• Tait D Shanafelt, David Larson, Bryan Bohman, Rachel Roberts, Mickey Trockel, Eva Weinlander, Jill Springer, Hanhan Wang, Sherilyn Stolz, and Daniel Murphy.
• Stanford Medicine, Stanford University School of Medicine, Stanford, CA. Electronic address: tshana@stanford.edu.
• Mayo Clin. Proc. 2023 Jan 1; 98 (1): 163180163-180.

AbstractHealth care delivery organizations are positioned to have a tremendous impact on addressing the variables in the practice environment that contribute to occupational distress and that, when optimized, can promote clinician well-being. Many organizations are committed to this work and have clarity on how to address general, system-wide issues and provide resources for individual clinicians. While such top of the organization elements are essential for success, many of the specific improvement efforts that are necessary must address local challenges at the work unit level (department, division, hospital ward, clinic). Uncertainty of how to address variability and the unique needs of different work units is a barrier to effective action for many health care delivery systems. Overcoming this challenge requires organizations to recognize that unit-specific improvement efforts require a system-level approach. In this manuscript, we outline 7 steps for organizations to consider as they establish the infrastructure to improve professional well-being and provide a description of application and evidence of efficacy from a large academic medical center. Such unit-level efforts to address the unique needs of each specialty and occupation at the work unit level have the ability to address many of the day-to-day issues that drive clinician well-being. An enterprise approach is necessary to systematically advance such unit-level action.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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