What Healthcare Leaders Will Take Away
Dr. Trisha Vinatieri is a clinical and organizational psychologist who began her career treating veterans with PTSD and now works with medical leaders on the system factors that wear good people down. She and Lillian talk about why healthcare keeps handing the problem back to individuals, what it looks like when an organization puts wellbeing into its culture, and which tools a team can start with.
- It is not your fault. Burnout, she says, is the consequence of the environment you work in.
- Resilience is one leg of the stool. Culture and efficiency of practice are the other two.
- Start where you have control. Listen, Sort, Empower and GROSS help a team fix its own workflows.
- Leaders set the tone. What you model, she says, is how your staff will respond.
Why has healthcare treated burnout as an individual problem?
She would also argue there is a little bit of fundamental attribution error, and explains it with an exam: if she does well, she studied hard; if she does poorly, the exam was unfair. When someone else fails, we assume they did not put in the work. Applied to a struggling colleague, she says, we assume it is something they are not doing right.
She asks people to start from one mindset: burnout is not your fault.
“Burnout is the consequence of existing in an environment where you’re being asked to do too much with too little oftentimes, or you’re in an environment that is not supporting you in doing the work that is being expected of you.” Trisha Vinatieri, PsyD
For the symptoms and early signs, Episode 94 covers recognizing burnout in healthcare.
What did the pandemic reveal about clinician wellbeing?
In her reading of the literature, clinicians are already a little more resilient than the average person. So, in her words, it wasn’t about resiliency.
Lillian remembers the pandemic as the first time healthcare gave people permission to stay out of the building when they were not well, and how closely colleagues watched out for each other. Both see healthcare sliding back since then.
“It’s like we have such short memories, and sometimes it feels like organizations are more about we need that position filled or we need to get the work done.” Trisha Vinatieri, PsyD
What does it mean to center wellbeing in an organization’s culture?
What that looks like in practice:
- Support after adverse events. Programs that take care of staff when something happens to them at work, because it happened at work.
- Protected time. Not a lunch break where staff choose between eating and 30 minutes of yoga.
- Leaders who model it. Taking leave and staying off the device while away.
- Signals that it is safe to struggle. Struggling does not mean the organization will question your ability to do your job.
She encourages leaders to look at the Dr. Lorna Breen Heroes’ Foundation, which works to remove mental health stigma from licensure and credentialing paperwork. Transforming Healthcare Coaching® is an ambassador for the Foundation. Lillian adds peer support programs to the list: trained colleagues who listen well and recognize the warning signs of moral injury, or step in after an adverse event.
Why does clinician wellbeing matter to patients?
She makes the case both ways:
“It’s a business investment if we want to get down to numbers and things like that. For me, it’s really about the moral imperative of taking care of our people.” Trisha Vinatieri, PsyD
What does the Stanford model say an organization needs?
- Culture of wellbeing. Staff can tell the organization wants them fulfilled in their work, because that shapes the quantity and quality of care.
- Efficiency of practice. People have the resources they need, workflows are clean, and the right people do the right tasks. She asks whether physicians are doing four hours of administrative work a day.
- Personal resilience. It has a part to play. She sees organizations reach for it, in part, she thinks, because it is cheaper: buy an app, or beef up the Employee Assistance Program.
That is where she sees the biggest gap between what leaders ask for and what helps. Leaders often ask her to teach mindfulness or personal resilience. Her answer is that they can do those things too, alongside the harder work: the electronic health record, staffing models, workload demands, and panel sizes that match the patients a clinician sees.
Handing people tools to manage it on their own, she says, amounts to this:
“We’re going to give you tools so you can tolerate the system that’s broken.” Trisha Vinatieri, PsyD
Lillian adds that leaders who do not run pilot projects or create more autonomy for their teams are part of the problem too.
Where can a team start, and what are Listen, Sort, Empower and GROSS?
About Listen, Sort, Empower, she says:
“Your staff have already identified things that could run more smoothly, and either they don’t want to bring it up because they don’t have time or they’re like I’m just going to use this workaround because if I bring it up, is it really going to change?” Trisha Vinatieri, PsyD
- Listen, Sort, Empower. A structure for a work group’s conversations about what to improve in its own workflows, and what is within its control. The module takes three hours in total and can be spread across several weeks or a month.
- GROSS. A department-wide campaign that collects the tasks people would remove. The time depends on the number of submissions. On average, she sees large services spend five to eight hours in total.
