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Episode 4

Creating a Culture of Well-being

Episode Description

In this episode, Heather Farley, the Chief Wellness Officer at ChristianaCare, joins Renee at The Table. They discuss many aspects of wellness and well-being, including the importance of a true culture of safety – and why it has to be more than just improving resilience and avoiding burnout. Heather also shares her personal leadership journey to her current role as Chief Wellness Officer, concrete steps to changing culture to prioritize well-being, and her work on the 2022 Healthcare Workforce Rescue Package.

About Our Guest

Heather Farley, M.D., Chief Wellness Officer, ChristianaCare

Dr. Heather Farley, an emergency physician by training, is one of the nation’s foremost experts on healthcare worker well-being. Since March of 2019, Dr. Farley has served as ChristianaCare’s Chief Wellness Officer. Dr. Farley leads advocacy programs and interventions aimed at optimizing the caregiver experience and fostering an organizational culture of well-being. Her mission is to restore joy and meaning in work for health care providers across the nation.


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Renee DeSilva 0:06

Welcome back to The Academy Table. I’m Renee DeSilva, CEO of The Academy and your host. This week, I welcomed Dr. Heather Farley, Chief Wellness Officer at ChristianaCare to the table.

In recent years, many health systems have operationalized wellness and well-being. Having started in her role in March of 2019, Heather was among the first chief wellness officers in the country, reflective of ChristianaCare’s long-standing support and commitment to a culture of well-being and safety, and that’s exactly where we spent most of our time together. Here are a few of my takeaways from the conversation.

First, I loved Heather’s definition of well-being: meaning, connection, and joy. It has to be more than just the absence of burnout. It’s a wonderful operating principle that guides Heather’s work at ChristianaCare’s Center for WorkLife Well-being.

Next, Heather so perfectly details the importance of changing culture to prioritize well-being. We often think about well-being in the context of personal resilience and addressing needs of individual employees. In this conversation, Heather pushes us to foster a culture where caregivers and employees feel safe and are empowered to work together to support each other. She talks about some of the leading indicators of a culture of well-being: completing tasks in regular working hours, reducing stigma, and encouraging help-seeking behavior.

Lastly, Heather discussed her work on the healthcare workforce rescue package, designed as a set of tactical recommendations to support care teams today. My favorite suggestion: get rid of the stupid stuff in our work, remove the low-value tasks and focus on what matters. It certainly applies to caregivers, but also to any of us leading teams in healthcare and beyond. So with that, let’s head to the table.

Heather, so happy to have you at the table today. Welcome.

Heather Farley 2:21
Thank you. I’m happy to be here.

Renee DeSilva 2:23
So I’m fascinated by your career path and would love to just start by you giving us a sense of some of the early forces that shaped your career and interest in health care.

Heather Farley 2:34
Well, we’ll start off with a very interesting note. So I originally wanted to be a veterinarian since I was in kindergarten all the way through college. And then I determined that what I actually wanted was to take care of the animals and not actually do anything invasive to them, but this required a significant shift out of veterinary medicine and into human medicine where I could actually explain to my patients why they were in paid. Yeah, that’s how I ended up in medicine. And then really developed an interest in administration very early on, I knew from my first year as a resident that while I found treating patients one on one extremely meaningful, I definitely wanted to impact healthcare delivery on a broader level, which I think is one of the things that drives many of us who do this work, really cut my teeth administrative Lee with the development and the opening of our first freestanding emergency department in the state. That was a soup to nuts project with that the candidate in a cornfield took it from a cornfield with nothing there to this extraordinary facility that provides value to our community and our caregivers are proud to work at. And that experience helped me learn that what really excites me is identifying a need, creating a vision for the future, and then inspiring others who have the talent to execute on that vision. I think that’s carried me through into the well-being space too.

