Promoting Organizational Change: A Urology Department-wide Wellness Program to Reduce Burnout.

INTRODUCTION: We developed a comprehensive wellness initiative to address burnout with specific interventions targeted at faculty, residents, nurses, administrators, coordinators, and other departmental personnel. METHODS: A department-wide wellness initiative was implemented in October 2020. General interventions included monthly holiday-themed lunches, weekly pizza lunches, employee recognition events, and initiation of a virtual networking board. Urology residents received financial education workshops, weekly lunches, peer support sessions, and exercise equipment. Faculty were offered personal wellness days to use at their discretion at no penalty to their calculated productivity. Administrative and clinical staff were given weekly lunches and professional development sessions. Pre- and post-intervention surveys included a validated single-item burnout instrument and the Stanford Professional Fulfillment Index. Outcomes were compared using Wilcoxon rank-sum tests and multivariable ordinal logistic regression. RESULTS: Among 96 department members, 66 (70%) and 53 (55%) participants completed the pre- and post-intervention surveys, respectively. Burnout scores were significantly improved after the wellness initiative (mean 2.06 vs 2.42, mean difference -0.36, P = .012). An improvement was also observed in the sense of community (mean 4.04 vs 3.36, mean difference 0.68, P < .001). Adjusting for role group and gender, completion of the curriculum was associated with decreased burnout (OR 0.44, P = .025), increased professional fulfillment (OR 2.05, P = .038), and increased sense of community (OR 3.97, P < .001). The highest-rated components were monthly gatherings (64%), sponsored lunches (58%), and employee of the month (53%). CONCLUSIONS: A department-wide wellness initiative with group-specific interventions can help reduce burnout and may improve professional fulfillment and workplace community.

Post-Disaster Recovery in Puerto Rico and Local Participation: Introduction

In addition to donations from philanthropic organizations but with minimal support from the local or federal government, substantial donations and volunteerism from individuals and the private sector made it possible for the nonprofit sector to have an extensive and impactful participation in the immediate emergency phase of post-disaster recovery (García and Chandrasekhar 2020). Meléndez (2020) identifies the absence of specific state-level policies benefiting community development, along with a weak support system, as important factors holding back the nonprofit sector participation in federal economic recovery programs. The studies included in this volume propose that the long-term benefits of federal disaster recovery programs are contingent on reforming public policy to encourage and support nonprofit developers' participation in developing reconstruction programs, strengthening nonprofit capacity, encouraging partnerships and collaborations, and providing professional development for economic recovery. Common indicators of post-disaster recovery found in the literature include the returning of population to the affected areas after natural disasters, the renewal of business activity, and the successful restoration of damaged infrastructure such as housing, public infrastructure, and government services.