Make a WISH — Wellness Initiative Supporting Health Mini-Grants in an Academic Medical Department

Abstract

Background

With rising burnout among health professionals, academic medical centers are faced with the challenge of sustaining well-being.

Activity

An academic medical department established the Wellness Initiative Supporting Health (WISH) small grant program to support locally developed wellness-related activities. This assessment describes the feasibility and early outcomes of implementing the WISH projects.

Results

Between 2018 and 2022, 36 of 69 (52%) proposals received funding. Projects focused on individual wellness strategies, team-building activities, and networking events. Grant recipients reported enhanced wellness for activity participants and strong agreement that the program should continue.

Discussion

Implementing low-cost, sustainable wellness initiatives at a “local” level of academic medical centers are feasible.

Background

Burnout and stress among health professionals is associated with poorer quality of care and an increase in adverse patient safety events. [1] With burnout on the rise among health professionals, academic leaders have been searching for effective strategies to enhance well-being among their faculty and staff members in order to promote high-quality patient care. [2–4] Both individual and structural interventions have been shown to have positive impacts on reducing physician burnout. [2, 5] Other studies and perspectives suggest the benefit of building a healthy workplace environment. [6, 7] While accrediting organizations have begun incorporating recommendations for wellness activities for learners (students, residents, and fellows), such as mental healthcare and duty hours for trainees, [8, 9] few guidelines and regulations exist for practicing clinicians and medical educators. Consequently, limited incentives and scarce resources exist for promotion of wellness of health professionals and their healthcare teams — a challenge particularly salient in academic medical centers. This communication highlights an innovative early-stage initiative at a single large academic medical center to address health professional well-being. Specifically, the co-authors designed, implemented, and evaluated the “Wellness Initiative Supporting Health” (WISH) program which provides small grants to foster well-being in an academic medical department.

The objectives of the WISH program were to (1) solicit diverse and creative proposals for wellness activities across an academic medical department (program feasibility), which in turn, would serve as models of effective work-life integration, and (2) enhance self-reported well-being among faculty and staff members in this department through new collaborations and local efforts. Based on previously described interventions, the co-authors anticipated that the proposed projects would be categorized into a framework as either individual or institutional/organizational initiatives.

Activity

The Department of Medicine at Baylor College of Medicine (BCM) in Houston, TX, has over 1500 faculty and staff in 14 sections across seven affiliate clinical sites (including a private outpatient center, large multi-hospital practice, county health system, and Veterans Affairs hospital). The Department of Medicine Vice Chair Group (VCG) for Faculty and Staff Development was created in mid-2017 with the charge of promoting faculty and staff development through mentoring, professional training, team building, and preventing burnout. This multi-disciplinary VCG developed and prioritized specific initiatives which included providing support for wellness activities with the VCG’s limited budget. A “wellness” fund of $20,000 was established from a designated donation and supplemented with department funds. In the fall of 2018, the VCG began using these funds to design and pilot the “Wellness Initiative Supporting Health (WISH) Grants” with the intent of creating a feasible, sustainable program. The VCG solicited online applications to fund small proposals of up to $500. The simple online application requested the following information: name, contact information, section, affiliate location, activity title, objectives, description (limited to 500 words), target audience, anticipated number of participants, budget with justification, suggested strategies for sustainability, and plans for evaluation (the latter two components were recommended, not required).

The primary applicant(s) of the proposed program had to be a staff or faculty member in the department; however, program participants could include faculty, staff, trainees, and family members. Requested funds could only be used to directly support wellness activities — either a single or recurrent event. Applications were scored by two to three reviewers at BCM but who were external to the Department of Medicine and reported no conflicts of interest. Composite scores (range 2–13) comprised of overall program quality (1–5), potential impact on wellness (1–5), the presence of an evaluative component (0–1), and sustainability (0–2). In addition to reviewers’ scores, the VCG considered section and affiliate clinical site diversity (thereby ensuring awards were not concentrated to only a few sections or clinical sites).

From 2018 to 2022, four grant cycles have been completed, and an average of nine applicants received funding each cycle. All WISH grant recipients were required to submit a brief final summary report to the VCG. They were also invited to complete voluntarily a brief, electronic, anonymous survey (via SurveyMonkey ®) to evaluate the program after completion of their projects. Feasibility was assessed by measuring the number and content of applications. Perceived wellness of participants was assessed via the grantee’s responses to the questionnaire.

The co-authors (same faculty as WISH grant program directors) analyzed the responses to assess if any program changes were needed. Mean Likert scores were used to describe and evaluate different aspects of the program.

The Baylor College of Medicine Institutional Review Board (IRB) reviewed and approved this program evaluation study. The authors and the study did not receive funding related to this project.

Results

Over four grant cycles between 2018 and 2022, 36 (52%) of 69 submitted applications received funding. Applicants were comprised of faculty and staff from various affiliate sites (clinics, hospitals, centers) across the institution and represented nearly all 14 sections within the department. The target audience for the grant-related activities included faculty, staff, fellows, and family members.

