coworkers - Developing friendships with people you work with can help buffer you from burnout. When you take a break, for example, instead of directing your attention to your smartphone, try engaging your teammates. Or schedule social events together after work.
• Limit your contact with negative people - Hanging out with negative-minded people who do nothing but complain will only drag down your mood and outlook. If you have to work with a negative person, try to limit the amount of time you spend together.
• Connect with a cause or a community group that is personally meaningful to you. Joining a religious, social, or support group can give you a place to talk to like-minded people about how to deal with daily stress—and to make new friends. If your field has a professional association, you can attend meetings and interact with others coping with the same workplace demands.
• Find new friends - If you don’t feel that you have anyone to turn to, it’s never too late to build new friendships and expand your social network.

REFRAME THE WAY YOU LOOK AT WORK

• Try to find some value in your work - Focus on aspects of the job that you do enjoy, even if it’s just chatting with your coworkers at lunch. Changing your attitude towards your job can help you regain a sense of purpose and control. Rediscover you professional purpose and meaning (include MAGIC resources)
• Try to integrate your two most critical aspects of life: lifestyle and workstyle – Discuss with your supervisor and colleagues work-life solutions that will harmonize your life: waste walk, flexible work schedule, etc.
• Make friends at work - Having friends to chat and joke with during the day can help relieve stress from an unfulfilling or demanding job, improve your job performance, or simply get you through a rough day.
• Take time off - If burnout seems inevitable, try to take a complete break from work. Go on vacation, use up your sick days, ask for a temporary leave-of-absence, anything to remove yourself from the situation. Use the time away to recharge your batteries and pursue other methods of recovery.

REEVALUATE YOUR PRIORITIES

• Set boundaries - Don’t overextend yourself. Learn how to say “no” to requests on your time. If you find this difficult, remind yourself that saying “no” allows you to say “yes” to the commitments you want to make.
• Take a daily break from technology - Set a time each day when you completely disconnect. Put away your laptop, turn off your phone, and stop checking email or social media.
• Nourish your creative side - Creativity is a powerful antidote to burnout. Try something new, start a fun project, or resume a favorite hobby. Choose activities that have nothing to do with work or whatever is causing your stress.
• Set aside relaxation time - Relaxation techniques such as yoga, meditation, and deep breathing activate the body’s relaxation response, a state of restfulness that is the opposite of the stress response (Virtual Energy Break).
• Set aside recovery time – Close the door behind you when you finish your work day and focus on family, friend, hobbies and other environments and activities that help you disconnect
• Get plenty of sleep – Feeling tired can exacerbate burnout by causing you to think irrationally. Keep your cool in stressful situations by getting a good night’s sleep. 

MAKE EXERCISE A PRIORITY

• Even though it may be the last thing you feel like doing when you’re burned out, exercise is a powerful antidote to stress and burnout. It’s also something you can do right now to boost your mood.
• Aim to exercise for 30 minutes or more per day or break that up into short, 10-minute bursts of activity. A 10-minute walk can improve your mood for two hours.
• Rhythmic exercise, where you move both your arms and legs, is a hugely effective way to lift your mood, increase energy, sharpen focus, and relax both the mind and body. Try walking, running, weight training, swimming, martial arts, or even dancing.
• To maximize stress relief, instead of continuing to focus on your thoughts, focus on your body and how it feels as you move: the sensation of your feet hitting the ground, for example, or the wind on your skin.

SUPPORT YOUR MOOD AND ENERGY LEVELS WITH A HEALTHY DIET

• Minimize sugar and refined carbs - You may crave sugary snacks or comfort foods such as pasta or French fries, but these high-carbohydrate foods quickly lead to a crash in mood and energy.
• Reduce your high intake of foods that can adversely affect your mood, such as caffeine, unhealthy fats, and foods with chemical preservatives or hormones.
• Eat more Omega-3 fatty acids to give your mood a boost –The best sources are fatty fish (salmon, herring, mackerel, anchovies, sardines), seaweed, flaxseed, and walnuts.
• Avoid nicotine - Smoking when you’re feeling stressed may seem calming, but nicotine is a powerful stimulant, leading to higher, not lower, levels of anxiety.
• Drink alcohol in moderation - Alcohol temporarily reduces worry, but too much can cause anxiety as it wears off.

Reference:  Burnout Prevention and Treatment - HelpGuide.org

• Feeling like you have little or no control over your work - such as your schedule, assignments or workload: This could lead to job burnout and you might feel like you have a lack of the resources you need to do your work.
• Unclear or overly demanding job expectations: If you're unclear about the degree of authority you have or what your supervisor or others expect from you, you're not likely to feel comfortable at work.
• Dysfunctional workplace dynamics: Perhaps you work with an office bully, or you feel undermined by colleagues or your boss micromanages your work. This can contribute to job stress.
• Doing work that’s monotonous or unchallenging: When a job is monotonous or chaotic, you need constant energy to remain focused — which can lead to fatigue and job burnout.
• Lack of recognition or reward for good work: If you feel that the value of your work is not seen and you lose your sense of purpose and meaning.
• Lack of integration of your work and personal life: If your work takes up so much of your time and effort that you don't have the energy to spend time with your family and friends, you might burn out quickly.

