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Keynote: Workforce Resilience - Burnout, Balance, and Belonging
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Bill Russell: My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week.
Now, let's jump right into the episode.
(Main)
Opening – The Breaking Point Define the crisis Urgent, grounded
Bill Russell (2): Welcome to a special Keynote Rewind episode.
Over the years, I’ve talked with hundreds of leaders across healthcare, and one thing keeps surfacing, the people inside the system are exhausted.
Burnout isn’t just a buzzword. It’s showing up in resignation letters, in silent commutes, in inboxes full of things that can’t wait.
And the scary thing? We’ve come to treat this level of strain as normal. Today, we’re taking a step back to ask: What’s really happening to the people holding healthcare together, and what’s actually working to bring them back from the edge? You’re going to hear from leaders and caregivers who’ve been to the breaking point, and some who are [00:01:00] trying to build something better on the other side of it. Let’s start where many of us found ourselves during COVID, running on adrenaline, solving impossible problems… and slowly breaking in the process.
Joel Klein: It's when people start feeling powerless and that they're just, being blown around by the wind of their work. That's when burnout really can take hold. And when you can all get galvanized around a common, goal it can be transformative. For us, and I know this is true for so many people in our industry, COVID was such the, the example of that.
So we are one of the health systems that did. A ginormous field hospital. Ours ended up having, a pretty decent census for most of the time that it was open. It was in the Baltimore Convention Center, which we did with the Army Corps of Engineers. It was one of these vast places that has, just endless rows of beds and our epic stuff and our, WoWs and our telephones and our printers and all that stuff in there.
But then, okay, now can you stand up, a monster vaccination [00:02:00] thing in an NFL stadium? Or we found another big parking lot over here. Can you have that, done tomorrow? The kinds of things that under, peacetime conditions people would say no, we can't do that tomorrow.
But under, what we all went through, people were just willing to do it and really go the extra mile. Now that we're past all that finding ways to give people input and say and an opportunity to participate in a project like this. It gives people hope.
Bill Russell (2): That kind of all-hands-on-deck effort brought out the best in us. But no team can operate in crisis mode forever. We talk about workforce burnout in the abstract, like it’s a line item or a trend to track. But behind every chart, every resignation, every quiet departure… there’s a person who reached a limit.
🧠 Act I – The Human Cost
Bill Russell (2): For Erica, that limit came in the form of a caregiving crisis, one she navigated in the middle of the night, searching for guidance… and finding it in an unexpected place.
Erica Olenski: [00:03:00] ChatGPT took a trauma-informed approach to interacting with me as his caregiver was validating.
Said, Hey, Erica, you're really on the right track here and these concerns are really valid. Here are some things that we might recommend you do. I would contact his hospice and palliative team. Here is a proposed script you can use when you make that phone call. Here's something you can do that overlies the symptoms that you've been sharing with me as you've been thinking through your next steps in caring for your son.
I use chat GPT throughout our ER admission. So having the ability to outsource, not just like the practical application of caregiving, but having an emotional validation friend, I suppose as I'm going through that's available to me, without any restraint.
I could do this until two or three o'clock in the morning and after the whole ordeal. It said, Erica, your decision to take him in was a good one and you should be really relieved and [00:04:00] proud that you took action when you did because it really was the right decision and you should feel really good about yourself.
And the emotional validation that this application gave me was remarkable. It was unbelievable. It was like talking to a friend.
Bill Russell (2): Sometimes the breaking point doesn’t come from caregiving or crisis. It comes from the pressure we put on ourselves, to succeed, to outperform, to never let up.
Ian Koniak: I, demoted myself from enterprise to commercial because frankly, I was going to be fired. So I had to get out of there and I wanted to stay at Salesforce. So I somehow snuck into the commercial division And in that year, I grinded like crazy. I had a lot of accounts and I still misquoted this time by one deal.
I missed it the last day of our fiscal year. And it was one of the most depressing and, low moments of my career. Because at that point I knew the problem wasn't my territory. It wasn't my manager, it was me. And I had to face myself.
Bill Russell (2): For Erica, that burnout didn’t stop with one crisis. It extended into every room where she had to fight for [00:05:00] her son’s care, even when the system should have been listening
Erica Olenski: So I actually had to elbow my way into the conversation and say, I need to make sure that I'm being briefed on whatever it is you're discussing, because first of all, you guys don't have
easy access to context on this patient and with his history and complexity. and any other patient that's.
Complex or in a long-term, more chronic acute scenario. They're facing the same issue. And just the lack of discussion was really striking. And I think I upset one of them. The other one was like, I'm really glad that you were here because you're a really good advocate for your son.
