EP 36: Wellbeing: Beyond the Buzzword with Dr. Dan Diamond

Tucker:
Welcome to THRIVERS: Nonprofit Leadership for the Next Normal. I’m your host, Tucker Wannamaker, the CEO of THRIVE IMPACT, and our mission is to solve nonprofit leader burnout. Burnout is the enemy of creating positive change. And we want to connect you with impactful mission-driven leaders and ideas so that you can learn to thrive in today’s nonprofit landscape. And, today, I am joined, as usual, by my co-host, Sarah Fanslau, our Chief of Impact. Hey, Sarah, good to be here with you today.

Sarah:
Hey, Tucker, great to be here.

Tucker:
On the show. And I’m also joined by a wonderful guest of somebody that we’ve been working with for a little while now on a particular project that we’re going to talk about Mr. Dr. Dan Diamond. Dan, it is great to have you here on the show.

Dr. Dan Diamond:
Thanks, Tucker. It’s a pleasure to be here. I’m excited about the work you’re doing.

Tucker:
Well, Dan, tell us a little bit about your background, really for… I know a lot about your background. But for our listeners, tell us a little bit about your background? And then we’ll talk about… We really want to get into things like well-being, what we’ve been learning through this journey that we’ve all been working on with a group of impact-driven leaders in healthcare. So we want to get into that, but before we do, Dan, tell us a little bit about you. Who are you, Dr. Dan Diamond?

Dr. Dan Diamond:
Other than being your friend, which is a great thing.

Tucker:
Which I love, which I love.

Dr. Dan Diamond:
I’m a family practice doc, and I’ve been doing international disaster medicine throughout my career. I ran the medical triage unit at the New Orleans Convention Center. I led first teams into Haiti, the Philippines, Honduras, Mexico, Africa, India. I’ve been all over the place, working in high pressure, high stakes environments where the work matters. So one of the reasons I enjoy spending time with you, and I’m excited to be on the podcast, is I have a passion for nonprofit leaders. And I understand that world really, really well.

Tucker:
That’s awesome. I love that, Dan. Well, and some other accolades, you’ve received something from President Obama, is that correct?

Dr. Dan Diamond:
Yeah, it was the Volunteer Service Award.

Tucker:
Yeah.

Sarah:
Nice.

Tucker:
So as we like to say at THRIVE IMPACT, high thrive, Dr. Dan, high thrive for-

Dr. Dan Diamond:
Thank you.

Tucker:
Yeah, that’s what we do. Well, today, we want to talk about, in some ways, thriving. It’s literally in our name. Dan, I know that this is a lot of your work too, is around how do you help organizations and leaders and teams to thrive. And particularly around a topic that has to do with well-being. It’s a word that gets, I would say, tossed around quite a bit, around people’s well-being. Some people don’t know whether we put a hyphen in between well and being, or we just have it as one word. That’s always a little fun thing that we always wrestle around with. But Sarah and Dan, both of you, I’m curious, from a well-being perspective, what are we really talking about when we’re talking about the well-being of our people, our employees, our team? From your perspective or from what you know from research and data, what are we really talking about when we say well-being?

Dr. Dan Diamond:
Sarah, you want to go first?

Sarah:
Oh, sure. It’s a great question, Tucker. I think many people are probably going to know the work of Dr. Martin Seligman, who really is, in many ways, the father of well-being. And came up with the first model, really one of the first models, to help people think about this piece. And he really developed PERMA, which is five core pieces, or building blocks, or antecedents, that are really important to support well-being. I think folks get tripped up on thinking, “Well-being is such a huge concept. It’s so multifaceted.” And it is. It’s not a single thing. It’s not happiness, for example. And so those building blocks are really positive emotions, engagement, positive relationships, meaning, and accomplishment. And, now, people have built on that from there. But I think that is the baseline of what we think of, or many people think of, when they think of what is well-being. Dr. Dan, what do you think? What is it to you?

Dr. Dan Diamond:
To me, it’s people coming to work and being able to bring their whole self, their enthusiasm, their joy, their energy. It’s a vibrance that people bring to the workplace. And in the nonprofit world, that’s really important. Because a lot of the nonprofit organizations that I’m working with are trying to get great work done with skinny resources. And so if your team is depleted, and they’re showing up, and they’re like, “Yeah, I’m just here for the paycheck,” that doesn’t work. You need people that are willing to come in with some enthusiasm, and lean into the work, and say, “Yeah, I’m here, man. I’m part of this. I can’t wait to be part of this. So how can I…”
As a family doc, I’m looking at it going, “How can people show up at work and be really fit emotionally, physically, spiritually, so that they’re able to make an impact?” So the energy goes out from them, and they’re not showing up and sucking the energy out of everybody else. I like Marty Seligman’s stuff. I think talking about positive emotions is important and engagement’s important. Relationships are important. Meaning at work is important in a sense of accomplishment. And our friend, Michelle McQuaid tacked the H on the end for health. When we start looking at those ingredients, it’s really what it takes to bring your people alive. And I say your people, but maybe it’s you too.

Tucker:
All of the people. Yeah, exactly.

Dr. Dan Diamond:
All of us.