- Protected time. Staff who join the work group and lead the changes need protected time to do it.
The return, in her view, is leaner operations and a culture where people keep looking for the next thing to clean up. Lillian notes that a leader can run a nimble team inside an organization that is not nimble. For more on how teams work within a larger system, Episode 112 covers teams thinking within the system.
What can you do if you are not in the leadership seat?
Questions she uses:
- What makes the job harder?
- What makes you wonder whether this is the job for you?
- What is the difference between a good day and a bad day?
Some answers will sit outside your control, such as hospital-wide policies or parking. Often, she says, they are within your sphere of control. Lillian’s addition: find like-minded colleagues across the building. She points to hospital sustainability committees as an example of people banding together across teams.
For leaders, the same questions work in team meetings, and so does checking on your own exhaustion. Staff, she says, will follow the leader.
“So if you are someone who’s taking care of yourself, you’re leaving at the end of your work schedule, you’re not answering emails at 2:00 in the morning … that is going to set the tone for your work group, for your staff, for your service.” Trisha Vinatieri, PsyD
Take the first step
If you lead a team and want to start with what is in your control, we are one conversation away.
Key Takeaways for Healthcare Leaders
Frequently Asked Questions
Why is burnout a system problem and not an individual one?
What does it mean to build a culture of wellbeing in a hospital?
What is the Stanford model of occupational wellbeing?
What is Listen, Sort, Empower?
What is the Get Rid of Stupid Stuff (GROSS) program?
What can frontline staff do about exhaustion at work if they are not in leadership?
Episode Transcript
Download transcript (.txt) ↓︎Segment 01 · 00:00
Burnout Is Not Your Fault
The episode opens on a clip of Dr. Vinatieri on the workplace, then Lillian describes the clinician who has done the yoga, the app and the resilience training and still feels hollowed out.
Segment 02 · 01:16
Meet Dr. Trisha Vinatieri
Lillian introduces a clinical and organizational psychologist who began by treating veterans with PTSD, then asks why healthcare has treated exhaustion at work as an individual problem.
Segment 03 · 02:23
Why We Blame Individuals
Research focused on self-care and resilience, the fundamental attribution error explained with an exam, and why clinicians did not lack resilience in the first place.
Segment 04 · 05:20
COVID Exposed the System
Staff who already knew about sleep and vacation, COVID throwing organizational challenges into relief, the pandemic permission to stay home when unwell, the relapse since, and Lillian on AI implementation.
Segment 05 · 08:26
Wellbeing as Culture
What centering wellbeing means, adverse event support, protected time instead of choosing between lunch and yoga, the Dr. Lorna Breen Heroes’ Foundation, credentialing paperwork, and peer support.
Segment 06 · 13:48
Quadruple Aim Case
Care of the care team as the fourth aim, patients who notice when their physician is burnt out, and the moral and fiscal case for investing in people.
Segment 07 · 15:23
Three-Legged Stool
The gap between what leaders ask for and what helps, tools to tolerate a broken system, the Stanford model’s three domains, staffing and panel sizes, and Lillian on leaders who wait for the system to change.
Segment 08 · 22:11
AMA Tools for Change
AMA STEPS Forward, Listen, Sort, Empower for work groups, GROSS for departments, the time each takes, protected time, and Lillian on stipends replacing embedded time.
Segment 09 · 26:45
What Staff Can Do
Speaking up with psychological safety in mind, asking what drives your own exhaustion, good days and bad days, the limits of your control, and Lillian on sustainability committees.
Segment 10 · 30:27
Lead by Modeling
Asking staff what fills their cup, explaining what is out of the team’s control, leaving on time and not answering 2:00 a.m. emails, and civility that starts with the boss.
Segment 11 · 33:28
How to Connect
Where to find Dr. Vinatieri: her website, cliniciancareconsulting.com, and her email, which she offers to share.
Segment 12 · 34:09
Closing and Next Steps
Lillian thanks listeners and invites them to send the workplace and leadership problems they want the podcast to take on.
Read the full transcript
Transforming Healthcare Coaching Podcast, Episode 132: How to Reduce Healthcare Worker Burnout Through Organizational Culture Change. Host Lillian Liang Emlet, MD MS CHSE CPC ELI-MP, in conversation with Trisha Vinatieri, PsyD, clinical and organizational psychologist and founder of Clinician Care Consulting. Published October 26, 2026.