Renee DeSilva 4:03
That’s fantastic. Your current role at ChristianaCare is Chief Wellness Officer and that is not a role that we necessarily see in every health system. Although, I will say that I think you were probably an early leader, but folks are maybe starting to move in that direction. Take us through how you arrived at your current role.

Heather Farley 4:25
Renee, it actually started on a very personal note. So back almost 10 years ago, now, I had I took care of a patient to had an unexpected death after I discharged her from the emergency department. And that case threw me into a personal and professional tailspin. And at the time, it was a time of shame and blame and silence around when these sorts of adverse events happen. And so it wasn’t okay to talk about it with anyone So I did it. And it took me a long time to climb back from that cliff and a lot of hard work to rediscover why I went into medicine in the first place, and to rediscover that joy and connection and engagement. And what I’m doing that I started talking to a lot of my colleagues and I understood that I was not alone, that there were so many other clinicians who had had this experience. And that really drove me to create our care for the caregiver peer support program, back in 2015, because I really wanted what happened to me to never happen to any of my colleagues. And so in creating that program, I then realized it was an incredibly impactful program. And I realized there’s so much more that we need to do. And that led me to want to do this work on a system level, go back and get my Master’s in Health Care Science Delivery at from Dartmouth and simultaneously create our business plan for developing our Center for work-life well-being. And that led me into the chief wellness Officer role in 2019. And you’re right, Renee, it is a relatively new role in health systems. But it’s a growing role. And there is actually a network of Chief wellness officers that meet on a monthly basis. And I believe Becker’s just recently did an article of around how chief wellness officers are an emerging role in the C suite. So my role at ChristianaCare is to be to our Center for work-life well-being at the overall well-being strategy to ensure that we create an environment where each one of our 14,000 caregivers can thrive.

Renee DeSilva 6:40
Heather, I didn’t appreciate how you came to the work. Even when you retell the story now, many years later, you can sort of hear the passion that you have for the work. It sounds like it’s a little bit grounded out of— I think you frame it as the trauma animal second victims that care providers can sometimes experience when things like this happen. I can’t help but reflect on just the last now almost three years of how much the caregivers have had to absorb in all the challenges and death associated with COVID. In other words, you’ve been at it for 10 years, but it feels like probably never a more needed competency and space to create in health systems.

Heather Farley 7:24
That’s absolutely right. I think that’s one of the silver linings of the pandemic has been that we’ve shone a light on the importance of investing in the well-being of our caregivers. And it makes hope it inspiring to see that more systems are creating programs like what we’ve created at ChristianaCare.

Renee DeSilva 7:44
And so let’s unpack that a bit, maybe just starting with some nomenclature. How do you define well-being?

Heather Farley 7:51
I’d start by saying that thinking about this, like what health is, it’s not just the absence of disease. Similarly, well-being or joy in work is not just the absence of burnout. We talk a lot about burnout, but we shouldn’t just be trying to minimize burnout, we actually should be trying to get to a place where our caregivers are experiencing joy in work. And that that word joy can be tricky, right? It’s very nuanced. And I think it’s experienced differently by different caregivers that can meet flourishing, thriving for from a work well-being perspective, it could mean experiencing a sense of professional fulfillment, feeling like what you do is meaningful and that you make a difference in others’ lives. And that that’s why ChristianaCare and our Center for WorkLife Wellbeing we talk about meaning connection and joy when we discuss well-being.

Renee DeSilva 8:43
Meaning, connection, and joy. That’s powerful. And I guess then if you think about and I love your reframe, it’s about joy and work versus just reducing or eliminating burnout. All of that through the lens of we know that one in five healthcare workers have quit their jobs altogether. self-reported levels of burnout are somewhere hovering around 50%. We know all of that has been exacerbated across the last three years. Maybe talk a little bit around how you’ve seen, maybe just for ChristianaCare, the journey unfold. So what were some of the early things that you all put into place to really start to think through shoring up this sort of “returning joy to work” culture?

