It was during the COVID-19 pandemic — when burnout was hitting the health-care system the hardest — that started thinking about joy at work.
The former 51ÁÔÆæ vice-provost and chair of pediatrics, now dean of medicine at the University of Saskatchewan, wondered how she could help her colleagues at the U of A and the .
“It’s about helping each person find those moments where they are feeling joy that shifts the whole mood of their day and then has a downstream effect,” Forgie says.
That downstream benefit includes less burnout, improved staff retention and better patient outcomes, according to Forgie and a U of A research team in a from Canada, the United States and the United Kingdom.
‘Joy is not a four-letter word’
“This is not rocket science, to be honest,” says first author , assistant professor of pediatrics. “It's things like increasing workplace flexibility, reducing administrative burden on physicians to foster better relationships with patients and colleagues — all of which will promote wellness.”
“Joy is not a four-letter word,” insists Forgie. “When I talk about it, I think where people go to is the extreme of , where you basically wash over everything and say everything's wonderful. That's not what we’re about.”
During the pandemic, Forgie worked with colleagues to set up formal conversations about joy at work with faculty and staff, and soon noticed that others were initiating the discussions. “It was like a virtuous circle. People were asking each other, ‘What brings you joy? What stands in your way? When do you feel your most joyful?’ This was making a difference.”
The team then went looking for the evidence behind what they had observed.
“Existing literature suggests that institutions which promote joy have better retention rates and increased productivity, and more innovative ideas tend to emerge in such settings. This leads to better patient outcomes,” says Rashid.
Rashid says medical workplaces that focus on joy tend to see strengths, rather than taking a deficit-based approach that emphasizes weaknesses, shortcomings and challenges.
Ninety-one per cent of the studies the team found were carried out in the United States, and they looked at disciplines within medicine including surgery, radiology, psychiatry, endocrinology and primary care.
Managing to promote joy
Two main health-care management approaches promote joy: The , which emphasizes positive emotion, engagement, relationships, meaning and achievement; and the model, which encompasses nine aspects including meaning and purpose, choice and autonomy, recognition and rewards, participative management, camaraderie and teamwork, daily improvement, wellness and resilience, real-time measurement, and physical and psychological safety.
The researchers acknowledge that while joy is experienced individually, it is up to health-care leaders to model it and promote it — a management skill that may take training.
They also intend to continue the research. Rashid, who is a member of the , will lead a qualitative study on Canadian physicians’ experiences of joy in the workplace. Co-author Nicole Firth, who is the U of A pediatrics department manager, will lead a project to improve psychological safety in the workplace.
Forgie is excited to bring joy to strategic planning in her new role as a dean, but she recognizes it may be a tough sell.
“Instead of looking at threats, we’re looking much more at our opportunities and our strengths and our aspirations,” she says. “It’s not what a lot of people are used to, and there is skepticism. We often focus on the negatives. That’s part of being human.”
She also continues to take joy in her own clinical practice, telling the story of a recent interaction with a patient on the pediatric hospital ward.
The toddler was sitting next to the nursing station because her parents were at work. Before seeing her next patient, Forgie took the little girl for a three-minute wagon ride through the hallway.
“She just got a big smile as I wheeled her around, and I thought, ‘Yep, that was awesome.’ It was a small moment but it brought me joy. It energized me for the rest of the day.”
