Personal resilience: a gateway to organizational health and progress.

THE TOPIC OF resilience could not be more relevant in today's shifting healthcare environment. As both feature articles point out-and as I know from personal experience as chief operating officer of a multihospital system-healthcare organizations today are challenged as never before. As the US healthcare delivery system undergoes dramatic changes in models of care to help people attain and maintain a certain level of health, our success depends on providing high-quality, cost-efficient care while offering the greatest value possible to patients and payers.As noted in Spake and Thompson's feature article, resilience in this context is crucial to success at the individual, team, and organizational levels. The path to organizational resilience shares many qualities with that of personal resilience, and I, like Wicks and Buck, believe it must begin with the leaders.Follow the LeaderWicks and Buck's discussion of a self-care protocol for building personal resilience that centers on self-reflection resonated with me. As an executive working in a fastpaced, demanding, and complex environment, "months, maybe years," can pass without one's realizing it. In fact, I often feel like that. Thankfully, in my life and work, self-reflection has been a valuable tool in understanding myself, renewing my energy, and bringing clarity to both personal and organizational challenges. While both feature articles touched only briefly on physical fitness, I have also found exercise to be a powerful antidote to stress, one that goes hand in hand with self-reflection.Exercise as a Path to Personal ResilienceSeveral years ago, when I was a few years shy of 50,1 "leaned back" and recognized that a lack of attention to my physical and mental health was going to limit my ability to support the leadership of our organization. I was coming upon an age at which managing one's health is critical under the best of circumstances. But a decade of not paying attention during the early years of motherhood left me overweight, exhausted, and feeling out of balance.As a result of this newfound self-awareness, I seized the opportunity for change and embarked on a regimen of exercise and diet management. I found that, along with the bonus of weight loss, exercise was a stress management solution. In both my personal and work life, I have become more balanced and now approach my duties with more equanimity. My outcome is not surprising: The benefits of exercise on health and mood have been well documented, and a growing body of evidence indicates that physical activity can significantly reduce anxiety (Herring, O'Connor, and Dishman 2010). For me, exercise is that period of "alone time" mentioned by Wicks and Buck- a time to be self-reflective as well as to reflect on my organization's status. It gives me the ability to be resilient and cope with the challenges that come my way, whether at home or at work. Alone time helps me to be present not only with myself but also with my family; my management teams; and our patients, physicians, and employees.It Takes a TeamIt is vital for all healthcare leaders to demonstrate personal resilience and to translate that positive energy to directing their teams and staff in embracing ongoing, rich agendas toward achieving success, not just during periods of acute stress but every day as we strive to provide the highest-quality and most efficient care possible. But, as both articles highlight, the executive cannot transform an organization alone; she or he needs "healthy" (Wicks and Buck) and "sophisticated" (Spake and Thompson) teams able to manage the complex healthcare environment and "rebound after stressful or traumatic events" (Wicks and Buck). Resilient teams, of course, are composed of resilient individuals. Through research described in Resilience: The Science of Mastering Life's Greatest Challenges, Steven M. South wick, MD, and Dennis S. Charney, MD (2012), found that individuals react to high levels of stress with varying degrees of resilience. …