Heather Farley 9:26
So I think at ChristianaCare, we were incredibly fortunate because we had this robust well-being infrastructure in place. And I know that so many other health systems, we all struggled, but so many other health systems struggled because they had not made that investment yet and trying to stand that up at the middle of a pandemic was was really challenging. You mentioned the numbers around turnover, particularly in light of the last two years and those of us have been doing this work for a while or not surprised. But we’ve been sounding that alarm long before the pandemic hit. We knew that the rates of physical psychological and moral distress that our caregivers were facing before COVID Were already unsustainable. And the toll that COVID has taken on our workforce has truly been devastating. And for many, a prolonged pandemic was the last straw in terms of their willingness and ability to continue to work under such challenging conditions. I think many had an existential crisis of sorts, I think even outside of healthcare, you’ve heard of the great resignation. And for sure, health care is not immune. But as I mentioned, I think there’s a silver lining here that now we get it, that the well-being and experience of our workforce is finally getting the attention it has long deserved by not only health system leadership, but I think also the government and regulatory entities and the general public. So I am hopeful that hopeful that we will finally be able to make the meaningful changes at those multiple levels that will be required to truly make a difference and to reinvigorate this beleaguered workforce.

Renee DeSilva 11:09
And when you think about your role as chief wellness officer, maybe unpack for our listeners that platform and how you think about maybe orchestrating the strategy around it, recognizing that you are but one person, so you also probably have to have local activation, a lot needs to probably rest with managers to talk about just the importance of having an operational leader for well-being and then maybe how you’ve thought about the role that you play in setting organizational strategy around this important topic?

Heather Farley 11:39
Yeah, that’s a great question. So I think there’s an analogy to the quality and safety movement here. So that used to be quality and safety used to be something that chairs kind of did on the side, or hey, and now we have multiple full-time roles in most organizations to lead the quality of safety effort. And the well-being field is similarly exploding and is sort of at that inflection point, and really requires and deserves someone dedicated to this work, someone who can interface with others in the field outside of your organization to keep abreast of best practices, but then also collaborate with other executive leaders within the health system to develop and execute on the workforce well-being strategy. If we don’t do that, and people are doing this on the side, what we end up with is sort of flavor of the month of wellness. And unfortunately, I think a disproportionate emphasis on initiatives around personal resilience, like I’m all for meditation and mindfulness and, you know, sleep hygiene. But the more impactful efforts from a system level, are focused on actually changing the environment in which our caregivers work. And that really does require someone whose sole focus is attending to this and serving on that system-level role.

Renee DeSilva 12:56
Yeah, I think that’s a really that I hear that a ton in the conversation that we had with our members around the importance of not just expecting the person to adjust to the environment and just be tougher or be able to handle more, but really beginning to the undergirding of the cultural tenants of the organization, which I know ChristianaCare has historically been very strong there. But maybe talk a little bit around, if you were advising someone on how to create a framework that’s anchored on an organizational culture of well-being, what constitutes that type of culture and where do people begin on the journey?

Heather Farley 13:32
So I’m going to take that I think in two pieces, but you spoke about a culture of well-being, so really, what does that mean? In my opinion, this culture of well-being, it’s really the most important and impactful area for organizations to focus on. So, a health system that has a culture of well-being creates an environment in which its caregivers feel safe. It also means that caregivers feel connected with one another, there’s a sense of camaraderie and teamwork, working together towards a common goal that’s larger than oneself. It’s also a place where equity and inclusion are at the forefront. And where caregivers feel like what they do, the time that they put in, is meaningful. They have a sense of purpose. And I think finally, it’s also a place where caregivers are empowered, where they feel like they have a voice and where they have a sense of choice and autonomy. And so how do you create that I think I’ll share with you a little bit about how we’ve created that at ChristianaCare and our Center for WorkLife Well-Being and the operational framework that enables us to do this work. So I’ll touch on that just very briefly. So our mission in the center going back to your first question to hate is to foster work-life meaning connection and joy. So to deliver on that mission, our operational framework defines what we do How we do it and who we do it with. In terms of what we do, we focus on bolstering three main contributors to work-life well-being there is that component of personal well-being, but then there’s a huge emphasis on culture of well-being. And also, finally, efficiency of work. It can’t be emphasized enough, that we’re not just focused on trying to make our workforce more resilient. You can’t take the canary, teach it to be more resilient, shove it back in the same coal mine, and expect it to survive. We actually have to change that coal mine.

