Rolling your eyes at the idea of joy in work? I was too until…

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By Samantha Buttemer

Over the past year I’ve morphed into a big supporter of ‘joy in work.’ I never would have imagined myself as such, because I literally rolled my eyes the first time I heard the term. I couldn’t see how joy in work needed to be prioritised, particularly with so many other pressing issues, from increasing health care costs to staff burnout. We need to be OK at work before we need joy, right? Clearly though, I’ve changed my mind on the matter, and here are a few major reasons why.

  1. Workplaces that prioritise joy have better outcomes

Simply put, workplaces that emphasize joy see better clinical outcomes for patients. Joyful, engaged staff are safer staff, and management practices that emphasize this are associated with better patient experience and fewer errors in medical care.

While that would be reason enough alone to focus on joy, it goes a step further: health care staff have better outcomes as well. When staff are joyful and engaged, they tend to use fewer sick days and stay in their jobs for longer. The cost savings in this regard are immense. Training and hiring new staff present huge costs to employers. Estimates in the USA have shown the cost of replacing a departing physician with a new one to be more than $1 million, and this is only in tangible costs. We haven’t even considered the less tangible costs of personal suffering due to lack of joy and fulfillment. We all deserve to generally like our jobs, given how much time we spend at work.

  1. Joy is a great proxy measure for a system working well

Measuring culture is hard. It’s well known in both quality improvement and management circles that strong culture is important for creating efficient, effective workplaces, and yet it isn’t always easy to put a finger on what good culture is. Joy is one of those things that can only happen when other things are going right: coworkers treating each other with humanity, workflows moving smoothly in the right direction, a sense of purpose permeating every action.

If any of these things are going poorly, for example timelines are being met perfectly well but there’s an unkind manager making others miserable, then joy isn’t going to flourish.  Asking your colleagues about joy and what’s getting in the way of creating joy is an easier way of getting to the meat of your local culture.

I like to use Maslow’s Hierarchy of Needs to conceptualize this. Joy of purpose comes from achieving your potential, which is only possible when your other needs are being met. Joy can also arise from other levels, such as a sense of belongingness or feeling appreciated. Each of these areas of need must be addressed to promote a culture of joy, something that can be considered “good culture”. The IHI uses the question, “What are the pebbles in your shoe?” as a way to ask about barriers to having needs met. Simple and straightforward. A focus on joy is a focus on meeting needs, and when needs are met the system is working well.

Figure 1https://www.simplypsychology.org/maslow.html
Figure 1https://www.simplypsychology.org/maslow.html
  1. There are small, simple actions that can be taken to bring joy to your workplace

Even if you aren’t the one in charge, you can bring joy. We all deserve to feel empowered at work, and sometimes it is nice to be reminded that we all contribute to bringing joy. Dr. Bob Klaber, a consultant paediatrician and member of the improvement team at Imperial College Healthcare NHS Trust in London, likes to remind everyone he works with, regardless of status, that they contribute to the environment and make a difference with their actions. He frames this with generosity: if we all make an effort to practice generosity at work, regardless of our role, the workplace is better for everyone. A medical student can take the time to thank a nurse for answering their question, a physiotherapist can appreciate feeling needed when another consult is given even if they are feeling a bit busy already, or a consultant can bring some scones and tea to the floor for everyone after a tough morning.

Below are some other ways we can all work to bring joy:

Figure 2. from Beyond burnout: a call to action for joy in work
Figure 2. from Beyond burnout: a call to action for joy in work

I hope this has helped reframe your thoughts on joy in health care. It may seem counter-intuitive at first, but it’s the clear way forward in creating effective, efficient, humane care systems for both staff and patients. If you want to read more of my thoughts on joy in work, check out my recent publication written in collaboration with Kaleidoscope Health & Care entitled “Beyond burnout: A call to action for joy in work” and for a deeper dive, check out the white paper that inspired us, the IHI Framework for Improving Joy in Work.

Samantha Buttemer is a family physician and public health and preventive medicine resident physician at Queen’s University in Kingston, Canada. She spent the past academic year at the London School of Hygiene and Tropical Medicine working on a degree in public health with a focus on health services management. You can find her on twitter at @sbuttemer.

References:

Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Annals of Surgery. 2010;251(6):995-1000.

Dawson J, West M. Employee Engagement, Sickness Absence and Agency Spend in NHS Trusts.; 2018.

Buttemer S. Beyond burnout: A call to action for joy in work. London, England: Kaleidoscope Health & Care; 2018.

Scutte L. What you don’t know can cost you: Building a business case for recruitment and retention best practices. Journal of Association of Staff Physician Recruiters. Summer 2012.

Perlo J, Balik B, Swensen S, Kabcenell A, Landsman J, Feeley D. IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2017

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