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and resentment — even cynicism veiled in the form of sarcasm. If you see a member of your staff who used to love coming into the OR suddenly lose their connection to work and appear to simply go through the motions, that's a red flag. When staff become rigid and less open to innovation (but we've always done it this way!), that's a sign of emotion- al exhaustion or depersonalization. Finally, look for alienation, situations where a formerly social staff member begins isolating themselves. Once you rec- ognize the signs of burnout, take the next step: Provide wellness solutions for your staff. Many facilities have ramped up their mental health offer- ings and made help more accessible to care providers during the pandemic. You should also work to understand and eliminate the stigmas asso- ciated with employee assistance programs and other support solutions. Trust in leadership Regardless of the type of facility you lead — an HOPD for a giant, multi-state health system or a free-standing, single-specialty ASC — it's impera- tive to put forth a safety-first message in every- thing you do during this pandemic. But what hap- pens when your staff loses trust in the decision- making and honesty of its leadership? You build and maintain your staff's trust by focusing on these three elements: • Authenticity. Be a visible leader by rounding reg- ularly through all areas of your facility. Ask staff members how they're doing with clear, jargon-free communications and make sure you're actively listen- ing to their needs. Not only does this help build trust, but it improves your situational awareness at the frontline of care. Be transparent about your facility's current metrics, issues and plans for the future. • Empathy. Provide convenience services for staff (food at work, grocery delivery, etc.); address hardships (enable sharing of PTO for furloughed staff); and promote resilience with initiatives such as oasis rooms, mental health support programs, drop-in counseling and town halls addressing stress. • Logic. Provide visible evidence of the safety practices you have in place to protect staff. Remove barriers to process improvements and conduct 3 D E C E M B E R 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 1 9 If you want to gauge how your staff feels about your facility's COVID-19 response, ask them to rate the following statements on a 5-point Likert scale (from "strongly agree" to "strongly disagree"): • Leaders consistently communicate information related to the COVID-19 crisis in an open and transparent way. • We have a plan for how to handle short- ages of supplies before they become issues. • My mental and emotional health needs are supported during the COVID-19 crisis. • During the COVID-19 crisis, I have had multiple ways to express any concerns through town halls, suggestion boxes, leader visits, etc. • I receive the necessary training and support when being transferred to new areas to work. — Martin Wright Checking in With Your Staff APPROVAL RATING pulse surveys to assess needs and supports for all staff members. Each of these elements can be applied to health- care leadership to build trust among their staff. Consider applying them in your facility to help your staff through these difficult times. OSM Mr. Wright (martin.wright@pressganey.com) is a partner of strategic consulting at Press Ganey Associates in South Bend, Ind., and co-author of "The Engaged Caregiver."