The optional program evaluation survey was fully completed (with internal consistency) by 18 (50%) of the 36 grantees. Respondents spent between 20 and 30 min on completion of the online application with 100% (N = 18) indicating the process was easy or very easy and 94% (N = 17) felt it was about the right length. Two major themes emerged from review of all proposed activities: mindfulness-type sessions (such as yoga, breathing, art) and social events (for example, picnics, escape room). The most commonly proposed wellness objectives aligned with the proposed framework and were focused on (1) individual wellness activities or (2) institutional/organizational interventions such as team-building and networking events. (See Table 1.) WISH grant awardees reported that the event(s) had high participation rates; fostered interdisciplinary, cross-institutional collaboration; and demonstrated positive outcomes such as meeting grantees’ stated objectives (94% agreed or strongly agreed).

Table 1.

WISH grantee example activities

	Type of activity	Examples
Individual	Fostering individual wellness	• Food as medicine culinary arts class • Mindfulness/yoga/breathing exercise activities • Gardening activity
Organizational/institutional	Team-building	• Ballroom dancing • Zoo trip • Escape room • Painting activity • Team recognition
	Networking	• Mentoring event • Book club • From complaints to commitments workshop

Formal project evaluations were not required of the grantees. Respondents replying to the statement “Based on informal feedback, our funded activity helped enhance wellness among participants” scored 4.88 (on a 5-point Likert scale where 1 = strongly disagree and 5 = strongly agree). Most respondents felt that the funded activity had an impact beyond the directly involved activity participants (61% (N = 11) strongly agree and 17% (N = 3) agree) (see Fig. 1). All respondents strongly agreed the WISH grant program should be continued. When grantees were asked would they apply again if there was a required program evaluation component to the application, 89% agreed (N = 3) or strongly agreed (N = 13).

Fig. 1.

WISH grant program evaluation results (N = 18)*

Representative respondent comments from the post-program evaluation include:

• “This simple intervention [grant project] has positively impacted the lives of many participants who have shared their first-hand reports of using the guided breathing exercises [learned through the WISH project implementation] during their challenging and often stressful days.”

• “Thank you so this grant opportunity! It has allowed me to pursue an initiative that I have been wanting to execute for some time.”

• “This was a great opportunity to initiate wellness at our institution. Hope we can have more of grants in future dedicated to wellness.”

• “Great initiative- much appreciated- larger funds could allow more people in section to participate and bond.”

Discussion

The novel WISH grant program met the objectives of demonstrating feasibility and perceived effectiveness of the program. As evidence of the success of the program, the WISH grants have been adopted as a well-received twice-yearly opportunity for members of the Department of Medicine. The number of requests submitted for the fifth cycle (January 2023) more than doubled from prior cycles with 39 applications. The program has continued to receive more applications than funding allows. The applications include diverse, creative proposals from multiple sections and members (faculty and staff) across the Department of Medicine. Furthermore, responding grantees perceived that their activities effectively enhanced wellness among participants and beyond.

The WISH grant program is limited in its generalizability due to implementation at only one institution — though it is a large and diverse academic medical department. As this program is early in its initiation, the authors studied process outcomes, rather than sustainable changes in the well-being of participants. The assessment is focused on the perspective of the grantees (primary applicants). For future iterations of the program, the VCG recognizes that it will be informative to have a more formal understanding of participants’ wellness (or burnout) and workplace climate through validated burnout and workplace assessment tools prior to and after the WISH grant activity, as well as an evaluation of those who have not or are not participating in a WISH grant-related activity. [10].

To sustain such an initiative at academic medical centers, we encourage departmental or institutional leadership to designate within the budget at least $5000–$10,000 per year to be available to support locally designed wellness mini-grants. Further maintenance of the program could be established through solicitation of small donations from members of the organization and potentially larger donations from philanthropic community supporters.

The robust response of WISH grant proposals demonstrates that there is a clear need and desire to create new programs and enhance ongoing wellness opportunities within this academic medical department. The grant program promoted collaboration within and across institutional affiliates and sections. The initiative also allowed for a customized approach to wellness based on needs of the applicant group by allowing stakeholders to have input. In other words, department members determine which initiatives such as individual or organizational/structural interventions are most needed locally at their particular work site. With minimal funding, effective interdisciplinary grassroots initiatives can be developed and/or supplemented to support wellness among faculty and staff members within a large, diverse academic medical department. The authors hypothesize that fostering a culture of wellness for faculty and staff may have a positive impact beyond program participants — including enhancing patient care outcomes. This initiative contributes to the existing literature on feasible and effective solutions to bolster well-being and resilience in the academic medicine community.

Data Availability

The datasets generated and analyzed during the program evaluation are available from the corresponding author on reasonable request.

Declarations

Ethical Approval

The Baylor College of Medicine Institutional Review Board reviewed and approved this program evaluation study.

Competing Interests

The authors declare no competing interests.