Stress Management and Reduction Program

Background: Stress affects U.S. healthcare workers (HCWs) and costs US$191 billion annually. About 30% to 50% of healthcare providers report burnout. Based on an assessment of a U.S. rural hospital system, 94% of workers experienced negative health consequences. We conducted a quality improvement (QI) project for the purpose of implementing a stress management program for HCWs in a hospital system.

Methods : A total of 500 HCWs were informed of the program through hospital communication channels. Using the Plan-Do-Study-Act (PDSA) process, we screened workers presenting to the occupational health clinic for care. Project team members recruited other workers for stress screening throughout the organization. Interventions included contacting workers with elevated scores on the Perceived Stress Survey (PSS; N = 213). The nurse practitioner scheduled them for a shared-decision-making (SDM) appointment (N = 33) where workers were informed of and encouraged to participate in stress reduction activities. Surveys were used to assess effectiveness of SDM appointments and the stress reduction activities. After each 2-week PDSA cycle, interventions were adjusted.

Findings: Of the 42% (N = 213) of workers who were screened for stress, 24% (n = 52) had elevated scores. Fifty percent (n = 26) completed an SDM appointment. Participants reported an 86% assurance level that they would use personalized stress management plans. Participants utilizing the interventions (n = 271) reported 25% to 72% reduced stress levels.

Conclusions/application to practice: This successful project, in a rural setting, included workers across job classifications. Team engagement, PSS screening, SDM opportunities, and stress management activities were project strengths. This low-cost project can be replicated.