Trisha Vinatieri, PsyD: When you think about burnout in the workplace, really ask yourself, "What are those things?" And start with the mindset of burnout is not your fault. Burnout is the consequence of existing in an environment that is not supporting you in doing the work that is being expected of you.
Lillian Liang Emlet: So we've all heard the advice: do the yoga, use the app, take the resilience training, get more sleep somehow. And if you're a clinician who's done all of that and still feels hollowed out, you've probably wondered quietly whether something is wrong with you. So what our guest today has spent nearly two decades proving is that nothing is wrong with you. The exhaustion you feel is a rational response to a system that was never designed to sustain the people that are inside it. The answer was never just about the one more thing that you're going to do by yourself. And today we're going to be talking about what actually changes when a culture, not an individual clinician, becomes the thing we set out to heal. And so everyone, we're really excited to have Dr. Trisha Vinatieri here with us. She's a clinical and organizational psychologist who has spent nearly 20 years at the intersection of the systems and the humans inside it. She began her career treating veterans with PTSD, and over time, her focus really widened from the individual to the conditions around us that can wear really good people down. And today, she serves as a chief wellbeing officer inside a large high acuity healthcare system where she works with medical leaders to address the system factors driving clinician burnout, using evidence-based frameworks rather than slogans. She's lived the difference between programs that look good on a brochure and changes that move the needle. So Trisha, we're so glad to have you today.
Trisha Vinatieri, PsyD: Thank you so much for having me. I'm excited to be here.
Lillian Liang Emlet: So I'm curious. We all assumed that we have to work in the world that we live in, right? I mean, all of us, whether we're a physician or we're a nurse, at the end of the day, we have to somehow survive inside it. But why do you think healthcare has been so quick to treat burnout as an individual problem rather than a systemic one?
Trisha Vinatieri, PsyD: I think in big part because that is how we've all been raised. There's so much research around the importance of self-care and resilience. Even if you look at the literature around how trauma therapists can take care of themselves when they're listening to individuals' most traumatic events day in and day out, it was really about self-care, taking care of yourself, building resilience. So I think that's just, in many ways, what the zeitgeist has been for so long, that it really lives within the individual to take care of themselves. And I would also argue there's a little bit of fundamental attribution error, which is if something good happens to me, I tend to attribute it to something that I did. I got a really high score on an exam, it's because I studied hard and I'm smart. If I do poorly on an exam, then it was the exam itself, or the teacher couldn't write a good exam, or everybody failed. Now, when we look at other people, if I see someone else fail an exam, I don't attribute it to the exam, I attribute it to them as a person. So they didn't study enough. They failed because they didn't put in the work to get a good grade. And if something good happens to them, it's the situation, not them. So I think that this is a bias we all have. This is a bias we all carry, and so I think it applies when we don't see people thriving, we assume that it's something they're not doing right that is preventing them from managing their burnout. So I think it's a mixture of both that bias, but also it's just historically how we've addressed dealing with challenges, like what can you as an individual do, when in fact the majority of things that drive burnout, as you said earlier, are within the system or the organization itself.
Lillian Liang Emlet: Yeah. Such a great point that our brains often are there to protect us, and I think one way of protecting us is to maybe... I love that, attribution error. You spent years treating PTSD before moving into organizational wellbeing, and that's definitely an interesting leap. What did you see on the clinical side that convinced you that the real problem was upstream?
Trisha Vinatieri, PsyD: So many of the people I worked with were so dedicated to providing good clinical care to their patients. And if we look at the literature, clinicians are already very resilient people. They are a little bit more resilient than the average person. So it wasn't about resiliency. It wasn't about people not having the knowledge of how to take care of yourself, because so much of what we do is we help our patients. We coach them into what they need to do to take care of themselves. How can they overcome these really challenging things they faced in their life? How do they experience post-traumatic growth? And so when I stepped back and started to really think about it, it was during COVID when I was a manager for a PTSD team, and people were really sharing with me the amount of burnout they were experiencing. And I went to that same place of what are the tools I can give my staff so that they can manage their burnout? So I was in the same place many organizational leaders are around like, what can we give our staff so they're not burnt out? And then I recognized like these are people that know what to do. These are people that know sleep is important, that know taking vacation time is important, that know eating well and having a good social support. So this isn't about people not having the skills. This is about something so much bigger. And I think COVID really threw into relief all those challenges within an organization that really impact the wellbeing of their staff, and then as a result, impact the quality of care we provide our patients.
