Empirical and anecdotal evidence indicates that veterinarians are at a high risk for work-related stress,1 compassion fatigue,2 and suicide,3–5 highlighting the growing urgency for veterinarians to prioritize their own health and well-being. To tackle this challenge, participants in the 2014–2015 AVMA Future Leaders Program created a series of online wellness resources addressing topics such as physical health, stress management, financial wellness, self-care, compassion fatigue, and work-life balance.6 As a follow-on to these efforts, participants in the 2015–2016 AVMA Future Leaders Program elected to focus on the issue of implementation of wellness in the workplace. Because adults typically spend a third of to half their waking hours at work, the workplace is an important venue for wellness activities.7–10
When considering workplace wellness, we sought to develop an implementation toolkit that encompassed both veterinarians and paraprofessional staff members and that would be broadly applicable in a variety of settings, including single-doctor practices, multidoctor practices, corporate practices, academia, industry, and other types of workplaces. The toolkit needed to be inclusive, free, and easy to implement. For beta testing, we distributed the toolkit to a number of veterinary teams over a 3-month period and sought feedback on areas that could be improved. The final implementation toolkit is available at the AVMA website11 and has 5 components arranged in a countdown format: a 5-minute, quick-start video with a message of urgency, a list from which employees can choose 4 healthy behaviors to be used in improving workplace wellness, discussion scenarios about confronting 3 barriers to shaping a culture of wellness, sustaining the momentum with 2 wellness huddles or check-ins each month, and designating 1 wellness champion for the workplace. The structure of the toolkit was intentionally based on the Kotter leading change model.12 This change paradigm begins with creating a sense of urgency among members, building coalitions, and confronting systemic barriers within ourselves and our profession.12 As short-term gains are realized, a renewed vision takes shape, accelerates, and ultimately forms new behaviors, resulting in a culture of personal and organizational well-being.12
The wellness implementation toolkit begins with a 5-minute video underscoring the high risks of depression, suicide,1,3,4 and substance abuse within the veterinary profession. The video portrays the true story of an individual who faced fatigue, frustration, and mental anguish associated with workplace stressors. We know that, over time, poor wellness may lead to helplessness, hopelessness, and incompetence, which in turn can cause veterinarians to leave the profession. The goal of this video was to create a sense of urgency as to why workplace wellness programs are needed in the veterinary profession.
The next step in the toolkit encourages modeling of 4 healthy behaviors to shape the culture of the workplace. There are several categories to choose from including nutrition, physical fitness, mental well-being, and fun challenges. The goal is to create wellness behaviors that are easy and enjoyable for the organization to implement. It is important to emphasize that shaping the culture is both an individualand management-level effort. When employees and management model healthy behaviors, a culture of wellness is supported and can continue to grow.
The third component consists of sample scenarios to stimulate dialog around barriers to workplace wellness. The scenarios cover potential obstacles and challenges ranging from lack of participation to indifference among employees and finding the time to implement a wellness program within the veterinary workplace. Also considered were the unique challenges of implementing wellness for solo practitioners and independent contractors, such as consultants. These scenarios serve as a foundation to collaborate and problem solve with colleagues and staff in anticipation of obstacles to implementation.
The next step includes facilitating regular wellness huddles or check-ins with team members. These are brief (< 20 minutes), engaging, and interactive meetings that enhance communication and prioritize wellness in the workplace. These check-ins are intended to focus on the mental and physical well-being of the entire team, in real time, providing a venue to share, listen, and support each other. Successful communication is frequent, varied in content, and tailored to the particular needs of the organization. Check-ins are also a way to encourage employee participation and give structure for management to validate, support, and sustain the culture of wellness.13
The final step in the toolkit is to identify a wellness champion who can serve as an ambassador and a resource to support a culture of wellness within the workplace. The duties of the wellness champion include communication of wellness initiatives, collecting feedback from program participants, and supporting the organization's wellness program goals. Ideally, this individual would be seen as a respected member of the team, would be enthusiastic about the program and supporting the participants, and would have the time and energy to support this endeavor.
Ultimately, the organization's management is responsible for developing and supporting wellness initiatives. Having the support of an organization's leadership and senior management positively influences the success of wellness programs.14 Management should define expectations for time commitment, provide support and resources, and recognize the contributions of the wellness champion and the actions of the employees.
Individuals in a workplace share a common purpose and can take advantage of social support when trying to change health-related behaviors.9 From an economic perspective, healthy employees are more productive, have better morale, and have decreased absenteeism.9,15 There is evidence that investment in employee health appears to be one of many facets demonstrated in successful, high-performing corporations.16 Many businesses support workplace wellness programs as an investment in human capital.14,16 The ultimate goal is to have a program that helps employees become healthier while decreasing health-care costs for the organization.17 An organization's investment in employee health will pay off in the long-run and have far-reaching positive effects not just on the workforce but also on families and communities.17
There are barriers to implementation of wellness programs. For instance, it is not always evident that developing these programs will lead to financial benefits, and best practices are not always consistent among industries and organizations. A lack of data and systems to capture and measure information regarding wellness interventions and their effects on costs makes evidence-based decision-making difficult.10 Additionally, there is no single definition of an effective workplace wellness program.17 However, despite the challenges of measuring results, the perils of indifference to the issue include higher employee turnover, increased absenteeism, and increased health-care costs.10
Other barriers to wellness programs include lack of employee interest and participation, lack of resources, and lack of management support.18 Ensuring employee participation can be challenging; there may be concerns that confidentiality won't be respected or that employers are meddling in their employees’ personal business.10,18,19 Employees’ reluctance may also be due to insufficient communication about wellness activities, financial costs for participation, and inconvenient times or locations for activities.18 A wellness champion can help to alleviate some of these issues by promoting the organization's programs.17,18,20 By surveying employees at the beginning of the program, it will be easier for employers to tailor program materials to employees’ interests.10 Additionally, using positive reinforcement in the form of positive peer pressure, social encouragement, and token rewards may be more effective than providing incentives.13
Perhaps one of the greatest barriers to implementing workplace wellness is the small business setting itself, where it may be difficult for veterinarians to justify the time, money, and energy to devote to this endeavor. Small businesses should consider collaborating with local organizations such as hospitals, colleges, and community organizations.10 They should also consider networking with local practitioners to share resources, such as group memberships for various services. There are low-cost initiatives that can be implemented, such as signs encouraging walking and taking the stairs,10 providing healthy snacks in the breakroom, and promoting websites that provide information on health and wellness activities.10 In addition to the AVMA's online resources, there are resources available through the Wellness Council of America21 and Partnership for Prevention22 websites. Additionally, the North Carolina State Health Plan in partnership with the Division of Public Health and the North Carolina Department of Health and Human Services has created an online workplace wellness toolkit.23
Numerous industries, from large corporations to small businesses, have recognized the need for wellness in the workplace.15,19 Wellness resources and programs have been implemented in corporations such as Johnson & Johnson,24,25 DaimlerChrysler Canada Incorporated,26 and PPG Industries Incorporated27 and in the healthcare sector5,20,28 and at the state level.29 It is time for the veterinary profession to implement wellness in the workplace also. We must acknowledge the professional and personal stresses and challenges of being a veterinarian. Despite these obstacles, veterinary medicine is a career deeply rooted in meaning and fulfillment30 along with many opportunities for compassion satisfaction. When attention is focused on their health and well-being, veterinarians will be in a better position to serve their patients, clients, and the public.
Acknowledgments
The authors were all members of the 2015–2016 AVMA Future Leaders Program. The AVMA Future Leaders Program is supported by Zoetis and High Impact Facilitation Incorporated.
References
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