Tucker:
It’s interesting to hear both of you from the perspectives, or some of the research that’s there, around PERMA plus H. Dan, thank you for bringing in the H. Positive emotion, engagement, relationships, meaning, accomplishment, and health. And, Dan, you were hitting on something that was, there’s this space of well-being that’s more of a looking at this from a whole human perspective. Yet, I do feel like, in our world and in our work… And we’ll talk a little bit about what we learned in a process that we did with this impact driven organization in healthcare. But there’s something about we’ve created many times these bifurcations, almost, of our professional life and our personal life. And I’m not saying that that’s right or wrong, it’s something I’ve noticed.
And I’m curious, what does well-being mean when it comes to the whole human? What does that mean? Does that mean we have to let people know about our personal lives now? Are there struggles here with what we’ve come from around our professional selves versus our other selves of us trying to figure out well-being? Does it feel like it’s getting too personal now with well-being? Do some people want to butt up against that because that’s not as professional? I don’t know. I’m curious to your thoughts and reflections on well-being when it comes to both personal and professional, or maybe this holistic view of humans.

Dr. Dan Diamond:
If I’m leading a team into one of these disaster zones, and I’m not saying all nonprofits are disaster zones, but when I’m-

Tucker:
Maybe about half. I don’t know, maybe a little more.

Dr. Dan Diamond:
When I’m working in a disaster zone, if I care about my team as people, it makes it so much better. And I’ve learned to just drop my guard at the beginning and say, “Hey, I’m going to make at least three major mistakes on this deployment. I’d appreciate it if you’d tell me before I blow my leg off, if you see me about to do something.” So instead of showing up with, “Well, I’m the team leader, I’m the director, and you need to do what I say, and I know everything.” I’d rather show up and say, “I’m going to make some mistakes. And let’s be real with each other. Let’s support each other.” I don’t expect people on my team to expose all their rawness.
And it’s interesting because when we get deployed, we meet at the airport. There’s a big roster and we’re randomly picked from the who can go. Because it’s like they hit the eject button and we got to go within 24 hours. So it’s, “Can I arrange coverage and all this stuff?” And then whoever meets at the airport, it’s, “Hi, I’m Dan.” That’s really how it starts. So I think it’s, as a leader, we have the opportunity to drop our guard and say, “I invite you into this conversation.” And it’s, I think, helpful to let people know that it’s a safe place to talk about stuff if they want to. But I’m not going to tie my team to a chair and say, “Tell me about your personal life. Have you ever been in a tough relationship? I need to know.” But I want to create a safe environment where, if they need to share, they can.

Tucker:
Yeah, that’s great, Dan. Love that perspective. Sarah, curious your reflections, and even lived experience, around this topic?

Sarah:
Yeah, I think the R in PERMA is relationships, and that’s about connecting with others, loving and being loved. And I think, Dr. Dan, this what you just talked about. Whether you’re at work or you’re at home, we are rarely somewhere… Some of us are somewhere just because we have to be, and I don’t want to downplay that. And even when that’s true, I think there’s a difference between being there because you have to and being there because you want to be. And relationships are an important part of that. All of the research suggests that.
And so I think in this intervention that we just finished, one of the things that we saw in the data coming out, and I know we’re going to speak to this in a minute, but it was the connecting with others that came out as the thing people like the most. And this is not unique to this intervention. Everything we do, every time we measure it, that’s what comes up for people. Because they find meaning in it, they find purpose in it, and they improve their relationships, which means positive emotions go up. I think that’s the thing about PERMA is they’re not separate blocks. They’re very interconnected. So when you’re improving relationships, you’re often also increasing positive emotions, which might help increase your engagement. All of those pieces fit together.

Tucker:
Yeah, that’s good.

Dr. Dan Diamond:
It almost feels like the R should be a little bit bigger-

Sarah:
I agree.

Dr. Dan Diamond:
… than the others. Seligman could have started it with the letter R, but it just would’ve been hard to pronounce.

Tucker:
It’d be REPMA, and that’s not great.

Sarah:
I was going to say, what is a [inaudible 00:11:26] for that?

Tucker:
REPMA, that’s a little strange. Well, I’m curious, if we talk about some of the pains or issues though, when it comes to well-being. You can listen to this podcast and you can hear a lot of the pains and issues around nonprofit leaders. Hence, what I mentioned as our mission, which is solving nonprofit leader burnout and some of the other things that we do. But I’m curious, just from y’all’s perspective, what are these pains or issues that these impact driven leaders are experiencing regarding well-being, understanding well-being, maybe even assessing of well-being? What are some of the things that you’re noticing are going on?

Sarah:
Wow.

Dr. Dan Diamond:
I think it depends on… Yeah, it depends on the leader. There’s some leaders that are like, “I don’t want to get into this work-life balance stuff.” Because, like I mentioned, this demands resources, balance. In the nonprofit world, oftentimes, the demands are really high and the resources are really skinny. We don’t have time to get into this well-being stuff. How do you do it and still have the time to do the mission that we’re on of our organization? But I would encourage people to think about, if we don’t take care of our people, they’re not going to stick around. And that gets to be really expensive. So the question of, is focusing on well-being worth it? What’s it cost to address it? I think the flip question of, what’s it cost if you don’t address well-being, is a potentially powerful one, especially in the nonprofit world.
So I think it’s something that we need to talk about, and we need to talk to the people on our team about. And have a game plan for how we’re going to measure it. And what we’re going to do, as an organization, to move that forward and make a difference so that people… When well-being is facilitated and tended like a garden in an organization, then people start getting connected at the heart. And then they’re really hard to recruit away from your organization when they say, “No, these are my people. I don’t care what you pay me, I’m not leaving. These are my people. I belong here.” So that’s the big question I’m asking is, how do we create that type of an environment in a nonprofit setting and still get the work done? Or so we can get the work done.