Lillian Liang Emlet: Yeah. And so it's interesting how in that time when we had to have all hands on deck and everything really changed with how we delivered care and how we organized things, and how we finally for the first time really gave permission that if you're not well, we don't really want you here in the building. Because for many reasons, right? You don't give friends contagious diseases, and also it's so hard to be actually at work that if you're not capable and able to do it, it's actually a hindrance for the entire team. And so it's somewhat strange that the reality is I feel in many ways we've lapsed back post-pandemic. Things are so different now from where we were, much more attentive to looking out for each other during the pandemic and really being almost hypervigilant about making sure that people weren't too exhausted or where they got the breaks that they needed. And most of clinical care across every sector changed.
Trisha Vinatieri, PsyD: Absolutely. I think, I think we have relapsed. It's like we have such short memories, and sometimes it feels like organizations are more about we need that position filled or we need to get the work done. It doesn't matter how. It almost doesn't matter the quality. And so there's oftentimes in healthcare, and probably other organizations too, where there's this mixed message of you need to get the work done, it needs to be high quality, and we're not going to do the things that really create a culture and an environment where you can be doing your best. And so it's like we want you to do all of these things, and we're not going to necessarily give you what you need to achieve that successfully.
Lillian Liang Emlet: So true. I hear this in much of the AI implementation in general in different sectors and who's teaching and whose responsibility is it to teach and learn? And then also, I think redefining. I think so much of it is COVID redefined so much about how everything was happening in the system, and AI's doing the same, except with AI this time, it's not clear that we're all actually all together pitching in trying to figure out a different way of what that work environment might look like. So I guess on wellbeing, what does it really mean to center wellbeing into the culture, and how is that different from how wellness programming currently is at most organizations?
Trisha Vinatieri, PsyD: Centering wellbeing in an organization means that you are dedicating time and energy and consistent commitment to demonstrating that you as an organizational leader or you as an organization are truly invested in the people that work for your organization. And what it means is that when there are opportunities to do it, you're demonstrating that through things like having programs within your organization that provide support to staff after some type of adverse workplace event happens. You're saying like, "Hey, this thing happened, and we are going to take care of you because it happened while you were at work. That's our moral responsibility." It means, yes, having those wellbeing resources available. So I'm not knocking and saying organizations shouldn't invest in things like mindfulness apps and staff yoga and things like that, but it has to be paired with, these are the things we're doing to address the structural challenges that drive burnout. So having those available, but also encouraging staff to engage in them, and maybe giving time to staff, protected time for them to engage in it, rather than saying "Okay, so for your lunch break, you can either eat or you can do 30 minutes of yoga, but you can't do both. You gotta choose. You gotta choose. Are you nurturing your body or are you nurturing your soul? You can't do both at the same time." It also means that you have leaders that are also modeling those behaviors. You have leaders that are modeling taking leave and not constantly being on their device while they're away or engaging in other types of wellbeing resources. Or maybe those wellbeing resources aren't their cup of tea, but they're demonstrating you have to take care of yourself as a human if you're going to do the work in healthcare. So it's about consistent commitment, and it's about connecting those decisions that you're making for the organization to promote wellbeing with the investment in the people. So one organization I really encourage healthcare leaders to look into is the Dr. Lorna Breen Heroes' Foundation. It's named after a physician who died by suicide during the COVID pandemic, and they're lobbying so much in Washington to really destigmatize mental health for physicians through things like looking at what the wording is in licensure and credentialing paperwork so that it destigmatizes any type of engagement in mental healthcare or any mental health conditions. And they have all these other really amazing tools that organizations can put into place that truly signal we do care. We're not just saying that we care about your wellbeing, we're really putting into place these different mechanisms so that if you're someone who's struggling, know that it's normal. Working in healthcare is a very, it's a very selfless thing, but it also takes a toll, so we want you to be taking care of yourself and we want you to know that if you are taking care of yourself and you're struggling, that doesn't mean that we're going to question your ability to do your job. What it means is we want to support you so you can get back to that place where you're providing that high quality care. So it's that commitment and those consistent actions and connecting those decisions and those positive changes to the investment in your people.
