Starting from Within

Eskenazi Health focuses on self-care to improve patient care

Lisa Harris, M.D., CEO of Eskenazi Health


Health care workers understand how to be healthy. They know they should eat right, exercise regularly, get enough sleep and avoid harmful behaviors like smoking and excessive drinking. They understand they should take good care of themselves in order to be refreshed, rejuvenated and ready to take on the day.

Unfortunately, it can be difficult to cultivate a healthy lifestyle when you work in the health care field. The long hours and high stress can lead to poor eating habits and a lack of energy, ultimately resulting in weight gain and other related issues. In fact, a study published in the American Journal of Preventive Medicine in 2014 found that 32 percent of health care workers were obese.

Two years ago, Indianapolis-based Eskenazi Health decided to address the issue of staff health head-on. It partnered with the Center for Mind-Body Medicine to develop a self-care program for its employees, focused on nutrition, physical activity, mindfulness and stress reduction, to help them take better care of themselves and incorporate healthy activities into their daily lives. To date, more than 500 employees have completed the 80-hour training program and reported reduced stress, lower blood pressure, weight loss and other benefits.

“We have been very deliberate in investing in the health of our staff,” says CEO Lisa Harris, M.D. “We know we can’t truly care for our patients unless we are caring for ourselves.”


As one of the nation’s largest safety-net hospitals, Eskenazi Health’s Sidney & Lois Eskenazi Hospital serves a diverse population of patients and provides treatment and services to nearly 1 million outpatients each year. Staff at the busy hospital often experience stress and burnout. To combat this, the self-care program places a heavy emphasis on mindfulness.

“If we’re coming in at our best, having slept well, having eaten well, having gotten exercise, we’ll be better able to focus on the care we provide,” Harris says. “People at the top of their game are the ones who take care of themselves and live a healthy lifestyle.”

The focus on mindfulness isn’t limited to staff. When a patient is feeling anxious, a message is sent to all staff who have received the self-care training to see if anyone is available to help. The volunteer, who may work in a variety of departments, will sit at the bedside with the patient, leading him or her through breathing exercises and guided imagery meditation. Sometimes the staff member simply sits and listens while holding the patient’s hand.

“At Eskenazi Health, everyone is a caregiver,” Harris says. “It’s very powerful when one of our non-clinical staff can see the anxiety in a patient’s eyes and be the one to alleviate it. It sends the message that they are a caregiver and this is care.”

Ultimately, the self-care program helps ensure both patients and staff at Eskenazi Health receive much-needed care.

“As health care providers, we know we aren’t always the best at caring for ourselves. We know our nurses are going to give it their all, even at the expense of their own health,” Harris says. “We’ve made self-care an expectation of working here. We emphasize that we must take care of ourselves and that everything we do to advance patient care starts from within.”


The self-care program isn’t the only way Eskenazi Health is working to improve patient safety. The system recently completed the development and dissemination of a harm scorecard, which is posted on digital signs throughout the hospital. The scorecard prominently displays data related to harm events, hand hygiene and readmissions.

“It’s visible for all our patients, visitors and anyone who walks in the doors to see,” Harris says. “It helps hold our feet to the fire. At first we were worried about sharing it with the world, but we haven’t received any negative feedback.”

CNO/Executive Vice President of Patient Care Services Lee Ann Blue says the scorecard is just one part of the system’s commitment to transparency and engagement.

“If there is an issue, we disclose what we can as early as we can,” Blue says. “We’re very forthright when it comes to patient safety.”

Eskenazi Health has implemented a number of evidence-based best practices in recent years, including leadership rounding and daily bed and safety huddles. Its efforts are paying off: Between 2015 and 2016, the system experienced a 52 percent decrease in harm events.

“Safety is who we are and what we do,” Blue says.

Eskenazi Health also is an active participant in the Hospital Improvement Innovation Network (HIIN).

“The HIIN helps move us forward. We’re learning from IHA and other hospitals,” Harris says. “When IHA staff come visit and show excitement for what we have accomplished, it re-energizes our staff even more. We’re constantly learning and evolving.”

Blue agrees. She notes that no matter what issue the system is tackling, staff are engaged and involved.

“There is a different mindset here than at other health care organizations,” Blue says. “At Eskenazi Health, challenges create opportunities. Everyone comes together and wants to be on the same team. If we keep the focus on our patients, their loved ones, and quality and safety, the rest of it takes care of itself.”