The RISE (Resilience in Stressful Events) Peer Support Program: Creating a Virtuous Cycle of Healthcare Leadership Support for Staff Resilience and Well-Being

Abstract: Healthcare leaders are responsible for creating an environment where their staff can maintain their resilience and well-being. However, there is a crisis of burnout among healthcare workers. The resulting increased turnover, diminished morale and performance, safety risks, and decreased worker engagement produces a vicious cycle of burnout. A strategic intervention is needed that focuses on worker wellbeing. This paper describes how the Johns Hopkins Resilience In Stressful Events (RISE) peer support program has helped healthcare leaders support their workers and strengthen the resilience of their organization. It explains the crucial role that leaders play in the success of the program. RISE peer was established at Johns Hopkins Hospital in 2011 to provide timely peer support for stressful patient and work-related situations. RISE helps break the cycle of healthcare worker burnout by providing peer support for stresses at work 24 hours a day, 7 days a week. This program structure also supports leaders by sharing the responsibility of emotional support and by providing them with new skills to do their job in a way that generates personal and professional satisfaction. The program has been implemented globally in over 140 healthcare organizations. Leaders are essential to integrate support and serve as role models. Institutions that successfully launch peer support programs engage leaders to participate in program design, participate in the program themselves, and adapt the program to meet the needs of their staff and organization. Peer support programs broaden the base of support for all healthcare workers by providing an employee-focused resource. Implementation of a RISE support model demonstrates an institution’s commitment to the overall health of the people it employs. Operational integration of the model conveys a positive impact on resilience at all levels of the organization, especially in institutions that broadly engage organizational leaders. Plain Language Summary: Before the COVID-19 pandemic, burnout was a major concern for healthcare workers globally. Unfortunately, in the worst of the pandemic, the impact of burnout was greatly magnified. In an attempt to mitigate the impact of healthcare worker burnout, in 2011 Johns Hopkins Hospital was among the first to implement an institutional peer support program, which was called RISE (Resilience In Stressful Events). Because of its pre-established presence, during the pandemic RISE was a primary source of mental, psychological, and emotional support, allowing healthcare workers to process their stressful experiences with a trained responder in a confidential, non-judgmental encounter. Leadership heavily relied on RISE to support them and their staff during these times of extreme duress. Leadership advocacy for the creation and adoption of the RISE peer support program yielded a substantial return on investment in terms of the resilience of both individual workers and the organization. With active leadership support, the RISE program established a formal curriculum that trains hundreds of Johns Hopkins employees per year, and expanded into a standardized employee support program which has spread globally. Peer support, as exemplified by RISE, helps health workers recover through difficult situations, and also serves as a resource for leaders. Leader engagement and buy-in are crucial for establishing an organizational peer support structure, and implementation and integration of a program into operations. Ultimately, leader engagement in peer support programs can result in culture change and strengthened resilience which benefit the individual, the team, and the organization. Keywords: RISE, peer support, burnout, resilience, leaders