Lillian Liang Emlet: Yeah, I really like that last part. Transforming Healthcare Coaching is a Dr. Lorna Breen Heroes' Foundation ambassador, and so we've had their CEO and CMO on our podcast, and actually, it's our charity every year that we do our Podcastathon charity and have one of them on. And I do think it's really surprising. We all do agree that mental health and physical health, it's all health, especially in healthcare. And yet it is somewhat strange that there are many antiquated practices at the board and state and system level where medical affairs and the credentialing people just really didn't realize some of their forms and the processes by making sure that we have quality individuals being hired into our organizations also accidentally stigmatized for decades. And to undo those decades of work it's pretty incredible that I think they're only about three-quarters of the way through. There's still some legacy places that just haven't really engaged and aren't aware that their paperwork is bad. And I do also really like what you're talking about, the fact that we do need to find ways within our working groups and our organizations to develop an entire arm of people within to teach them, to show them a different way, and to have a place where champions can be safe people to go talk to. So many places have peer support programs, trainings for how to be a more active, neutral listener, someone who can recognize those warning signs of when moral injury is starting to happen or an adverse event has happened in the hospital, which sadly, with the amount of violence in our hospitals, there's an adverse event happening everywhere in some state somewhere right now, even as we're recording. So I really love your definition for how can we really begin to think that this is a really important pillar for your organization to think about, that wellbeing is a culture.
Trisha Vinatieri, PsyD: Absolutely. Yeah, I'm sure many people have heard of the quadruple aim. For a long time, we had the triple aim, and it was like when patients have a positive experience interacting with staff, they have better health outcomes, and that lowers the cost, operational cost. And at some point, someone realized the missing piece there is, are we taking care of the people providing the care? Because if the people who are providing the care aren't doing well, then patients aren't going to have a positive experience. There are going to be more medical errors. They're going to pick up when somebody is burnt out. It blows me away when I hear from patients, they're like, "Yeah, I met with my physician, and I really think they're burnt out." Patients see it, so that's going to impact their experience. That's going to impact their health outcomes, and that's going to drive costs up. So we gotta be mindful. It's a business investment if we want to get down to numbers and things like that. For me, it's really about the moral imperative of taking care of our people. But some people they have to think about the numbers. That's how they keep their organization viable. And so it's also a fiscal investment to take care of your people as well.
Lillian Liang Emlet: Yeah, it absolutely is. It's really interesting, whenever I talk about what we at Transforming are trying to do by providing coaching to all professions, all leaders in healthcare so that they can be well in their leadership and integrated with what their values and mission are so they can align with the organization, most people who are non-medical are like, "Oh yeah, totally. So good. You should totally help the helpers." And then when I speak to clinicians, sometimes they're actually skeptical. They actually are like, "Don't know. I don't know about coaching." And I'm like, "But there's actually so much evidence for it." And so, I mean, to go into what you do as well, when you walk into an organization that is thinking about change and recognizes their staff turnover, recognizes that their culture is a problem, recognizing that their recruitment, like their budget for recruitment is ridiculous and they want to try to narrow the leak for their healthcare system, what is the gap between what the C-suite leaders think will help and what actually does?
Trisha Vinatieri, PsyD: Again, it goes back to that original topic we were discussing around this idea that we have to give people the tools so that they can basically manage their own burnout, which is basically saying, "We're going to give you tools so you can tolerate the system that's broken." We're not actually giving you tools to succeed in the workplace and to thrive and to do what it is that you've spent years of training to be able to do, and to lean into your altruism. We're giving you tools that will help you tolerate the system that needs to be revamped or the system that has processes or demands that just do not allow people to do well in the workplace, and so oftentimes that's what I see. It blows me away how many times I will meet with leaders and say, "Here's some things you can do at a work group level that can identify some of the processes and day-to-day work that your staff are doing that you and your staff have the power to change." No, it's not high level national guidelines or quality or accreditation processes you have to do. There are things that are happening in your everyday work that