1. Optimal Healing Environments Integral to Workplace Health
Presented by:
Dr. Cynthia Hamilton &
Dr. Amandah Hoogbruin

2. Introduction In nursing,
A healthy work[place]is…a practice setting that maximizes the health and well-being of nurses, quality patient/client outcomes, organizational performance and societal outcomes (RNA0, 2010, p.2)

3. Why is a healthy workplace important?
To protect worker’s health, safety, and well-being.
Ethical- do no harm to others
Practical- benefits of prevention surpass the work-related costs of illness, injury, & disability
Legal- occupational health & safety violations

4. Elements of a Healthy Workplace
Healthy Workplace practices
Workplace balance
Health & Safety
Employee Recognition
Employee Well-being
Stress Management
Job Satisfaction
Staff Morale
Organizational Improvements
Absenteeism
Accident/Injury Rates
Staff/Patient Satisfaction
A Business Model
Key Influencing Factors
Communication
Leadership- “walk the talk”
Listen and act on employee identified needs & recommendations
Be coherent, consistent, & timely
(Grawitch, Gottschalk, & Munz, 2006)

5. The Nurses’ Workplace An exceptionally, stressful environment
Increased acuity levels of patients, shorter lengths of stay, & less than optimal staffing ratios
Crawford & Thornton, 2010)
RNs continue to have the highest rates of absenteeism due to illness or injury in Canada
(Canadian Federation of Nurses Union, 2009)
1 in 5 nurses leave their job in Canadian hospitals each year.
(O’Brien-Pallas, L., Tomblin-Murphy, & Shamian, 2008).

6. Hospitalization: A Source of Stress

7. A Paradigm Shift from Cure to Healing in the Health Care Environment
Health trends
Aging population
Negative Impact of multiple life stressors
More people living with chronic disease
Need for a sustainable health care system
Research evidence
Environmental psychology
An interdisciplinary science that focuses on the interplay between human beings and their surrounding environment
Psychoimmuneurology
Interaction between psychological processes and the human neurological & immune systems.
Health trends
Aging population
Negative Impact of multiple life stressors
More people living with chronic disease
Need for a sustainable health care system
Research evidence
Environmental psychology
An interdisciplinary science that focuses on the interplay between human beings and their surrounding environment
Psychoimmuneurology
Interaction between psychological processes and the human neurological & immune systems.

8. Towards an Optimal Healing Environment
An environment in which all aspects focus on supporting and stimulating healing & wholeness
Physical
Emotional
Spiritual
Behavioral
Environmental
©2009 Mary Grande Pre, Inner Embrace Pastel

9. ©2011 Jonas, W. Cultivating OHEs in nursing & health care

10. Here is a more detailed description of the key components of the optimal environment originally proposed by the Samueli Institute in There are inner and outer environments that interface through the internal, interpersonal, behavioral and external relationships among patients, their families, caregivers, and the whole health care system. All of these factors are based on evidence related to for example in our inner environment, when we develop inner healing intention we enhance awareness that enables experiencing personal wholeness and enhanced integration; at the interpresonal level by cultivating healing relationships, caring is enhanced; and healing organizations can be created to enhance a culture of caring.
©2011 Jonas, W. Cultivating OHEs in nursing & health care

11. Design For Optimal Healing
©2011 Jonas, W. Cultivating OHEs in nursing & health care

12. ©2011 Jonas, W. Cultivating OHEs in nursing & health care

13. ©2011 Jonas, W. Cultivating OHEs in nursing & health care

14. Healing Places, Healing Spaces The Hospital Environment
Healing paths/ gardens/ pleasant view
Windows with natural light in the room
Community, staff, personal & sacred space
Private rooms for family
& friends to be together
Architectual design to
increase time for
staff to interact with
their patients

15. ©2011 Jonas, W. Cultivating OHEs in nursing & health care

16. Next Steps: Optimizing the healing environment in a public hospital
Part 1
Making healing as important as cure
A self-assessment survey about healing programs
A wide variety of staff at Lions Gate Hospital will be invited to complete this survey
To gain a comprehensive understanding of the status of the organization, on its journey to becoming an Optimal Healing Environment

17. Attending to Inner Environments
Part 2
A research demonstration of a mindfulness-based stress reduction (MBSR) intervention
developed by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical Center; now offered in over 200 medical centers, hospitals, and clinics
Practicing mindfulness-based stress reduction is associated with significant improvement:
chronic pain
sleep deprivation
depression, mood disorders, and heart disease

18. MBSR Intervention 8 weekly classes & 1 full day session
Guided instruction in mindfulness meditation practices such as walking meditation and the "body scan."
Gentle stretching and mindful yoga
Group discussions aimed at enhancing awareness in everyday life
Individually tailored instructions and daily home assignments
“A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses.” – Hippocrates
©2011 Laura Schenck

19. Specific research questions to be addressed
What is the feasibility of delivering MBSR as a 2 hour weekly group session for 8 weeks in two different work environments (acute psychiatric and acute oncology and palliative nursing units)?
What is the impact of MBSR on subjective wellbeing (i.e., stress, burnout, depression levels, and anxiety trait); and health and safety in the workplace (i.e., frequency of adverse events, overtime, and absenteeism related to illness or injury)
What is the experience of the nurses who participated in the MSBR?
What are the potential barriers and facilitators of implementing MBSR in each context?
What is the experience of the respective action teams who engage in the participatory action part of this research demonstration project?

20. Acknowledgement
Funding for this pilot study has been generously provided by the

21. References
Crawford, J. & Thornton, L. (2010). Why has holistic nursing taken off in the last five years? What has changed? Alternative therapies, 16(5), 22-24
Canadian Federation of Nurses Union (2009). Quick facts on the Canadian nursing Landscape. Retrieved 20 June 2011, from
Grawitch, M.J., Gottschalk, M., & Munz, D.C. (2006). The path to a healthy workplace: A critical review linking healthy workplace practices, employee well-being, and organizational improvements. Consulting Psychology Journal: Practice & Research, 58(3),
O’Brien, P., Tomblin-Murphy, G., & Shamian, J. (2008).Understanding the costs and outcomes of nurses’ turnover in Canadian hospitals: Final report. Toronto: University of Toronto, Nursing Health Services Research Unit.