10-Minute Intervention Boosts Health Worker Well-Being

In a randomized trial involving healthcare workers, a brief web-based intervention integrated into routine continuing medical education led to short-term improvements in four domains associated with well-being, results published in JAMA Network Open showed.

In this exclusive video interview, study author J. Bryan Sexton, PhD, of the Duke Center for the Advancement of Well-Being Science in Durham, North Carolina, discusses the WELL-B (Well-Being Essentials for Learning Life-Balance) intervention and the results of the trial.

The following is a transcript of his remarks:

For the objective of the study, we basically used five 10-minute activities that were embedded within a continuing education framework — hour-long continuing education sessions, we would put 5 to 10 minutes in each of them — to reduce emotional exhaustion. And it worked more than COVID increased emotional exhaustion over 3 years. And 90-plus percent of the healthcare workers that tried it, they rated it favorably.

We used these little 10 minute activities to give healthcare workers a chance to briefly reflect on some of the things that are not a disaster in their lives right now. And through this — what we call “microdosing of positive emotions” — we were able to get a pretty cumulative and powerful impact on their well-being.

The results were across four different well-being outcomes. The first one was emotional exhaustion — that’s basically the most common way of people measuring burnout — and emotional exhaustion came down quite a bit, that actually improved the most. Second was emotional recovery, which is your ability to bounce back after an emotional upheaval. The other two domains that that improved were work-life integration — so sleeping better, taking breaks, taking care of yourself — that improved, as well as emotional thriving, which is to what extent that you are flourishing on a day-to-day basis.

Those were the four domains: emotional exhaustion, emotional recovery, work-life integration, and emotional thriving. And they all improved within 8 days.

Burnout and stress and disruptive behaviors and staffing problems, all these things that are so critical right now in healthcare, they’re an ongoing crisis for healthcare systems. This intervention targeted emotional exhaustion, which is the number one driver of all of those things. It drives patient engagement, medical errors, infection rates, mortality rates — it’s all driven by the emotional exhaustion of the workforce.

So this WELL-B intervention, in brief, was this simple but effective intervention that works on-demand. You can do it now whenever you want. You can do it from a phone or from a tablet, and it’s effective for every group that we studied. Every demographic group across gender and race and ethnicity and roles and years of experience, people who are clinical, people who are nonclinical, all roles, all disciplines — it was effective.

Just the fact that nine out 10 said that this was pretty good, that’s unusual for a well-being resource. There are so many people that like to poo-poo well-being resources, and in fact there are a lot of well-being resources that should be dismissed as being unhelpful. So the fact that they liked this one — we actually think that one of the more important outcomes is that they liked it.

The 5 hours that we used to do this training is called WELL-B Essentials. That can be the start of a journey for many people. A lot of folks that finished the intervention would come back and say, “These tools, they’re pretty cool. I shared them with my adult children,” or “with my spouse,” or “with my colleagues. You got some more of where that came from?” And we developed a 17-hour program where at the end of 17 hours, that is the training that we give for our well-being ambassadors.

So, what is the future? Where is this going? We want every single healthcare work setting everywhere to have someone who is the go-to person for well-being in that work setting, that can bring the science and the research and the really good options to bear on local problems.

Everyone likes to say, “Fix the system.” Yes, we have to fix the system, but the way you fix the system is by making sure you’ve got reasonably tailored approaches for every single work setting. That’s going to look different in every work setting. And to that end, we want to build infrastructure and capacity to do that.

So we created this well-being ambassador training. We’ve trained 800 well-being ambassadors at Duke and over 17,000 nationwide, and we want that to continue to grow. We want people to be able to use the best available science. We want them to be able to use the best available resources.

And what we found in this process is that it’s not the number of well-being resources you have on your list that matters, it’s the quality of the well-being resources on that list. So having several things that are really good is much better than having dozens of things that are all kind of lousy. And unfortunately, what a lot of health systems have right now are lists of dozens of things that are all kind of lousy.

WELL-B, this intervention, is free and open right now to try it out for anybody listening and to share it with others. There’s a lot of uncertainty in the world right now, and it’s time to regain some of what we lost in the past few years. And so I encourage folks to go out and try things for well-being and to share what works for them with others. If you don’t like what we are doing, fine, go do something else, and then share that.

But my message to folks is just right now, it’s really important to be a light in the darkness.

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