Renee DeSilva 15:37
I love that.

Heather Farley 15:39
Yeah, that’s kind of how we focus on that. And we also focus on those three components by employing three levers. This is the how of our framework. So we do provide direct well-being services, like peer support after the adverse event that I experienced or mental health services. But the second level at lever, I think, is really important. And that’s empowered action. So many of our caregivers, after they’ve received some of these well-being services, are really excited to positively impact their teams and to help create that culture of well-being. And so they can serve as peer supporters or resident well-being champion, or well-being ambassador, for example. And then that third lever of how we do what we do is advocacy. So that’s on the local, state and national level. So for example, at the local level, we have a gender equity Task Force. On the state level, we’re working on revising the medical licensing language so that it decreases the barriers to help-seeking behavior for clinicians. And then nationally, working on efforts like the rescue package that I think we’ll talk about, and with the National Academy of Medicine.

Renee DeSilva 16:46
Yeah. Let’s put the advocacy aside for a second, but I do want to go there. Before we go there, I want to stay a little bit around the ways in which you invest in this framework.

The notion of psychological safety is such an interesting one. And I have been reading Amy Edmondson, I think it’s her most recent book on the fearless organization that really starts to unpack this. But what resonates with me about what you said is this, this way of creating the right organizational environment where people feel like they can share the things that are hard that they can note when they are having challenges. And what I would love for you to come in on would be, so you have to orchestrate that at your level. But the premise of a lot of Amy’s work is that psychological safety is also built at the local level. So what are the ways that you ensure that the top line strategies that you’re developing that are aiming to really go at this get reinforced by you know, you said, 13,000 caregivers, maybe more than that, like how do you make sure that that there’s a top-down and a bottoms-up? I’m curious about the bottoms-up things that you’ve seen work given how local some of these things can be experienced.

Heather Farley 17:55
That’s a fantastic question. I think you’re spot on there. It does have to be led and modeled from the top down, but then actually brought to life locally. And so I think one of the most powerful tools that we use is our continuous improvement methodology here, and it’s called Making tomorrow happen in our organization. And it’s designed to empower our frontline caregivers to identify and solve problems. And those can be all sorts of prop of problems. But one of the underlying tenets of making tomorrow happen is that psychological safety, peace and that humble inquiry. And so it’s really baked into everything we do, and in our deal in our day-to-day work. And I think so there’s a component of there’s that expectation that local level leaders and Frontline caregivers are working together in that psychologically safe environment to identify and solve problems together. And I think another component of this is measurement. So what are you holding yourself accountable to? And as we know, strong organizations just don’t implement programs, we measure how effective they are. And we measure what matters. So I think there’s another corollary back to the quality and safety movement here. So think about back in the day, when we first began after two eras human report came out, what were we measuring, then we were looking at sort of lagging indicators of more like mortality. And it took us a long time to figure out what the appropriate leading indicators to measure. We’re now we’re all over CLABSI and Kotti. But similarly, what are those leading indicators around psychological safety and well-being that we shouldn’t be paying attention to as an organization so that it really can be that bottom-up approach. And so what we’ve started doing at ChristianaCare is assessing measures of that culture of well-being and holding and helping frontline leaders to actually operationalize that on the local level. So we’re looking at and asking about things like frontline caregivers’ perceived workload demands versus the resources, they have to carry out those demands. Were asking about work-life integration measures, I was able to complete my assigned work during my regularly scheduled work hours, on most days, for example, we’re measuring things like stigma and help-seeking behavior. So with what are the barriers to help-seeking behavior, and a sense of recognition, from leadership for work that our caregivers are doing, and their sense of feeling that they have sufficient professional development opportunities. So I think it’s that measurement component as well as the operational framework that you use to do this work that creates both that top-down and bottom-up approach that you mentioned.