Sarah:
Right, yeah. Yeah, and I think you all mentioned PERMA and then H. Recently, there’s been an addition of three other elements, mindset, environment, and economic security. And this is called PERMA+4. And this is specific to the workplace well-being conversation. Because I think part of what folks found, as they were going out and doing research, is that there’s a really important systems level piece here that we can’t ignore. It’s not just about asking individuals to have better relationships or think positively. There are real environmental factors that are important. And economic security is literally about what you’re paid. So I think really important when we’re talking about well-being that there’s both individual and systemic factors.
And one meta review recently of workplace well-being studies found that, something like, there were 30 really well-done studies. And two of them were focused at the system level and the other 28 were at the individual level. And that’s because it’s easier to do. It’s easier to focus on individual well-being and harder to focus on system level well-being. But that doesn’t mean it’s not important. And this is where, in particular, I think the nonprofit conversation comes in. Because we know from some of our data that foundations aren’t supporting overhead in the way people need. And so it becomes this starvation cycle where, often, nonprofits don’t have enough funds, or aren’t putting funds aside to support this work at the system and at the individual level. And it becomes a real crisis.

Tucker:
Well, and to both of your points, I’m curious, Dan, you asked… I love the question of flipping the, what is the cost of not putting attention towards this? And really getting clear about that. What do you both see is the cost, as best as we can? I know there’s data out there, and we may have some ready in our heads or at our fingertips, or we may not have it all. But what is the cost of not putting attention towards this for these things?

Dr. Dan Diamond:
From a dollar’s perspective, it’s usually something like two and a half times their annual salary to recruit and train somebody new to come in. But I also think there’s a lack of productivity. I have worked with people in healthcare that have said out loud the following sentence, “I’m just here for the paycheck.” And I’m thinking, “Man.” It’s like, “Really?” Because we need you to lean in and help take care of these patients, and show up with a great attitude, and welcome people, and help them feel loved when they’re here. And you’re just here for the paycheck?
I think what we’re talking about is, how do you move people up to become invested in the work? And then, how do we get them to take ownership in the work? Which is not going to happen if they’re burned out. So well-being is, I think it’s crucial. Sometimes, it costs more to have people on the team that are burned out and there just for the paycheck, than it does if they’d quit and you’d to hire somebody new. So when you have to hire additional people because the people that are there are not doing the work that they need to do, it gets really expensive, really fast.

Sarah:
Yeah, there’s some data point that it says what a disengaged employee is. Like every $3,000 of $10,000 of their salary is basically wasted because of their disengagement.

Tucker:
Like you might as well just throw it in the trash.

Sarah:
Which I think is interesting. And, Dr. Dan, I know you have a bunch of data. Michelle McQuaid’s Wellbeing Lab produces a bunch of great research on some of these consequences of well-being at work. But some of them, we know, low turnover intentions. Dr. Dan’s just talked about that. Being proactive at work, both at the individual team and organization level. Being adaptive, reporting less stress from the job, more satisfaction. And then, this piece, which I think speaks to what you were just talking about, is better organizational citizens. We’re not just there to do what we have to do. We’re there to do what the organization needs us to do in support of the positive change we want to make. And so it’s really important. All of these factors are what we want to see in the folks coming in to work at our organizations.

Dr. Dan Diamond:
Yeah, you almost cut sick days in half.

Sarah:
It’s so crazy.

Dr. Dan Diamond:
It’s like, “Huh?”

Tucker:
Well, let’s pull in this data. Because I asked, of course, the pain question because, Dan, you asked it. And I love that question. And it’s helpful for anybody listening to be thinking, “Oh, what is the cost of me not doing something about well-being?” And being explicit about that, and really understanding the cost that this has for you and your organization. But what does the data… And I know this comes out of Michelle McQuaid’s work at the Wellbeing Lab of why well-being does matter. And some of the data that hits on it directly is, people are 6% more likely to feel engaged.

Dr. Dan Diamond:
Six times more likely.

Tucker:
Six times, sorry, not 6%. Six times more likely.

Dr. Dan Diamond:
Six times.

Tucker:
29% more likely to be more productive. 45% more likely to be satisfied in their jobs. 46% less likely to experience unhealthy days. 125% less likely to burn out, which leads to disengagement and leads to all those things that we just talked about. And 32% less likely to quit. Those are some pretty good stats.

Dr. Dan Diamond:
Yeah. 125% less likely to burn out. Healthcare has got a huge problem on burnout right now, and so does nonprofit organizations.

Tucker:
Well, and then, Dan hit on some of this data that she says. And by the way, we’ll put this in the show notes so you can see the link to these exact stats that come, again, from Michelle McQuaid. But there’s this whole bottom section, Dan, that speaks to workplaces that invest in employee well-being experience on average blank. Tell us, Dan, just hit on that for just a minute, what the data says?

Dr. Dan Diamond:
70% fewer safety incidents, which makes great sense to me. Because if you’re exhausted, and you’re not feeling good, and you’re walking around with your head down, you walk into stuff and get hurt. 41% less absenteeism, somewhere between 24% and 59% less turnover.

Tucker:
That’s a big one.

Dr. Dan Diamond:
That’s huge.

Tucker:
That’s a really expensive one that we just talked about.

