When Yale New Haven Health System’s Bridgeport Hospital had its first patient with COVID-19, it turned their world upside down. That’s when the health system mounted substantial efforts to take care of patients and staff, including a call center, triage tents, education on donning personal protective equipment—and lots of pizza. But pizza was assuredly not the solution for addressing the enormous strains that physicians and other health professionals were experiencing.

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Many of the hospital’s doctors and other workers “felt isolated and worried for their own physical safety and the health and safety of those who they love,” Kristin Edwards, MD, said during a session at the International Conference on Physician Health, a collaborative meeting of the AMA, Canadian Medical Association and British Medical Association.

“In recognition of the tremendous stress that these staff experienced, we launched well-being check-ins” with a goal of creating “a space that was encouraging and supportive without fear of negative consequences,” said Dr. Edwards, chief wellness officer and medical director of palliative care at Yale New Haven Health Bridgeport Hospital.

The Yale New Haven Health System’s executive leads for the well-being check-ins project were Javier Alvarado, director of social work, and Stephanie Sudikoff, MD, director of simulation at the system’s SYN:APSE Center for Learning, Transformation and Innovation.

Well-being check-ins were designed to help staff cope with the acute stress and prevent PTSD through confidential phone calls, operated by licensed mental health professionals. Using the acute stress screening tool—which has 19 questions around the symptoms someone might be experiencing—the mental health professionals would drive the conversation around the acute stress someone is dealing with at the time.

But the check-ins weren’t a hit off the bat. Through trial and error, Yale New Haven Health System was able to successfully reach physicians and other health professionals with the effort, with 1,720 employees participating in the well-being check-ins to date, many of whom are physicians.

Here are four keys that helped the Yale New Haven Health System reach physicians and other health professionals with well-being check-ins.

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The final version of the well-being check-ins began in September but have been extended twice now. Initially they were expected to run for about two months, but because of the uptick in use, the well-being check-ins continue to this day.

What made the final version of the check-ins so successful was that “it is now offered as a benefit rather than a service,” said Dr. Edwards, noting that “it was the use of wording such as benefit that was particularly appealing.”

This appeal had to do “with the sense that if people don’t use a benefit, it’s like they are passing up on something that is already part of their compensation package,” she explained. “It’s something that will provide them something positive” because a “service sounds a bit more transactional, and there are many services that aren’t necessary or bring substantial added value to an individual person.”

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Another lesson learned “to help promote this type of service was to use an opt-out process,” Dr. Edwards explained. “We think that that really lowers the barrier to participating.”

Additionally, “certainly keep it voluntary, but make sure that the appointments are just generated and given to the staff and medical staff who will be participating,” she said.

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It is also important to “use senior trusted leaders to communicate the opportunity,” said Dr. Edwards, adding that leaders should also be encouraged to “attend their own check-in.”

This allows them to “speak from a position of knowledge of having participated in one” while also lowering stigma around well-being check-ins, she said.

A benefit isn’t good if it is unknown. That is why Yale New Haven Health System placed “multiple visual reminders throughout the hospital,” said Dr. Edwards. “There are signs everywhere.”

This helps to bring well-being check-ins “to the forefront of people’s memories,” she said.

The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.

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