Renee DeSilva 20:49
That’s so powerful. I’d love one of the sentiments that really landed with me from the workaround psychological safety is this, this notion that we all owe our colleagues the expression of our idea, right, like those ideas are what can really add to the collective enterprise. But in order to to get people comfortable with not ordering them or being uncomfortable with raising them, you’ve got to create an environment where that can come through. The way that you’ve connected all the various dots on this is incredibly impressive, and not easy to orchestrate over a multiple state health system with a really broad footprint. So just it’s really exciting to see what you’ll have done here. We have a lot to learn as an industry on this friend. I want to just tie in one piece related to this conversation to get your view on it, which is I did a recent podcast episode with Dr. Tom Lee, who’s the Chief Medical Officer at Press Ganey. And he was sharing just some of the data and insights that they’ve captured on all of this, or parts of this, but the lens of women, physician leaders in particular. And so I wonder if you have any thoughts on you know, I think of equity and inclusion as a lens by which we do all things. And so I wonder, as you’re doing this work, do you ever think about how this needs to be curated differently based upon gender or even ethnic diversity, I just would love to hear your thoughts on the well-being worth the lens of D and I.

Heather Farley 22:18
It’s so important, Renee and we often say there is no wellness, there is no well-being without D and I and I think the interview that you had with Dr. Lee, and the article that Doctors Dudley and Lee wrote in HBR, I think highlights how important this lens is. So really seeing that higher rates of depression and burnout and lower rates of perfect professional fulfillment in women physicians, is startling. And we know that there are similar discrepancies from a racial and ethnic perspective as well. And so you know, how can we look at this differently so that we can, they’re there, as we’re doing well-being worked, there are things that apply, I think, across the board, because we’re human beings. And so you know, things like creating connection and camaraderie and autonomy, you know, are all of those pieces of culture of well-being that we talked about, I think are important. But then there’s also, it is important for us to step back and understand who is having a unique experience and what we need to create or change to in our approaches, so that we can reach that population most effectively, and make sure that they are having the same opportunity to enjoy joy at work as their colleagues. So and I think that doctors Dudley and Lee were spot on with their recommendations, particularly around women physicians, but I think you can think about this more broadly too. So we need to get really creative and improve our flexibility. Clinical schedules working remotely job sharing are kind of no-brainers. I thought what was really interesting in that article was that you would think that equitable compensation also seemed like a no-brainer. Yeah, it’s so much more complex, and we’re learning we may actually need to develop new payment models that account for the greater time that women physicians might spend with their female patients or patients with multiple comorbidities. So it is really complex to unpack that. But I think looking at it from a DI perspective is a key lens that we need to use when we’re implementing strategies around well-being.

Renee DeSilva 24:32
Yeah, even your earlier comment around some of the leading indicators of well-being around workload measures in terms of new intensity of work, can I get my work done and sort of my normally a lot of time, it sort of struck me too, because a big part of that article, which I don’t think I fully appreciated was a big driver of this is often that there is more time spent and documentation, you know, evidence-based documentation for women physicians is higher than for their male counterparts. And so there are things that are just in terms of how the work is getting done that contributes to it. I think it’s to just double click on that it’s a really powerful takeaway for all of us. And not just people who are delivering care, but just you know, sort of broadly across the organization. So that landed with me. All right, I want to switch us to the advocacy work. So at the beginning of February, you partnered with a number of other health institutions—AHA and AMA were among them—to develop the Healthcare Workforce Rescue Package. Can you walk us through what that was and some of the key recommendations there?