Bill Russell (2): And for some, it’s not one moment. It’s years of pressure, decisions no one wants to make, challenges that never let up. Until finally… they step away.
Bill Russell: I talk about my experience at St. Joe's and I think sometimes people think I romanticize what it was like. But I also preface that by saying hardest job I've ever had in my life was being the CIO at a 16 [00:06:00] hospital system.
It was so challenging. But today I want to talk about. being a CEO and setting the culture and all those things, was that the hardest job you ever had or was there a harder job you had?
Deborah Proctor: No. Definitely the hardest job I had. And it became harder the more years I was in the job as the environment of healthcare became harder because it forced us into some situations of con contemplating, mergers, and that was very difficult, stressful work.
It probably what caused me to retire when I did
Bill Russell (2): These stories are hard, because they’re true. But they also point us toward something hopeful. Because where there’s pain, there’s often purpose. And across healthcare, some leaders are taking that purpose and turning it into progress.
🔧 Act II – What’s Actually Working
Bill Russell (2): So what do we do with all of this? The strain, the silence, the breaking points, they’re real. But they’re not the whole story. Because across healthcare, leaders and teams are redesigning the [00:07:00] way work actually works. Quietly. Carefully. And in some places, effectively.
It doesn’t always take a massive program to make a difference. Sometimes, it’s as simple as removing the noise.
Jake Lancaster: Over the pandemic years with burnout rising and staffing shortages so how can we reduce the administrative burden on. our Physicians and providers and working a lot more with the nursing staff as well to try to decrease some of their burden.
So we've done all the classic things like decrease alerts, so that. We made a lot of progress early on. We had , a million alerts a month across our system. And we've brought that down to just slightly under a hundred thousand, which you know, is a huge improvement.
Most of those were going to the nursing staff and had never been looked at. And so we got a group and were able to take that down, but the nurses are still spending way too much time in the chart. And so helping with that group to really redesign some of that [00:08:00] workflow. And then for physicians over the last couple of years, it's been with more patients moving and getting more comfortable with the patient portals just that volume of messages that are coming in.
Bill Russell (2): But even the best tools don’t matter if the culture tells people they don’t belong. Fixing burnout means listening to what’s broken, and then asking those closest to the problem what the solution might be.
Theresa McDonnell: So when the frontline feels like they're valued. Their opinion matters when they're engaged.
When we ask them what the pebbles are in their shoes, that helps create that culture of empowerment, and it's that culture of empowerment that then drives the retention. You know, when people feel like they're just a cog in a wheel.
They don't feel any sense of belonging. And One of the things I'm most proud of in the last 12 months here at Duke is we actually just had another culture pulse survey where we, you know, send a survey [00:09:00] out to our staff. And our belonging scores were some of the highest we've ever seen, and we benchmarked far higher than some of our sister organizations.
That brings me joy to know that people feel like they belong here.
Bill Russell (2): Sometimes the best ideas come from walking alongside the people doing the work, literally. That’s exactly what one organization did.
Bridget Barnes: We have what we call wellness sprints. We just initiated a program. We did a pilot the last 18 months, and we got funding to roll this out across the organization so that we'll go to all the units across the organization where we have our clinical informatics team goes shoulder to shoulder and shadows shadows, physicians and clinics and says, okay, show me how you're doing.
Show me how you're doing the work. And we help them with an optimization going clinic by clinic. Using software that also helps we can send them to study portal so we can see where they're looking, it evaluates their eye movements so we can see where they're going in the [00:10:00] chart to get information and then help them say okay you know there's a more streamlined approach to do this, how, and then give them that personalized training that they need.
In order to streamline their workforce. And sometimes it could result in, personalization that would be appropriate for that particular position. So there's a large effort a couple of million dollars a year that we're spending our hope is that helps lessen the burden for providers.
So they aren't, doing pajama notes so that they can get all that work done while they're on site, as opposed to so much work that they're now doing after hours.
Bill Russell (2): Burnout doesn’t just live in the back office. It shows up in the calendar, the inbox, and the rigid systems we’ve built around both patients and providers.
Scott MacLean: Well, just to comment generally, \ think we are trying to respond to what patients want to do online but also keeping in mind that there are clinicians who are also human beings on the other side of it, right?
Who practice probably in more than one location. And also have disruptions in their lives, whether [00:11:00] it be another patient emergency or personal thing that happens in their life where, the physician needs to have more open space to do something different. So, we've gone through and continue to work with our physician community to be able to.
Build schedules that work for them that can then match up to consumer needs. Standardizing visit types something that fits into an algorithm for a consumer to interact with versus how it's been done manually for many years.