your staff are probably tolerating because they just have to get through the day that could probably change and make their work a little bit easier. Or there are things that when I'm having conversations with leaders of organizations, I'm like, "These are 10 things you could put into place right now that when you add them up are going to save people time, they're going to save people energy, but they're also going to signal to your staff that you are invested in them as people." And it's amazing how many times when I'm having those conversations people say, "Well, I think I was thinking more of could you come in and maybe teach some mindfulness or can you talk to people about how to build personal resilience?" And I'm like, "I am hearing what you're saying, and we can do those things too." But you have to have three things in order to have occupational wellbeing, and this comes out of Stanford research. The first is a culture of wellbeing. We've covered some of the things that looks like. But again, it's the culture of an organization where a staff member shows up and they're like, "This organization really wants me to be able to be fulfilled and do my work because they understand how that's going to impact the quantity and the quality of the care we provide." The second is efficiency of practice. Do people feel like they have the resources they need to do their job? Are the processes quick and efficient and they're able to do what they need to do their work or are they bloated? Are they slogging through the day through all of these administrative tasks because we just haven't cleaned them, cleaned up workflows or we're not aligning the right people with the right job responsibilities? Do we have physicians doing four hours of administrative work a day? The third is personal resilience. So personal resilience does have a part to play, but if you think about a three-legged stool, if you only have one leg, that stool isn't going to stand. If you only have two legs, that stool isn't going to stand. You need all three. So that really is where I see the biggest gap, where organizations, in part because I think it's cheaper to just say, "Well, let's buy an app," or "Let's beef up our EAP," or "Let's bring in some other resources that help people build resilience," and really making a commitment to making systemic change. Let's look at our electronic health record and see what changes we can make. Let's look at our staffing models. Let's look at our workload demands or our panel sizes. Are we right-sizing them? If we have someone who's seeing many geriatric patients, are we demanding the same amount of panel size as we would somebody who may be seeing a population that's maybe higher functioning and maybe needs less in terms of medical support? So those conversations can sometimes be hard because I'm sharing with leadership the hard work that needs to be done. Or even if it's a manager or a frontline supervisor and I'm saying, "Actually, I'm going to empower you to make those changes," it can really, I think, be uncomfortable because people are like, "I wouldn't even know where to start," or, "That sounds really hard." And what is so much easier is saying, "Hey, there's this resource you can engage in if you want to that is going to help you be more resilient."
Lillian Liang Emlet: Yes, this is true. I think sometimes if people think the system is so big they don't know how to change it, but they also don't really realize they're complicit. If they don't do pilot studies and they don't think about rearranging and to create more autonomy for their team, they're actually part of the problem, too. So when we work with our individual clients, our first job is making sure that they're well. Because a lot of times, I feel like the wellbeing problem trickles down. There are some mandates from mysterious above that then trickle down: "This is the KPI whether you like it or not." And it's hard to rework in individual values, whether they're team values or individual values, to saying that, "Well, where does wellbeing fit?" When in the end what you want is leaner operations and more patients coming through your system. Doesn't seem like it would ever make sense that if people are always being asked, "Do more with less," and there's no opportunity for system redesign. But yet, the reality is there probably is an opportunity, but people don't see it, that there actually is a chance that in the face of, "Okay, how can we increase profit," basically, whether you're in a private practice group or in a large healthcare organization. When you are profitable as a service line, you will get more resources from the organization, right? Because, well, you're a good service line, and therefore you deserve to have more, I don't know, FTE or more people to support you, like more techs. And more things will be given to you if you can actually do the hard work like you're describing, which is maybe take a step back and try to find a way to redesign workload allocation, structures, efficiencies and taking the time for the retreats, like taking the time for the department retreats. And I'm curious, if someone's thinking, "I want to do this better," "I am inspired by Dr. Vinatieri. I do want to do something different," how do you even begin coaching a team of leaders? "Okay, well, we believe this. Where do we begin?"
