How can healthcare teams build resilience and prevent burnout?

I think in healthcare we need to be careful with the word resilience. Most of us have spent years training and working long hours to get where we are today. We are, undoubtedly, resilient. It therefore seems rather patronising to suggest that healthcare professionals need to work on their resilience. Indeed, I suspect most healthcare professionals offered resilience support would tell you where to go! Talk of resilience is, at best, a misguided attempt to help individuals for something that is a system problem, and, at worst, a cynical attempt to shift organisational problems onto individual blame.

I couldn't disagree more. Resilience is not a skill that you develop and you should run a mile from anyone who suggests it is! Resilience is an innate capacity built into every being. It is the visible manifestation of our inbuilt psychological immune system: our capacity to fall out of harmful thinking processes and back to presence.

All of these suggestions are good, common sense ideas. Whether people actually do them or not – especially when feeling under pressure – is another matter. You cannot *build* individual resilience, you can only lead individuals to see, insightfully, that they already *are* innately resilient, by unpicking culturally learned misunderstandings about how they are experiencing the workplace and their (often overlooked) innate capacities.

At Johns Hopkins Hospital, Dr. Peter Pronovost introduced the "checklist initiative" to reduce central line-associated bloodstream infections. Recognizing the expertise of every team member, from senior doctors to nurses, he encouraged open communication and collaboration. By actively listening to frontline staff, he adapted the checklist based on their feedback. This fostered a culture of respect and trust, ensuring every voice was heard. Disagreements were resolved with respect for each person's experience. Their joint effort led to a significant drop in infection rates. The team celebrated this achievement, solidifying their bond. Pronovost's approach exemplifies how trust and collaboration can drive incredible outcomes in healthcare.

Because resilience is an individual's innate capacity to return to their default state of clarity and peace of mind, it is unwise to ascribe the term to teams or organisations. As mentioned above, teams stand or fall on good, open communication, and respect for colleagues. When conflict arises – which is inevitable – it is best resolved when both parties, and whole teams, have a solid grounding in the human psychological operating system, and the nature of separate realities (i.e. the fact we all experience our own unique perceptual version of a situation, rather than the ‘situation’ itself). Seeing that we are *all* responding to our own conditioned beliefs (not other people) greatly reduces the tendency to ‘take things personally’.

WHO defines burnout as an occupational phenomenon, "a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed". Being dedicated and altruistic are risk factors for burnout. For me, burnout prevention is something that needs to be done at system and organisation level, much more than at individual level. Organisations need processes and structures that don't create chronic stress - something very hard to do in the stretched health services. But how long can we keep going? What's the cost of a system that is always running hot? Burnout is everywhere - who will be left to care for patients? We need to invest in better systems today, to help patients today and tomorrow.

The best way to prevent burnout in the workplace is for all employees, at every level, to have a comprehensive grounding in how the workplace itself is experienced. To look at the nature of stress. What is it? Where does the feeling of it come from? Why does our experience fluctuate? How do we best access wisdom and creative solutions to workplace problems? This is not to say that poor working conditions should not be addressed – they should! – or that institutional policies affecting staff experience should not be improved – they also should! – but the individual's experience of the workplace is essentially all they get, so understanding exactly how that works offers the greatest leverage in helping an individual to avoid burnout.

At the Cleveland Clinic, they noticed an alarming rate of physician burnout. Recognizing the critical impact on patient care and physician well-being, the administration initiated a comprehensive wellness program. Dr. Smith, a cardiologist, was among those deeply affected. By leveraging this program, he reduced his clinic hours and participated in mindfulness and resilience training sessions. The Clinic also introduced mentorship programs where senior doctors provided guidance and support to their juniors. Dr. Smith, took on a mentoring role, fostering a supportive environment. As a result, not only did his personal well-being improve, but the entire cardiology department reported increased job satisfaction and patient care quality.