CMO Exchange: Denver Health Adopts RISE Healthcare Worker Well-Being Program

Denver Health's chief medical officer says the program is specifically designed to provide support for healthcare workers.

Denver Health has implemented the Resilience in Stressful Events (RISE) program to help boost the well-being of the health system's healthcare workers, Chief Medical Officer Connie Savor Price, MD, MBA, said during the recent HealthLeaders CMO Exchange.

Stress and burnout are common in the healthcare industry. Healthcare worker burnout has reached alarming proportions during the coronavirus pandemic, a healthcare worker well-being expert has told HealthLeaders. Prior to the coronavirus pandemic, healthcare worker burnout rates on average ranged from 30% to 50%, says Bernadette Melnyk, PhD, APRN-CNP, chief wellness officer of The Ohio State University and dean of the university's College of Nursing. Now, burnout rates range from 40% to 70%, she said.

RISE was developed by Johns Hopkins Medicine specifically to help healthcare workers, Price says. "The concept of RISE is geared toward the specific needs of healthcare providers and what they face in some of the difficulties of being healthcare providers. Healthcare providers are involved in adverse patient events and medical errors, and bearing witness to those can result in emotional or even physical distress."

RISE programming is designed to play a supportive role for healthcare workers, she says. "RISE is basically a service to empathize, listen, validate, and normalize. It facilitates a connection to other providers and resources if that connection is needed. It is available 24/7 and there is strict confidentiality. RISE is not counseling. It is not a problem-solving service. It does not provide psychotherapy or any kind of psychiatric care. It is a support service, with listening and connections to other resources."

Denver Health has launched seven RISE initiatives:

• 24/7 RISE Line (303-436-RISE): This phone-based service provides 24/7 access to emotional support and psychological first-aid, including a handoff to well-being resources.
   
• Department or team-specific RISE group support: Group support opportunities are available virtually or in-person. Any leader can activate a group support request by emailing dhrise@dhha.org or by calling the 24/7 RISE Line for urgent requests.
   
• RISE Up Staff Support Center: This is a dedicated space staffed by RISE peer responders that provides staff with a place for self-care, reflection, emotional support, and access to resources, snacks, and beverages. The support center has been open seven days a week from 10:30 a.m. to 8 p.m.
   
• Inter-disciplinary virtual RISE group support: These group support opportunities are offered on a weekly basis for various themes of distress and specific affinity groups such as the Black Affinity Group.
   
• Peer Assault Care Team: PACT offers immediate, confidential, and voluntary support for staff after an assault in the workplace. A PACT response can be initiated by any staff member or leader by calling the 24/7 RISE Line and requesting the PACT responder on-call.
   
• RISE outreach: RISE peer responders are available to provide outreach to staff to introduce RISE services and assess needs. The peer responders also provide emotional support, psychological first-aid, and connections to resources. Requests for deployment of outreach services can be made via email at dhrise@dhha.org or by calling the 24/7 RISE Line.
   
• RISE 2 You: This mobile service can be requested to come to a department or clinic. RISE peer responders and other resources are available by requesting a visit via email at dhrise@dhha.org.

Stress in healthcare settings

There are multiple sources of stress among healthcare workers, Price says.

"I am at a Level 1 trauma center and public health hospital, and our provider staff frequently witness distressing events. The problem of being a 'second victim' is you also often feel personally responsible for the outcome. Sometimes, you feel that you should have been able to do more—you question whether you did everything you could have done. So, there are special needs among healthcare providers. There are also factors that we are seeing in the workplace such as an increase in violence. There are ethical dilemmas and moral distress—there are patients who can't access the healthcare they need because they do not have the right insurance. There are tragic events—there is a lot of stress in healthcare teams," she says.

At Denver Health, three dozen themes of distress were identified through RISE from July 5 to Aug. 1 this year, including grief and loss, death of patients and colleagues, physical and mental exhaustion, conflict with co-workers, staffing shortages, isolation and loneliness, and desire to quit.

Related: 4 Hot Topics at HealthLeaders Chief Medical Officer Exchange