Trisha Vinatieri, PsyD: Definitely. Hallelujah to everything you just said. Mostly leaders need to take care of themselves, but also where do we look for those opportunities for system redesign or continuous process improvement? And I would recommend to anybody that's in a place where they're like, "Yes, I want to do this," check out the AMA, the American Medical Association's STEPS Forward. It's their kind of CE education arm of the AMA. And look up Listen, Sort, Empower and GROSS, Get Rid of Stupid Stuff. Those are two very straightforward models. AMA STEPS Forward walks you through how to implement them. Listen, Sort, Empower is work group level. How do you put a framework around having these conversations around what is it that we need to improve in our workflows? How do we have cleaner operations that are within our control? We're not going to be able to redo the whole hospital, but what's within our control? And this is the thing, your staff are already thinking about these things. Your staff have already identified things that could run more smoothly, and either they don't want to bring it up because they don't have time or they're like I'm just going to use this workaround because if I bring it up, is it really going to change? They're thinking about it and they probably have solutions. So that's Listen, Sort, Empower. Get Rid of Stupid Stuff or GROSS is more like departmental or service level. So if you are the oncology department or you are the mental health or behavioral health department, this is something that you can integrate. And it does take the investment of time, but it's time that is going to pay dividends because you're, again, having leaner operations. But you're also, again, signaling to your staff, "I want to hear what ideas you have. We know things could go better, so let's create a culture where we're constantly talking about how things could run better. Let's make space for it. Let's encourage people to bring these things up." And so it becomes just part of the culture where people are like, "Hey, I noticed another thing that we could change that would save us all time." So it really becomes this thing where people move away from that's how it's always been done or that's just how it is, to where can we find gold elsewhere? Where can we find places to really make improvement? And when you look at the two modules, Listen, Sort, Empower is three hours total. So you can do it across several weeks. You could do it across a month. Get Rid of Stupid Stuff, it really depends on how many submissions you have where people are like, "Hey, I identified a GROSS item." And so it is an investment, but when you look at really the time of maybe five or eight hours total to do that, which is on average what I'm seeing when large services do that campaign, the Get Rid of Stupid Stuff campaign, it's like five to eight hours total, and that's really not that much. You got to give your staff protected time, though, if they're going to be on the GROSS campaign work group and they're going to spearhead the changes. You got to give them protected time because we are asking them to do something that, again, is going to pay dividends. It's going to really be a positive change for everybody because again, it's signaling we care about you, we want to do better, but it's getting people in this mindset of what else can we clean up?
Lillian Liang Emlet: Yeah. So often administrative time is more and more I've watched some of our clients lose the time factor. And instead it's do more, we'll give a small stipend rather than having the embedded time and the structure which is a very scary deprioritization and headed in the wrong direction when we just know as an organization that for every single person's leadership role, they will have embedded time because there should be strategy embedded in the role. So we've talked a lot, and I love your Listen, Sort, Empower, and I love, I forgot about, the Get Rid of Stupid Stuff and having that place where like a little jar where you just like, "Here's another idea. Here's another idea." And then people can rank them and just go ahead and really feel like they are making change quickly. 'Cause I think a lot of times people feel like most organizations are not nimble, but what you're describing here as a leader is that you actually do have agency. You have a way to say, "This is how I'm going to run my team, and I get the fact that maybe the whole organization isn't nimble, but my group is going to be nimble." And so you can take that back, that power. But for the people who are listening who are not in the leadership seat and still feel very disempowered, what is within their reach right now to be able to try to help their leaders and their teams maybe begin to hear the fact that there are opportunities.
Trisha Vinatieri, PsyD: Yeah. So I know speaking up, depending on the psychological safety in your group or the type of trust you have with your leader can be a vulnerable process, and I'd really encourage people to lean into that and to share maybe ideas you have or what you're noticing is creating your burnout. So that's one of the things when I work with leaders, I ask them to do that self-assessment, what's driving your burnout, 'cause it's likely something that is also driving the burnout of your staff. But thinking about for yourself what is driving your burnout. Now, there are going to be personal factors. Maybe it's your commute, maybe the salary you make is just enough to make ends meet, maybe you're balancing work life with demands in your personal life. There can be many things that can contribute to burnout. But when you think about burnout in the workplace, really ask yourself what are those things and start with the mindset of burnout is not your fault. Burnout is the consequence of existing in an environment where you're being asked to do too much with too little oftentimes, or you're in an environment that is not supporting you in doing the work that is being expected of you. So it's something we experience at an individual level. The symptoms are experienced by us as individuals, but it's the environment, the culture around us that's driving the burnout. So that's the one thing I really hope people take away from this, whether you're a leader, whether you're a frontline staff, to move away from this, "If I just did X, Y, and Z, I wouldn't be burnt out." It's a losing battle. This is not about who you are as a person. So if you are experiencing burnout, think about what in my day-to-day work makes my job harder, makes me consider is this the job for me, should I consider leaving, or is the difference between a good day and a bad day, and that's probably where you'll find those things that are contributing to burnout. And I encourage you to have conversations with your supervisor around are these things we can change, 'cause oftentimes, as you were saying earlier, they are within your sphere of control. No, again, we can't change hospital-wide policies, we can't change parking, we can't change the food that's served in the cafeteria necessarily. But there are things that we do in our immediate environment that we could probably change and improve.