Dr. Dan Diamond:
They’re three and a half times more likely to be seen as creative and innovative. And wow, when we get deployed, we’re all about improv. We’re trying to figure out, “Okay, the hospital is now a pile of rocks over there. What are we going to do to set up a field hospital? What’s that going to look like?” I need people that are going to be innovative and creative. And not ones that go, “Oh, now what are we going to do?” 10% higher consumer ratings or customer ratings. And this is an interesting one that I don’t know that this applies to the nonprofit world, but 10% higher over average shareholder returns.

Tucker:
Which does hit into… We’ve said this many times on the podcast, nonprofit is a tax status, not a business model. And that nonprofits need profit. It’s just that the profit doesn’t go to shareholders, it just goes back into the mission. So what I hear in this is that they’re essentially 10% more profitable, in a sense, a way of thinking about it. Which nonprofits need to be profitable. It just doesn’t go to shareholders. So it speaks directly to what nonprofits do need to be putting some attention towards. Well, so, Sarah, curious if you had any thoughts that you wanted to add in? Just hearing some of that data, you obviously knew a lot of that. And have seen a lot of this in your own data work because you are our data person at THRIVE IMPACT. And I’m so grateful for it. Anything else that you wanted to add in there, Sarah, in terms of what you’ve seen in your own work in your master’s degree right now or other places?

Sarah:
I think we’ve primarily covered it. The only point I’d make is that there are consequences or associations with well-being that are also personal and outside of the workplace. And fulfilling and satisfying social lives outside of the workplace is an antecedent of increased well-being. Performing better at school, achieving higher levels of academic success, these are things research has found, and studies have found, that can happen as a result of increasing personal well-being. Earning more income and generating more wealth across careers. So just to say that well-being is not just about the workplace. It’s really about each of us individually, and it has impacts and consequences in our personal life and in our professional life.

Tucker:
Yeah, that’s great. Thank you, Sarah, for bringing that in.

Dr. Dan Diamond:
Well, I’ve seen that… Before we move on, Tucker, I’ve seen seen that so many times in healthcare. If we have somebody on the team that’s not doing well, it impacts the entire team. There’s this ripple effect. And how I show up matters, how the other people on my team show up matters. If I’m having a bad day, have I created psychological safety with my team so that they can support me when I’m having a bad day? So it doesn’t ripple out as much, but they’re actually rippling into me. So I think there’s this…
We can look at well-being from the individual perspective, from the team perspective, and then from the organizational perspective. And we can go one step beyond and say, “What’s the well-being like of the people that we serve?” So if we’re looking at the people that we serve, if I’m not well, the impact that I can have on the well-being of the people I’m serving is decreased. There’s still some. If you have a broken leg, I can still put a cast on your leg and make you better. But it’s different than if I’m well and I’m taking care of you. You’ll feel that differently and it’ll be a different experience.

Tucker:
Yeah, just to wrap up this part, and what you were just sharing, Dan, there was a wonderful quote out of Dr. Daniel Friedland’s book. And we’ve referenced him a lot of times. Dan, I know that he was a dear friend of yours as well. He wrote Leading Well from Within: A Neuroscience and Mindfulness Based Framework for Conscious Leadership. And his research was very clearly showing… He said, “Burnout…” And if you think about the word burnout, think about that of not having well-being. I don’t know if that’s a fair exact comparison, but close enough for this purpose. “Burnout is not only debilitating for the leader, but the leader’s stress and reactivity can ripple through an organization, eroding the culture and significantly impacting employee engagement, impact and revenue growth.” So just hitting on that quote that comes out of Dr. Danny’s research that, yeah, a ripple effect is real. Not just from the leader, but anybody within the organization that ripple affects where we are, affects how others are. And that’s a really important point, so appreciate you bringing that in, Dan.
Briefly, I want to go over… We’ve been talking about this. We’ve been working with an organization of impact driven leaders in healthcare, and they work with kids primarily. And they wanted to bring us in to help support them on well-being, quite literally. They wanted to improve the well-being of their pediatricians, of their administrators, of their medical assistants, of all these people that are within the organization. And they wanted to create some space for us to be able to do that, and for them to not have the pressure of patients coming in all the time. And they carved out real space, which I want to applaud them for doing that. Because I think when they had done stuff like this before, it was on weekends and it was after hours and things like that. But I think just want to appreciate them for saying, “No, we need to put a line in the sand, and say, ‘This is important,’ to the point of, we’re not going to have patients come in and we’re going to make sure that we can help improve the well-being.”
So I wanted to speak very briefly, maybe in the next 10 minutes, to both the program model in terms of what we learned. And as well as what we learned from it, some of the things that we felt like, from our perspective, Dan, that we saw were effective. And then, Sarah, you really dug into the data, especially we did an end survey of what people were sharing. And also you dug into a little bit of the PERMA side as well. And we can all just share a little bit about what this program was and what we did.
And, particularly, I’m curious, as we share about it, what can a nonprofit leader or impact driven leader do? One, they could hire us to come and support them. But there’s also things that we did that they can do too. That while we are, of course, professionals in this work, a lot of the things that we did were actually just teaching people a rhythm that they can now do themselves. And so I want to make sure we hit on some of those pieces, especially for our listeners, for them to be thinking about, from a program model perspective. So, Dan, I’m curious, just at a high level, go over the program model briefly of what we went through with them, and then we’ll go from there.

