Project Thrive: Seeking Clinician Input to Improve Clinician Well-being

While significant data exists to demonstrate that clinicians are increasingly becoming burned out, surprisingly little data exists to support interventions to prevent it. Like many organizations, ours has struggled to address the underlying, system-level characteristics that drive clinician burnout and diminish joy in practice.¹ So, in late 2019, we created Project Thrive to explore how to best support our clinicians' well-being. The cornerstone of this project was a series of focus groups in which we asked our clinicians for their input, not specifically to uncover “what burns us out” but to illuminate “what builds us up.” In the end, we learned much more than that.

This article shares the steps we followed, what we learned, and what we have done based on the results.

Project Thrive is a five-step model that we found to be a simple and effective method to elucidate the supports and obstacles to clinicians' professional satisfaction.

1. Create a project team. Ideally, teams should include clinicians as well as members who have expertise in well-being promotion or quality improvement science.

2. Build a guide for your focus groups to investigate what components of clinicians' work help them thrive. We developed our guide (see the questions below) based in part on recommendations from the Institute for Healthcare Improvement's framework for improving joy in work.² Questions ranged from “What would make you feel more valued at work?” to “If you could break all the rules, what one thing would you change?”

3. Hold the focus groups. Ours were scheduled for each practice site over lunch or during a monthly clinician meeting, and we invited primary care physicians and advanced practice providers. We held two additional focus groups for clinicians who were unable to attend their clinic-specific session. Attendance was optional. Two clinicians led each focus group, and we held them via a videoconferencing platform for convenience. The focus groups were recorded and later transcribed by an outside company.

4. Review the data in a systematic manner. We suggest using rapid qualitative analysis methods³ to review the data and build a matrix based on how focus group participants answer the questions. Look for emerging themes or agreement for each question.

5. Based on the data, identify what is working well in your practice and areas where changes could improve clinicians' lives and daily work. Define potential actions and partner with practice leaders to implement changes.