Bill Russell (2): The best leaders know — if you take care of your people, they’ll take care of everything else. And that mindset is becoming more than a mantra. It’s becoming strategy.
Marijo Rugh: What we've realized through COVID is just The importance of our employees. And so I think with, the turnover rates that we're experiencing while we're making a small dent in it, we really have to stay focused on our employees because guess what, if we take care of our employees, then we're going to take good care of our patients.
So I think while there's certainly [00:12:00] technologies out there that will improve patient care or, allow us to do things different. That will improve patient outcomes. I also think that we in healthcare also need to remember to take care of our employees. So as we look at how can we make their life easier, that's really going to be a focus of mine, probably to take me to the end of my career, where not only does the patient come first,
but our employee needs to come first.
Bill Russell (2): None of these fixes are perfect. Some are still in progress. But together, they offer a glimpse of what’s possible, not just to reduce burnout, but to rebuild trust, restore balance, and create systems that care for the people within them.
🤝 Act III – Building Belonging
Bill Russell (2): Fixing burnout is the beginning. But what happens when we start building systems that people want to stay in, not just survive in?”That’s where the conversation turns to culture. Belonging. And leadership that’s both intentional and personal.
And when culture’s done right, it doesn’t need to be announced. You feel it, [00:13:00] in the pride, the collaboration, the sense that everyone’s pulling in the same direction.
Tanya Townsend: Culture appreciates the level of change. Go live is only the beginning. It's a big family and they're doing wonderful things. They've got great recognitions in terms of awards and we don't have to rattle all those off, but they are high achieved in all of those different areas.
And everyone, like I said, is super supportive, super collaborative, very welcoming. And I would say that's not just within IS, it's really across the whole organization. So I'm really excited to be a part of it because that's not the case everywhere.
Bill Russell (2): So what is culture, really? One leader put it best.
Theo Theodosiou: The default cultures are almost always problematical, but intentional cultures, so the very idea that you set out to weave something that would be weight bearing, the very idea, the moment you decide that You have, I think, a significant advantage.
And so what I would tell you is just to build on that, because you'll make it very obvious, the [00:14:00] definition that the firm has introduced for culture and we've used very consistently is in very simple terms, culture is the lived version of your values, Bill. Culture is simply the lived version of your values,
Bill Russell (2): It shows up in who you hire. How you grow your team. And the standards you set for what good looks like, not just in performance, but in purpose.
michael restuccia: My biggest challenge has been to build the team that can enable and support. These great researchers and great clinicians and keep patients coming to Penn Medicine and try clinical trials coming to Penn Medicine. And that's why I spend a good portion of my day, week, month around two things.
One is human resources and focus on the team and on employee. Ensuring we're providing the right career paths and opportunities and ensuring we have the right technology to. Keep them turned on and ready to go and advancing their career and grow.
What it boils down [00:15:00] to what we look for and what we've trained our leaders and our managers to zero in on, and just for order of context, our entire team is about a thousand employees. And out of that, there's about 150 leaders, managers, directors, VPs, whatever. We focus a lot on our leaders in the recruiting to determine how individuals will be energized to come into a not for profit organization with a mission for the betterment of mankind, health, research and find those individuals that believe in that mission and who want to exceed expectations each and every day.
And that's what we promote during the recruiting cycle. We ask individuals to share with us whether in their professional or personal life, where have they exceeded expectations? What was the standard? What goes above and beyond? What would they bring to Penn Medicine in that respect? And it's curious when you hear some of the responses you might get, because that's not a question that [00:16:00] most candidates are prepared for.
They're prepared for, well, tell me about. with this tool in this job, not how you exceeded expectations.
Bill Russell (2): And connection doesn’t require a badge swipe. It requires access. Visibility. And leadership that brings people into the work, no matter where they are.
Alastair Erskine, MD: The problem I'm trying to solve is mitigate the fact that my staff is remote.
And you know, initially I was under the impression that I was going to be able to just. dictate that people come back to the office three days a week. And very quickly, I got some feedback that may not be as easy as I had anticipated. And so the question is, all right, well, what are we really trying to accomplish by having people be on site?
Well, we want them to have that water cooler conversation. We want to have that sort of whiteboard experience. So every Monday morning, every Friday morning, I go to some part of the hospital or clinic. It could be the basement of the hospital for the pharmacy department.
It could be the ICU. It could be the [00:17:00] warehouse where we, you know, house all the equipment, whatever it may be. And I sit down with the leadership for an hour and talk to them about how they organize and what the issues are and what the technology needs are. And then I round, meaning walk around whether it's the unit or the warehouse or the pharmacy, whatever it may be.