Dr. Dan Diamond:
I’d like to start with what it was not. Because I think, all too often, programs like this, it’s the executive team going away for a weekend and talking about the strategy we’re going to put in place to deal with well-being. They come back and they say to the frontline people, “Hey, we had a great strategic retreat. We care about your wellness. Here’s what we’re going to do. We got these three main initiatives that we’re going to do. Who wants to be on the committee? Oh, and by the way, it’s a voluntary thing. You don’t get paid for it. And it’s actually not voluntary.” And the old guard that’s been working there for a while whispers to the young guard, “Don’t raise your hand. Don’t make eye contact. Because this goes away, just give them a couple of weeks and they’ll forget about it.” This was not that.
We intentionally invited the voices of the entire team into this experience. So it didn’t really make any difference if you were a doc, or a nurse, or a medical assistant, or the front office receptionist, or the administrator. Everybody was invited into the conversation where we started talking about how do we create a life-giving culture? What does that look like? So that was the foundation of what we started with was let’s create psychological safety. And we did some very specific things to do that. How do we connect people? How do we bring all the voices into this conversation so everybody owns it? So that was the foundation that we started with.

Tucker:
I love that. I think that this is a helpful perspective of good old-fashioned top-down leadership approaches to well-being that actually, probably go against well-being altogether. In fact, make it even worse.

Dr. Dan Diamond:
Yeah, no kidding.

Tucker:
Right, yeah. That’s great. So what did we do with them, Dan? We had a six-month program. It was once a month, we would meet with… There was two different clinics that were part of this. And everybody from within the clinics were part of it. And we would meet for them, I think we kicked it off with a… Was it a two-hour experience? And then we did 90 minute experiences once a month after that. And then we ended it with a celebration. So we really had seven experiences, all roughly 90 minutes in length, except for the first one.

Dr. Dan Diamond:
And we had a team of champions.

Tucker:
And we also had a team of champions, yeah, which we met with for 30 minutes on the off bi-weeks in a sense. So that way, we were doing that as a way of really getting a pulse check of, “What are you noticing? What are you seeing? What’s happening? Hey, here are some…” Actually, we were trying to co-create with the clinics themselves, and particularly with these champions, so that way we can get a sense of, “Hey, what’s resonating? What’s hitting? What’s not, actually, for that matter?”
So, for example, one of the times, I think this was about the third month in, we met with the champions. And we had done a couple of experiences that were what we call a rapid 5I. But what that really means is a real rapid brainstorming around specific areas around, how might we increase positive emotions? Because we used PERMA, we did a PERMA plus H assessment through Michelle McQuaid’s work at the Wellbeing Lab. We used that as an assessment to be able to help people get a sense of where they were when it came to these different factors, the PERMA factors. And what were the areas that they wanted to spend some time working towards? They specifically mentioned positive emotions was one of them. And I think health was one of the other ones. And so we did a rapid brainstorming time of helping to come up with very specific, very clear ideas for them to be able to try. And we tried to open up the space of what might be safe to try? What is something that is worthwhile to lean in and give it a go?

Dr. Dan Diamond:
Yeah, design sprints with a prototype.

Tucker:
Yeah, design sprints. Exactly, design sprints. So quick questions, quick ideas, first and best thoughts, with a prototype that… And by prototype, we mean people put down different steps, different thoughts, different ways of doing it. And then said, “Okay, now who might have the energy around doing it?” So we invited their own energy. And some people raise their hand, for sure, and were like, “Hey, let’s do this.” So that was one of the program factors was rapid design sprints in the room, with all the voices involved.

Dr. Dan Diamond:
And it wasn’t just the leaders that raised their hands. It was, on the org chart, some of the people were at the bottom of the org chart, and some of the people were at the top of the org chart, when we said, “Who wants to take the lead on this? Who wants to take the ownership?” So that was really cool. That was impressive.

Tucker:
Mm-hmm. Yeah, and inviting people’s energy like, “Hey, here are some options.” Or, “Here’s some of the things that we want to move forward on. Who has energy around that?” And, literally, when you invite people’s energy, people have energy towards what they get to create. We’ve said that many times. That comes from my friend Jon Berghoff, dear mentor of both of ours, and all of ours really on this call, of helping to increase these types of things. But then we worked with the champions to get a sense of, “Hey, would it be helpful for us to do another one of those? Or what if we went down into doing some deeper training?” And we slowed it down on the third one, I remember very clearly, to do some of the work that we do around conscious leadership, and teaching, and training of Dr. Daniel Friedland’s work. And helping people, going back to Sarah, what you said earlier around what the data said around what was most supportive, creating even bigger spaces for people to connect with one another, by also inviting them into some training around reactivity versus creativity and leadership.
And I remember we asked the question, and we love this question, which is, after we trained on some of the concepts, “Where is reactivity creating more harm than good in your life? And what is it costing you?” Almost like the question you were asking earlier, “What is it costing you to not focus on well-being?” We, in a sense, asked people the same question, but on an individual basis. “Where’s reactivity creating or causing more harm than good in your life? And what is it costing you? And what is it costing your family? And what is it costing your team? And what is it costing those you’re serving?”
And then the second question was one around, “A year from today, what do you want to be celebrating about your own personal transformation as a conscious leader in this particular area?” So that was one thing that we co-created with these champions. But I wanted to give those questions that really created… While the design sprints were really helpful, and I think people spoke to that in the data, the space to have more and deeper conversations around deeper questions. But, also, generative questions, was really meaningful for the staff people that were on these experiences.