Heather Farley 25:28
Absolutely. So you’re right, back in the fall. It actually started with as a conversation, sort of a complaining conversation on the phone with a colleague of mine, Dr. Tina Shah, she and I were talking on a Saturday evening about how our work was going. And we’re very frustrated that there was lot of well-intentioned advice and strategy out there, how to help this workforce in crisis. But our leaders, we felt we’re getting bombarded with too many different messages from too many sources. There’s great long-term solutions out there. But what’s needed right now is a succinct tactical, urgent list of actionable strategies that any health system can and should take in the short term, that the hat spurred us to kind of call our friends on and to convene, as you said, diverse group of some prominent healthcare key stakeholders, including leadership from the National Academy of Medicine, the AHA, the IHI, the AMA, and the American Organization for Nursing Leadership, CEO Coalition, the Lorna Breen Foundation and the CHARM Chief Wellness Officer Network. And so we created this 2022 Healthcare Workforce Rescue Package, and it is a list of the top five actions that health system should take in the next three months to rescue our caregivers. And it really is that unified, succinct guidance that health system leaders can use right now.

Renee DeSilva 26:52
So I think the audience is probably going to wonder what are the five actions, and I have them in front of me, but you run through them and I have a follow-up question. Maybe you don’t want to go through all five, but if you think through what are the ones that you feel like are the ones that landed the most or have the biggest opportunities that inflect the environment?

Heather Farley 27:13
Yeah, I think there are three that rise to the top for me. Number one on our list is ‘these are non-normal times, adjust expectations.’ This was really the beginning of the conversation that Tina and I had was, ‘Oh my gosh, we keep functioning and talking to people like these are normal times when the house is on fire!’ These are not normal times and we cannot expect people to function in the same way with such high demands and lower resources. So how do we reduce those demands and increase resources for our caregivers and get that balance closer to where it needs to be? And that means giving clinicians more flexibility and autonomy. Maybe it’s getting creative around partnering with legal, compliance, IT, to identify, for example, documentation that could be paused or eliminated and sort of getting rid of some of the ‘stupid stuff,’ is our number two there so that our clinicians can focus on that critical task of patient care.

Renee DeSilva 28:20
I love that, the get rid of the stupid stuff is a great takeaway because there are probably things that we all unintentionally do as leaders that create this dynamic for our teams that we can be much more deliberate around. So that’s fantastic. Where do you hope to see this sort of body of work continue to go? Are you hoping that it ends up sort of informing policy decisions that are made? What does success look like for you in this rollout? Or recommendations.

Heather Farley 28:48
Yeah, we’ve already seeing the rescue package amplified on many different platforms. And we’re hoping to really, this is a resource for health systems and an opportunity for frontline caregivers who happen to see this to use it for advocacy within their systems, too. So we’re going to continue that amplification efforts. But we also created on the all-in website where this is housed, we created an opportunity for organizations to endorse the package and then we’re hoping to also create a mechanism for health systems to pledge that they will actually implement some of these strategies and create a forum where the interested to health systems and leaders can learn from one another, and how to implement some of these best practices in each of these five areas. I think one of the pieces we’d love to see move is around mental health and the fifth, the number five on our list is EAP or employee assistance programs is not enough like a lot of health systems just like say, Oh, we’ve got EAP We’ve checked the box, but EAP is really not enough. We need to do more and So we’re urging implementation of this, what we’re calling the foundational three. So providing quality mental health services with from mental health providers who have cultural competence around what it’s like to actually be a caregiver, and to work to reduce the barriers to help-seeking. The second piece of that is standing up a peer support program. And that was an incredibly effective support strategy for our own organization over the years. But especially during the pandemic, we saw just a tremendous uptick in the utilization of that program. And then finally, offering psychological first aid training for people leaders, it doesn’t mean making your leaders, counselors or therapists, but it means giving them the tools to recognize distress and their teams to respond effectively and get them connected with effective resources.