But I bring my assistant with me and she is carrying around an iPhone. And the iPhone is streaming the experience. It's not recording anything. It's streaming the experience. Only to those that are invited, and they invite my entire Emory Digital team with me. The people know that they can't watch the streaming experience in a public area.
They have to be in a private area because we don't want to... Expose any PHI, and only those invited can come to the meeting. So we have some way of containing that. By virtue of the fact that I'm not recording anything means that I don't have to keep track of where it's stored and who can subsequently see it.
And I also give early warning to the area I'm going to [00:18:00] a few days before that I'm going to be coming, and anybody who doesn't want to be part of this can opt out and not be involved in the streaming experience. I have no one who said they're not interested. And in fact, what's happened when I'm on site and I'm asking questions is sometimes one of my team members, and I have somewhere around 200 folks that join me, that's about half of my team, and they will answer a question that is asked by one of the frontline doctors or nurses, or jump in and talk about the fact that they're working on that, or sometimes even fix something on the fly.
So not only am I bringing the team so they can experience and empathize with the front line and appreciate the importance of doing one thing over another. But on top of it, I'm bringing my entire team to do a quick fix if necessary. And it ends up what's happening now is the team is growing. More and more people are wanting to join these sessions.
Bill Russell (2): When people feel seen, supported, and connected to the mission, everything changes. Not [00:19:00] overnight. But over time, these small acts of belonging add up. And they build something worth staying for.
🌅 Closing – The Path Forward
Bill Russell (2): Burnout isn’t a footnote in healthcare, it’s a flashing warning light. But what comes next doesn’t have to be a crisis response. It can be something better, something built with intention.
Because at the end of the day, this isn’t about finding heroes. It’s about showing up like a pro, listening well, collaborating deeply, and solving the right problems.
Chris Harper: My role as a CIO really isn't to present the best technology. It's in collaboration with my peers, really understanding the problem at first. Right? And so today I think, a lot of CIOs want to be the hero, I'd rather be a pro than a hero.
Bill Russell (2): That also means seeing wellness not as a perk, but as a priority. Not just for doctors and nurses, but for every person keeping the system running.
Chero Goswami: Employee health has become a strategic imperative. We always talked about provider health, which is [00:20:00] important, but today it doesn't matter if you're a provider or a non-provider, every employee in the health system, every health system is stressed to a point. And the behavioral health of our very own has become an important factor.
Bill Russell (2): At one organization, they started with a deceptively simple question: how do we bring joy back?And the answer started in the data.
Aaron Miri: How do I bring joy back?
The actual data on usage patterns in the EMR to figure out when pajama time is and what those bugaboo workflows. Has been invaluable to be able to sit down with a primary care physician or sub-specialist and go, you're spending a ton of time placing orders.
It's that customization, personalization, taking the junk out of documentation,
Bill Russell (2): From there, it expanded. Forecasting what patients really need, and bringing care to the communities that need it most.
Aaron Miri: what are our patients coming to us for and how do we maneuver some of these clinics? As these regions grow to do more services, what are people looking for? What do they want? And being able to proactively [00:21:00] forecast
Bill Russell (2): And let’s be honest, no one wants to make another phone call to schedule care. These teams are proving that convenience isn’t just possible. It’s overdue.
Aaron Miri: alleviating all the manual phone calls and scheduling and all the things that that are cumbersome in healthcare that everybody universally.
And despises. If we can really automate those and manage that so that it's as easy as ordering a pizza
on Twitter from Domino's,
Bill Russell (2): None of this happens without clear insight. That’s why more organizations are building data teams that don’t just report the past, they help design the future.
Aaron Miri: What we did was reorganized our analytics team into a central function. It is underneath it, but accountable to the enterprise. We have both a data intelligence. These are the folks who are like data managers, data architects, and decision science who help write the basically lenses as to what does this data actually mean for us.
Those two teams then work with finance, hr. And really curate out those questions from the data sets that we did not have the ability to see [00:22:00] before. On top of you getting more efficient from an EMR in general, which alleviates other burdens that cascade down through the health system. It gives you a pen of view you just never had before.
So for us right now, it's like, Walking into a giant restaurant with a huge buffet of options,
Bill Russell (2): So where do we go from here? We start by caring for the people who care for everyone else. That means more listening. Smarter systems. Better support. And a deeper belief that the future of healthcare is worth staying for, not just surviving through. Thanks for joining us for this special Keynote Rewind. We’ll see you next time.
Bill Russell: Thanks for listening to this week's keynote. If you found value, share it with a peer. It's a great chance to discuss and in some cases start a mentoring relationship. One way you can support the show is to subscribe and leave us a rating. it if you could do that. Thanks for listening. That's all for now..