Thursday Thoughts – Taking Time to Reflect… to Stop and Smell the Roses

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Without question, each of us is experiencing some level of disruption to our professional and personal lives as a result of COVID-19. The demands on safety net health care staff have only been magnified with the required rapid response to patient needs, new workflows, personnel changes, and updated policies coming from their organizations and from government officials alike. This non-stop reactivity to the volume and frequency of change pushes us to operate in “survival mode,” and unfortunately puts us at high risk of burning out.

Now is the time to practice finding moments where we can temporarily pause for reflection before hurrying on to the next thing. Consider usingRose, Thorn, and Bud,” a brief exercise that can be adapted for use as a reflection, where participants can share one response for each category, or as a brainstorming session guide, where team members generate as many ideas as possible under each category.

There are many templates and guides to leverage (for example, from Life Design Log, Mindful Schools, and the MITRE Innovation Toolkit), but here is a summary of the steps:

  1. Choose a topic (e.g. patient intake processes) or period of time (e.g. yesterday).
  2. Identify the “Roses,” or a positive aspect.
    What worked well? What was one success or achievement? What are you most proud of?
  3. Identify the “Thorns,” or a negative aspect.
    What did not work well? What pain points did you experience?
  4. Identify the “Buds,” or the new ideas, opportunities for improvement, or goals.
    What demonstrates potential for success? What else can we try? What are you looking forward to tomorrow?

This activity is useful in a variety of contexts: 1) individually, as a personal reflection exercise, 2) as an icebreaker activity in a team meeting (virtual or in-person), 3) in a daily care team huddle, to identify small tests of change to try for the day, or 4) for a long-term improvement project, to assess progress and determine course-corrections.

We hope this activity gives you and your colleagues a chance to acknowledge your wins, identify pathways for potential opportunities, and highlight the things that continue to bring us joy amid these uncertain times. What Roses, Thorns, and Buds would you like to share with IHQC? We’d love to hear from you!

Program Announcement: Making the Value Connection – Los Angeles

Request for Applications – 2020 MVC Cohort
The Making the Value Connection Program (MVC) was developed to support community health centers in preparing for changing payment methodologies. Led by IHQC and Capital Link, the program consists of direct coaching, workshops, roundtable meetings, tools, assessments, and other resources to guide participants in improving value and finding balance between quality and financial sustainability.

The MVC Program is free to safety net clinics based in Los Angeles County, thanks to the generous support of Cedars-Sinai.

Please download the MVC Program Overview and Application here for additional details on how to participate.

Please know that you – our alumni, sponsors, clinics, delivery systems, QI geeks, colleagues, and friends—are never far from our thoughts. However, we recognize that your email inboxes are probably at an all-time volume high right now.

Therefore, IHQC’s Thursday Thoughts will transition to a bi-monthly schedule – the 1st and 3rd Thursdays of each month. 

If we can be of any assistance, or if you’d like to share a story of your improvement work, a resource that you find helpful, or just a quick note, please reach out to us at

Teresa Hofer

Teresa Hofer, MPH, PMP, CHES®, is a Senior Program Manager at IHQC.

Teresa HoferThursday Thoughts – Taking Time to Reflect… to Stop and Smell the Roses