Well-Being Index Case Study
For Dr. Andres Flores, Director of People and Culture Strategy at UChicago Medicine AdventHealth, the challenge wasn’t identifying that nurses were struggling — it was understanding why, and knowing where to start.
When Flores and his colleague Cherese Chery, Vice President and Chief People Officer, stepped into their roles at GlenOaks Hospital, they inherited a unit in crisis. The medical-surgical floor had weathered three ownership transitions in just a few years. Ninety percent of its physicians were independent contractors — not employed by the hospital — creating a structural gap that left nurses shouldering the weight of communication between providers, consultants, and patients. Clinical turnover on the med-surg unit had climbed to 46.3%.
Organization:
UChicago Medicine AdventHealth
(Great Lakes Region)
Well-Being Index Version:
Nurse Well-Being Index
Measuring What Was Hidden
Before they could act, the team needed to understand the depth of the problem. They turned to the Well-Being Index to establish a baseline.
The results were stark. During the pretest period (July–August 2023), the GlenOaks medical-surgical unit scored 2.41 on the Well-Being Index distress scale — well above the national average of 1.72, and squarely in the “Struggling” category. Of the unit’s 25 nurses, 36% were distressed and 36% were struggling — meaning nearly three-quarters of the team were in a state of significant distress or burnout.
But the Well-Being Index offered more than a snapshot. The team used the tool’s process improvement question feature to probe deeper into what was driving the distress. They asked one focused question: What is the greatest challenge in your workflow?
The answers pointed directly at the nurse-physician relationship:
- 33.3% cited long wait times for physician orders — medications, admissions, and discharge instructions
- 26.7% reported regularly performing tasks that fell outside nursing’s clinical scope
The Well-Being Index data also surfaced something the team hadn’t anticipated. When results triggered follow-up conversations with staff, seven nurses were identified as experiencing suicidal ideation. With the help of Employee Health Manager Valerie Gonzalez and resources connected through the Well-Being Index platform, all seven were connected to care.
Nurses described the experience of taking the Well-Being Index as unlike any survey they had completed before — as Flores recounted during his presentation at the Champions of Wellness Healthcare Summit: “They said, ‘This is not a normal survey. It feels as if it’s asking me about me, about my own wellness, about my own heart, my own vitality.'”
The team paired Well-Being Index data with qualitative listening sessions, bringing multidisciplinary groups of nurses and team members together to map their lived experience. “For the first time, nurses felt heard,” Flores said. “We really want to provide that sense of psychological safety within the team.”
A Triple Approach to Rebalancing the Ecosystem
Armed with data, the team designed a three-part intervention strategy — one that treated nurse well-being not as an individual challenge, but as a systemic one.
1. Executive Alignment
Before any frontline work could begin, Chery and Flores started at the top. Cross-disciplinary executive debrief sessions — grounded in AdventHealth’s mission, values, and service standards — brought the local CEO, CNO, and CMO into alignment. This proved especially critical given the hospital’s physician structure. Getting independent contractors to change their communication practices required executive leadership willing to have difficult conversations and, as Chery noted, leaders who were “courageous enough” to hold physicians accountable to team standards.
2. Process Improvement Events — Building Collaboration Through Unity
Between September 2024 and May 2025, the team facilitated a series of Kaizen events that brought nurses and independent physicians to the same table — many for the first time in years.
Early sessions were emotionally charged. “The first process improvement event… people, nurses and leaders, they were crying, they were in high distress,” said Flores. “But the crying, the emotional state of that unit, was not only sadness — it was kind of a release. And that was very powerful.”
Through these sessions, the team uncovered the specific structural gaps fueling the breakdown: no standardized communication tools, no consistent contact method between nurses and physicians, problematic discharge consult processes, and incomplete admission orders. Perhaps most importantly, they found that nurses wanted to communicate better with physicians but lacked the psychological safety to do so.
The interventions that followed were concrete: EPIC chat was introduced to reduce communication delays, escalation protocols and standard work were developed, and multidisciplinary rounding was implemented at the bedside. A physician-nurse communication template was formally approved by the hospital’s Medical Executive Committee, and the CMO personally committed to rounding with all independent physicians to address workflow inefficiencies.
The effort was framed intentionally as a patient safety and quality initiative, not just a wellness program — a framing that helped secure physician buy-in.
3. Mental Health Sessions
Recognizing that nurses bring the whole of their lives to their work, AdventHealth launched a seven-week virtual mental health series led by a doctor of psychology, initially for leaders and later extended to all team members. As Chery described it, the sessions “fostered vulnerability based on trust and peer connections,” empowering staff to prioritize their own mental health.
The Results: Signs of a Healthier Ecosystem
Two years after implementing these interventions, the data tells a clear story of transformation.
Well-Being Index Distress Scores
|
Milestone |
National Average |
GlenOaks Med-Surg |
Interpretation |
|
Pretest (July–Aug 2023) |
1.72 |
2.41 |
Struggling |
|
Post-test (June–Oct 2024) |
1.69 |
1.90 |
Trending to Okay |
Turnover
|
Before |
After |
|
|
Med-Surg Unit |
46.3% |
18.2% |
|
Hospital-Wide Clinical |
~38% |
12% |
The med-surg unit saw a 28-point reduction in clinical turnover — a shift the team directly correlates to the sequence of interventions tracked against the Well-Being Index data. “The turnover dropped 28.1 percentage points,” Flores noted. “This is a dramatic shift representing not only cost savings but also stability for patients and for the care team.”
The results have been compelling enough to drive expansion. As Flores shared: “We have been expanding the well-being project across the Great Lakes region.”
What They Learned
Chery and Flores closed their presentation with four lessons they hope other healthcare leaders will carry forward.
“A thriving clinical unit is an ecosystem, not a collection of individuals.”
“Well-being is a shared responsibility, enabled by leadership, culture, and systems.”
“Trust is the foundation for compassion, collaboration, and resilience.”
“Well-being is a strategic driver of organizational outcomes, directly influencing team member retention and the quality of clinical care.”
As Flores summarized: “These outcomes remind us that when we treat clinical well-being as an ecosystem rather than a collection of individuals, we create conditions where well-being, trust, and retention naturally grow.”
About the Well-Being Index
The Mayo Clinic-invented Well-Being Index is a validated assessment tool that enables healthcare organizations to measure clinician and team member well-being, identify burnout risk, and surface actionable process improvement insights. Learn more at mywellbeingindex.org.
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