Dr. Dan Diamond:
Yeah, one of the sessions that we did that I thought was… In our initial design, when we were planning this six month journey, we didn’t have it on the radar. But the champions, when we met with them, said, “Hey, it would really be helpful if we could have a session to talk about how might we as a clinic thrive during flu season?” Because flu season in a pediatric’s office, oof, it could be challenging. It could be a bit rough.
So, again, it was such a refreshing experience to watch them come together as a team. The org chart was set aside and we flattened the organization. They flattened the organization. And they created this opportunity for people to bring their voices in. And they came up with some very creative and practical ideas that I don’t think we could have come up with because we didn’t know the nuts and bolts of how their office works. So it’s a different feel than saying, “Hi, my name’s Dan Diamond. I wrote a book called Beyond Resilience: Trench-Tested Tools to Thrive Under Pressure. If you just read my book, you’ll be fine.” That really doesn’t work as well as saying, “What’s your biggest need? And how can we come together, and crowdsource, and co-create a meaningful strategy and create a prototype? Let’s try some stuff. Let’s experiment.”

Sarah:
Yeah. Well, and I think one of the interesting things for me, y’all did these great workshops, and then you met with the champions. But then people were left to bring this back. They were left to bring it back. And in some ways, we weren’t quite totally sure of the ideas they had co-created and what they had brought back. But in the survey, 85% of individuals noted that they had implemented the things that they had co-created in the workshops in their real life, which is a huge amount. To be honest, one of the things I was curious about is, does this intervention need more support at the ground level to make sure that things coming out of the workshop are really going into people’s lives? But for the most part, people took them and brought them in, which I think speaks to-

Tucker:
Wow. I didn’t even see that in there, Sarah. Wow.

Sarah:
Yeah, yeah. It’s amazing, honestly. People took it and they did it, which also says something about when it’s your own idea, but also when it’s easy enough to do, you can go ahead and do that. And I think some of the ideas, and y’all will know better than me, but literally adding small connecting questions to the morning huddle. Instead of just going right into patient care and what we need to do that day, saying, “How was your weekend? What did you do?” Which doesn’t sound like rocket science maybe, until you start doing it, and then you realize what it feels like.

Dr. Dan Diamond:
Yeah, but you know what doesn’t work is for me to show up as a consultant and say, “What you need to do is morning huddles.” And then everybody stands around, and they’re kicking their shoes, and they’re looking down, going, “This is stupid. These huddles are stupid. I got so much to work, why do I have to do these dumb huddles?” It was their idea that they came up with. They owned it, they implemented it. And it was fun to hear their comments. “I didn’t know that my doctors were actually people.” It’s like, “Wow, you guys are really connecting.” “Yeah, we connected. We talked about what’d you do on the weekend? How’d you…” And it just sounds like such simple stuff, but do you want to belong to an organization where our people feel loved? I guess that’s the big question. Can you say the word love on your podcast?

Tucker:
Well, yeah.

Sarah:
Now, it’s out there now.

Tucker:
Not the L word. Yeah, of course you can. Well, and that was the significant feedback that I felt like I heard right off the bat from the champions, even after the first experience. They kept saying, over and over again, “This place feels more human.” That was the sentiment that they kept hitting on. “I feel like I’m getting to know people more.” Going back to that capital R, relationships, in PERMA that we were talking about earlier. That’s the feedback we were getting from the champions themselves. Sarah, I’m curious, if you happen to notice if there was anything in the data? And I guess you were hitting on that, which is the number one factor involved. What was it, around the program… The number one thing that people said was the highest value was connecting with one another. Is that right?

Sarah:
There were two. One was sharing wins in progress, which I think speaks to that research from Brene Brown and a lot of other folks. That gets you out of scarcity when you reflect on your wins and your progress. And so that was the first. And then the second was connecting with colleagues. And so 74% of our survey respondents said that sharing wins in progress had a high value. And then another 18.5% said it had a medium value. So really the majority of people are saying, “This is really important to me.” And then connecting with colleagues was next, yeah.

Tucker:
Well, oh, thank you for bringing that in, Sarah, because that was another one of the factors that we did. We started to get into a rhythm, I think it was on the second month. We started the process of… Basically, it’s a rhythm that all of you who are listening can get into with your own teams, which is where, over the last month… And because we were doing monthly cadence, we did it based on the last month, but if you have a weekly check-in or whatever, you can do that on a weekly basis. Which was, “Where did you see any wins or progress around the particular PERMA surveys?” But we really were asking, “Around your own leadership and your own well-being, where have you seen a win or a progress in yourself?” And we also ask, “Where have you seen a win or a progress in your clinic?”
And inviting them to pause to reflect on the last month, we gave them probably a good solid minute to think about this. And then go in to share with each other in a small group in a breakout. We did all this on Zoom, by the way. And then make sure everybody gets a chance to share if they choose to. And then come back out and hear some of the share outs and some of the themes or the commonalities. And that was literally a staple of every single experience, from the second one all the way through the seventh one. And so we were trying to teach a rhythm.
And that’s, again, what all of you listeners can be doing. That is based on what Sarah was saying around some research that Brene Brown had. That when we reflect on our wins and our progress, even in small or big ways, it doesn’t matter. And we would say things like, “Hey, did anybody bring your measuring tape today?” No, nobody really did, because we’re not measuring whether or not your win is a good win or a bad win, or a big win or a small win. That’s not the point. The point is for you to reflect on where you’ve made a win or had some progress, and to let others celebrate you and what you believe is a progress for you. And, Sarah, I’m glad you’re bringing this data forward. Because that was one thing we really honed in on and wanted to make sure was a part of the rhythm. And it sounds like it was really supportive for people.