Renee DeSilva 30:51
So powerful, also probably feels like it gives folks the agency and set of tools, so they maybe feel less helpless in the moment when these things are sort of naturally unfolding around them. Exactly. So maybe two final questions in our remaining time together. You spend so much of your time supporting your fellow providers and their well-being my dad used to say like if you looked at the cobblers shoes often needed to be repaired the most because they were spending so much time helping others that they like didn’t necessarily, it was sometimes it was hard to take care of themselves. And so I wonder, how do you kind of keep your own well-being front and center in this work? What works for you in terms of unplugging from the work? Because I imagine a lot crosses your desk, right? In some ways you are seeing the best of these things coming together. But also when these things feel really hard. So what advice might you give? Or how do you approach this sort of unplugging and keeping yourself at the center and grounded through this work? That’s very much heart work, as well as head work.

Heather Farley 31:55
Renee, I feel like you just called me out.

Renee DeSilva 31:58
I didn’t mean to!

Heather Farley 31:59
Yeah, I know, traditionally, or are historically I should say I was probably one of the worst offenders here I was, you know, very much as many of us I think are in, in healthcare and leadership, just very knows those down getting it done. And interestingly, when I became when I started doing this work and became chief wellness officer, I was, I had a moment of oh my gosh, I can’t approach it like this anymore. I have to figure out how to be effective, and take care of myself, because what happens if your chief wellness officer isn’t doing so well, right? So I had to figure that out. And it’s a message that in a conversation that we have in our team as well because we can’t have our Center for workplace well-being team all of our doubt. So for me though, personally, I am incredibly calendar-driven. So then the solution for me it was putting myself on my own calendar. So putting date night with my husband, or you know, my workout or coffee with a friend that’s on my calendar. And I protect that just as fiercely as I do, you know, any other important meeting so that is what has been super helpful to me, I also pay attention to how I spend my time so that how have allocated my time in each area of my life is aligned as best as possible with my personal values. So you know, physical fitness, my personal relationships and spending time in nature are super important to me. And I get very cranky when I’m not like that’s not true. If I can even combine those three that’s like the Holy Grail if I can go on a hiking trip or scuba diving somewhere. I’ve never been with my favorite people in the world and put that on my calendar, so I make sure it happens. That’s how I stay sane.

Renee DeSilva 33:46
Yes, I think that’s really well said constant calibration. I think we’re all somewhere in that journey. And important to just keep reminding ourselves that we’ve got to fill our own cups first. So I have one final question for you. It’s sort of as connected to that last one, which is so much of where I think all of us draw energy and to sort of get so much out of is just being in conversation with people that motivate us or delight us or you know, we just really get energy from in that conversation. So I wonder ask all my guests this and you can take any creative license that you want. But if you could invite two people for a conversation at a table that you curate, who would they be and why?

Heather Farley 34:27
I am going to take so creative license with that. It was someone who I’ve never met it is actually three people who are the original founders of the Best Friends Animal Shelter, and it’s the largest no-kill shelter in the country and such faith Aloni Michael mountain and Francis Battista, I hope to one day meet them and to tour the facility there but bringing this all full circle. My plan in my retirement is to open an animal shelter so and get back to those early aspirations of being a vet.

Renee DeSilva 34:59
That’s all And then hire a vet to do the hard stuff and you can just stay Gamble’s and all the fun stuff. Exactly. I think that’s great. Well, Heather, it’s always a delight catching up with you. I appreciate you joining us at the table today.

Heather Farley 35:11
Thank you so much, Renee. My pleasure.

Renee DeSilva 35:14
Thanks again for joining me at the table. The Table is a podcast produced by the Health Management Academy. Make sure you catch future episodes by visiting our website,, or by subscribing on the podcast platform of your choice, and if you have suggestions for topics or guests, I’d love to hear from you. Please drop me a note at I look forward to talking with you soon.