Lillian Liang Emlet: Yeah, so true. Although I do feel like you can change the food and also there... I mean, it's really pretty fascinating to me to watch the committees who talk about sustainability from an environmental perspective, and that it's actually a cost savings to actually have the gardens and the green buildings, and to have people banding together to say, "Look, we can save not only the carbon emissions for our hospital, we can also give better food and partner with local businesses." And so it's interesting when there's a couple like-minded people, you find your friends in the organization and see if you can make change together. 'Cause even though it's not in your team, there might be someone in the whole building. So I've always been impressed by the people who brought more sustainable practices. You and I both remember 10 years ago, I mean, we wasted so much equipment, supplies, but all healthcare systems are much more conscious about all of these things now in general.
Trisha Vinatieri, PsyD: Absolutely.
Lillian Liang Emlet: And so it's been amazing having a conversation where you've been really thinking about what can leaders do from a systemic perspective, because so often we don't talk about that. And so what question have I not asked that you would like to share or impart with our audience on the podcast about perspectives on what we can do?
Trisha Vinatieri, PsyD: I would encourage leaders to be talking with their staff about what drives your burnout. And you don't need to use those words, but having a conversation around maybe using similar words like I just used, like what's the difference between a good day and a bad day? What are the things that really get you into flow state and fill your cup during the day versus those that don't? And I guarantee you staff are going to bring things up that are completely out of your control. And so you can share, "I understand that. I want you to know, if there are current advocacy efforts to address that or if those are concerns that have been shared with leadership of the hospital or maybe even higher up," fantastic. But really asking your staff, "What are the things that we can control, that we can address?" And also checking in with yourself about your own burnout, because staff will follow the leader. So what you model is going to be how your staff respond, and it's going to set the culture for your organization. So if you are someone who's taking care of yourself, you're leaving at the end of your work schedule, you're not answering emails at 2:00 in the morning, and you're really saying, "It is really important to take care of yourself," that is going to set the tone for your work group, for your staff, for your service. So model the culture that you want within, if you're a leader of an organization, if you're the leader of a group. If you are a frontline staff member, model the kind of culture you want. Because a boss that says, "I demand civility in the workplace," and then is yelling at their employees or is engaging in uncivil behavior, that is the culture that they're going to create. So modeling and taking care of yourself, because again, that in and of itself is going to demonstrate to your staff the importance of taking care of yourself.
Lillian Liang Emlet: Yeah, modeling is huge. So thank you so much for sharing all of these techniques. I really do think this last pearl that you've shared about what fills your cup is also just knowing your people, right? So much of just understanding your team, understanding the humans that we have working together is so helpful because then you can do the right strategic things that are necessary for putting the right people on the right projects and engaging them for the things when, at the right time. And also knowing of like when things are going on in their personal lives where maybe it's just not, it's not a good time to ask for more in general so that you can be a wiser manager and see people first, more first and foremost. And I also love all of these questions because these are also things you can use in group and team meetings because that's how you show everyone that not just the agenda for reduced infection rates or profitability or efficiencies, that we're more than just the data, that we also are the people who are deciding to be in the group together. So how can people work with you? You come into healthcare organizations and help them see the strategy as a neutral party to help them see with clarity some of the things we've discussed. Where can people find you? How can they work with you?
Trisha Vinatieri, PsyD: Yeah. So people can contact me through my website, cliniciancareconsulting.com. Again, that's cliniciancareconsulting.com. And reach out by email. I can provide it to you if you want to include it as well. But that's really the best way to get ahold of me.
Lillian Liang Emlet: Great. Sounds good. And you can also, we'll put the link to her website and her LinkedIn below, along with all of the different references that Dr. Vinatieri mentioned today. So thank you everyone for listening to the Transforming Healthcare Coaching Podcast, and again, please let us know what you want us to cover. What problems are you facing in your workplace, in your leadership journey that you would like us to unpack, give little tidbits, and find speakers, and cover ourselves? So contact us at podcast@transforminghealthcarecoaching.com. Have a wonderful day.
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Dr. Lillian Liang Emlet
Physician · Executive Coach · Founder, Transforming Healthcare Coaching®
Lillian is a practicing physician, certified executive coach, and the voice behind the Transforming Healthcare Coaching® podcast. She works with clinicians, clinical leaders, and healthcare executives leading through role transitions, seasons at capacity, and culture change — helping them lead with clarity, intention, and sustainability.
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