Dr. Dan Diamond:
I think one of the numbers that jumped out to me when we were looking at all the data at the end… Because we did PERMA at the beginning. We did PERMA at the three-month point. And then at the six-month point, we compare the data across. And PERMA gives us a lot of data. It looks at how people see themselves, how they see the team, how they see the organization. And it really gives us an opportunity to dig in and begin to understand what some of the issues are.
But there’s also a separate question that’s not directly part of PERMA, but it’s a separate question that made me go, “Oh, wow.” And that is, “Do you see yourself as being high thriving or low thriving right now?” And I’m not talking about this high thrive, I’m talking about the other high thrive. At the beginning, 62% said that they were high thriving. They would describe themselves as high thriving. Which is great, because the world average right now, according to Michelle McQuaid’s group, is 50%. So they were at 62%. But at the end of the six months, they went up to 86.7%. That’s a huge improvement in how they would describe themselves as far as thriving. That, now, they went from being low thriving to being high thriving. We had an increase of, I don’t know, 22 some percent. That was cool. That was a lot. That just brought joy to my heart.

Tucker:
Now, I wanted to say, are there any other specific program factors that we want to bring forward that would help a nonprofit leader or a leader of an impact driven organization be able to use? And then, after that, Sarah, I’d love to bring in some of the… This wasn’t all sunshine and rainbows, for sure. There were some people who were like, “Basically, I hated it.” And so I want to speak to that because an important… I want to have integrity into the data. We had did a good, solid survey at the very end, beyond PERMA, and that’s real. That’s what the data is. And I want to make sure we’re speaking to that because that was in there. But before we do that, Dan, are there any other program… Or, Sarah, even as you heard us, I know you weren’t in any of the workshops, but you definitely were a part of some of the design or overheard us thinking about it. Were there any other factors that would be really helpful for people to understand around ways that they can really help their team to improve in well-being?

Dr. Dan Diamond:
Yeah. I’ll just tell you that I’m an avid mountain bike rider. And I have learned the hard way that you go where you look. I’ve hit trees. I’ve launched myself off a cliff on my bike. And, fortunately, snagged into a tree that was sticking, or a little shrubbery, that was sticking out so didn’t go a couple of hundred feet down to the bottom. You go where you look. And so the questions that we ask are really important. If we’re just going to stay focused on what are we going to do about burnout? And one of the things that I’ve seen happen is, you do the Maslach Burnout Inventory, or some sort of an inventory, to figure out how badly your people are burned out. You get the results back. They want to know what the results are. And when you have to tell them that 60% of the people are burned out that work here, then everybody goes, “Oh my gosh, so toxic here.”
And then the burnout gets worse because, now, they’re thinking that they’re working in a toxic environment. They’re starting to look at where else they might want to do, or maybe they just want to become an Amazon truck driver. I don’t know. So I’m always asking myself, when I’m thinking about working with organizations, “What’s the better question?” And instead of saying, “What are we going to do about this burnout issue?” Actually, there is a better voice. “What are we going to do about burnout?” I’d rather ask, “How do we create a life-giving culture in our organization?” Because that’s a generative question that’ll make people’s eyebrows go up. And they’re like, “Oh, yeah, man, I want to be part of that.” “You want to be out on the burnout committee?” “No, we’re going to be on the thriving committee.” “Yeah? Do you have shirts? This is going to be fun.”
So I think the questions that we ask are important. And that’s something that you can do as a nonprofit leader right now, is to say, “What are the questions that I’m asking? And how do I ask questions about where we want to go?” It’s not that we ignore burnout. I have a passion for doing something about it. And I want to sit with people and say, “What is this burnout thing? What is it costing you? Why do you think it’s happening? Why is it important for us to solve this?” And then transition to, “So where do you want to go? A year from now, what do you want to be celebrating?” It’s not the lack of burnout. It’s a year from now, how do we have a vibrant, life-giving culture where we are all healthy and well, and leaning in and changing the world?

Tucker:
That’s great, Dan. Yeah, really great point. Don’t create a burnout committee, please.

Sarah:
Yeah, it isn’t the absence of, it’s the presence of something that we’re working towards. Yeah, interestingly, we had a workshop yesterday with a nonprofit we’re working with, and talked about the reframing power of questions. And one person said, “You know what? We have all been thinking about that we’re on a sinking ship. That we’ve been on a sinking ship and that we’re on a sinking ship.” And staying stuck in that mindset of, “I’m on a sinking ship,” causes the ship to sink, and sink faster.

Dr. Dan Diamond:
Yeah, it makes the people weigh more so the boat sinks faster.

Sarah:
Yes, instead of focusing on the sinking ship, let’s focus on the horizon or where we’re going. And so, we literally saw this happen yesterday. It’s so powerful when people shift that mindset.

Tucker:
Yeah, that’s good. Yeah, Dan, Sarah, thank you for bringing that in because that’s the whole predisposition to this work anyway. But there’s going to be some people who aren’t even going to like it. There’s going to be some people who are like… I think there was one sentiment that said, “Make this completely voluntary,” in the survey data. Now, I didn’t know if this was a mandatory thing that everybody had to be at, or if it was strongly recommended. That’s something that’s a curious question. But, Sarah, what was some of the data suggesting? And there was a lot of positive data, for sure, that this definitely helped people, that there were pieces. But this is not always for everybody.

Sarah:
No, no.

Tucker:
The reality is, some people are in different places. So tell me, Sarah, I’m curious, as you looked at the data from your perspective, and having not been in any of the workshops, I think it’s an interesting and advantageous position of, what is it really saying for those who are struggling maybe?