Other Individual Factors that Play a Critical Role

Other factors may create the right context for burnout, including your lifestyle and personality traits. In fact, what you do in your downtime and how you look at the world can play just as big of a role in causing overwhelming stress as work or home demands.

Lifestyle factors:

• Working too much, without enough time for socializing or/and relaxing – recovery time
• Lack of close, supportive relationships
• Talking on too many responsibilities, without enough help from others you have expectations from
• Not getting enough sleep

Personality traits:

• Perfectionistic tendencies - nothing is ever good enough 
• Pessimistic view of yourself and the world 
• The need to be in control – reluctance to delegate to others 
• High-achieving expectation for self 

If this sounds like you, consider what steps you can take to combat burnout.  Some helpful tips are here. Be well.

Resources: Burnout Prevention and Treatment - HelpGuide.org

• Have you become cynical or critical at work?
• Do you drag yourself to work and have trouble getting started?
• Have you become irritable or impatient with co-workers, customers or clients?
• Do you lack the energy to be consistently productive?
• Do you find it hard to concentrate?
• Do you lack satisfaction from your achievements?
• Do you feel disillusioned about your job?
• Are you using food, drugs or alcohol to feel better or to simply not feel?
• Have your sleep habits changed?
• Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?

If you answered yes to any of these questions, you might be experiencing job burnout. Consider talking to a doctor or a mental health provider because these symptoms can also be related to health conditions, such as depression.

Our CareATC office near the medical center, now offers EAP (counseling) services. Consider making an appointment today by learning more here. Everything you share  with this health care professional is confidential.

Reference:  Job burnout: How to spot it and take action - Mayo Clinic

Stress, by and large, involves too much required, i.e. too many pressures that demand too much of you physically and mentally. However, stressed people can still imagine that if they can just get everything under control, they’ll feel better.

Burnout, on the other hand, is about not enough left. Being burned out means feeling empty and mentally exhausted, devoid of motivation, and beyond caring. People experiencing burnout often don’t see any hope of positive change in their situations. If excessive stress feels like you’re drowning in responsibilities, burnout is a sense of being all dried up. And while you’re usually aware of being under a lot of stress, you don’t always notice burnout when it happens.

Stress vs. Burnout 

Resources: Burnout Prevention and Treatment - HelpGuide.org

Most of us have days when we feel helpless, overloaded, or unappreciated—when dragging ourselves out of bed requires the determination of Hercules. If you feel like this most of the time, however, you may be burned out.

Physical signs of burnout:

• Feeling tired and drained most of the time 
• Lowered immunity, frequent illnesses 
• Frequent headaches or muscle pain 
• Change in appetite or sleep habits

Emotional signs and symptoms of burnout:

• Sense of failure and self-doubt 
• Feeling helpless, trapped and defeated 
• Detachment, feeling alone in the world 
• Loss of motivation 
• Increasingly cynical and negative outlook 
• Decreased satisfaction and sense of accomplishment

Behavioral signs and symptoms of burnout:

• Withdrawing from responsibilities 
• Isolating yourself from others 
• Procrastinating, taking longer to get things done 
• Using food, drugs or alcohol to cope 
• Taking out your frustrations on others
• Skipping work or coming in late and leaving early

Does this sound like you? Our CareATC office near the medical center, now offers EAP (counseling) services. Consider making an appointment today by learning more here. Everything you share  with this health care professional is confidential. 

Reference:  Burnout Prevention - Mental Health America of Eastern Missouri (mha-em.org)

The WHO (World Health Organization) defines burnouts as…

1. “… a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
   1. Feelings of energy depletion or exhaustion 
   2. Increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job
   3. Reduced professional efficacy
2. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

The Basics of Burnout:

• Burnout is a gradual process. It doesn’t happen overnight, but it can creep on you. 
• Burnout refers specifically to how one individual perceives and reacts to their work and/or work environment. 
• Burnout is a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity Personality traits, family life and other individual factors influence the way one experiences burnout. 
• Burnout is not classified as a medical condition, but could lead to serious medical conditions. 
• Burnout does not refer to how individuals perceive and react to areas of life other than work (e.g., family, friends, school, etc.), but the negative effects of burnout spill over into every area of life—including your home, work, and social life. 
• Our best employees may be burnt out. 

Our CareATC office near the medical center, now offers EAP (counseling) services. Consider making an appointment today by learning more here. Everything you share  with this health care professional is confidential. 

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