Sarah:
Yeah. The data essentially says that there were between 8% and 11% of folks, on any given question, that didn’t love it. That disagreed that the workshops were engaging. But that means about 90% thought they were. So we have 10% of folks, and it’s a relatively small sample size, that didn’t love this and didn’t get a ton of value out of it. But I think one of the things we saw though, looking across their responses, was that these were folks that may not have been in the best spot in general. And so we asked them about whether their organization supported… Generally, they felt like their organization cared about their well-being. And some of these folks said, “No.” And so I think these are folks who may be further down on that burnout scale, who struggled, potentially, to find the time and resources to make this happen and didn’t think it was worth it. And so, yes, some people, again, about 8% and 10%, didn’t love it. And maybe didn’t think it was worth their time or effort.
And then I think this piece around it being voluntary is really important. But 90% did. And one of my favorite qualitative pieces here was somebody wrote, “I think our team was already pretty high functioning, but I think this program would be even more helpful for larger clinics where people get lost in the shuffle.” And then somebody said, “I hope we can do this regularly because it was something I really enjoyed.” And then a few people wrote about totally other things, like staffing.
And this is where we get into those other four pieces of PERMA, the PERMA+4. Because we weren’t there to solve the staffing issue. We weren’t there to solve a pay issue. That wasn’t our job. But that still affects people. And if you’re somebody that’s particularly struggling, maybe with a pay issue or a job fit issue or something like that, this may not have helped improve those. It wouldn’t, because that wasn’t the intent. So I think we just have to be clear about what our goal was, which was overall improving individual wellbeing. And our PERMA results, at the individual level, showed that we did that. So, in general, I think the data’s positive, and there are a few folks who didn’t love it.

Tucker:
Mm-hmm. Yeah, thank you for bringing in that perspective. And I appreciate, Sarah, how much you strive to make sure that there is integrity to how we’re speaking to the data. And I have been learning a lot around how do we make sure. And be transparent around what is the data really saying? Let’s look at the data objectively. What is it saying? And that’s why I’m grateful for your voice in a lot of this work because you have that perspective and are able to bring that forward.
I’m also thinking about these people. There’s one angle that you could look at this and say, “Well, they were already disgruntled.” Or, “They were already frustrated.” But I’m also like, “I wonder what would be an approach, if I’m a nonprofit leader, or maybe I even did a survey like this and I did some well-being work, and then I realized that some people didn’t like it?” Just to throw out the idea, what would be a tactical way that a leader can approach somebody who may be the “naysayer”? Or maybe the cynic of this type of work, or may have gone through this work and were like, “That was dumb. I hate it.” How would you suggest, I’m curious, this is a little rapid fire curiosity, approaching people who might have been those people who filled out that survey that way?

Sarah:
Yeah. Well, I think one quick thing is this is just the importance of stay interviews, not exit interviews, but stay interviews, with folks across the board. This is an anonymous survey, so we’re never going to know who said that. And in many cases, folks aren’t going to be transparent in surveys that aren’t anonymous. But that only supports the real importance of stay, of annual or every six months stay conversations. Because unless you do that, you have no idea where folks are at, and what they need to remain in their seats. And so that is one thing I always recommend to folks. You’re going to learn so much through those conversations.

Dr. Dan Diamond:
I think there’s something that we could have done better. And that is, when we were early on starting this project, we could have done a better job enrolling, and next time, we will, in talking about why does this matter? And to acknowledge, some of you, your biggest concern is staffing. And staffing is directly related to what we’re going to do. Because if your staff isn’t connected, isn’t thriving, they’re not going to stay. So if you want to have more staff, and you want to have your staff stick around, lean in. We need you to be part of this. We didn’t set that up. So I think the people that show up that are like, “This stuff’s stupid. All I care about is I need staff and I don’t want to spend time. I don’t want to spend any effort on this. This is dumb. It’s not about well-being, it’s about staffing.” And we could have enrolled those people to say, “This is all about staffing.”

Tucker:
Yeah, that’s good.

Dr. Dan Diamond:
Lesson learned.

Tucker:
Yeah, I’m always learning as a facilitator, that’s for sure, yeah. And, also, too, I was thinking, how might we look at… I think about our list of behaviors that reinforce learning, and including all voices, and particularly those who might be dissenting voices. We actually did a podcast on this, quite a few months ago, around inviting the dissenting voices. And just making sure to invite those voices. And as somebody said that behind every cynic, or every critic, is an unrealized hope. And what might be underneath there, what might be underneath there? And exploring that. And looking at them from an appreciative lens, and an understanding that they’re a human with a need. And how might we understand what that need might be that’s not being met right now? So that’s what I was thinking about when I was asking the question too.
Well, hey, both of you, thank you for the time. I feel like this was a really rich conversation about well-being. It’s really important. It’s a big deal. And I’m glad we hit on some of the data around why well-being matters. I encourage all of you to think about what it’s costing you for not looking into this. We’ll put some things in the show notes for you to be able to click on and take a look at a little bit more about some of the data that Sarah shared, and Dan shared as well. But other than that, I just invite you all to keep on thriving. Find ways to thrive so that you can have impact. And really the impact that you’re setting out to have, and the impact that your community needs from you. That’s why thriving’s so important. So thanks everybody. Sarah, Dan, wonderful to be with you.

Dr. Dan Diamond:
High thrive, buddy.

Tucker:
Thanks for being on the show.

Sarah:
Good to be here.

Tucker:
High thrive.