What is a Sustainable Self-Care Initiative (SSCI)?

"We have a culture where it is not looked down upon to take time for self-care, so most employees practice self-care in some way."
- CFO, Health System, Senior Executive Wellness & Self-Care Study Participant

SSCI is an evidence-based strategic initiative, undertaken by a health system, to improve the health and wellbeing of the community and stakeholders it serves.  The SSCI can be adapted for any healthcare system committed to achieving a higher level of engagement and sustainability. With a SOHL SSCI, you can start at the size and pace that is right for your health system, such as with a certain population or group of patients.  No matter where you start, improving the health and wellbeing of your healthcare system’s community is a vast, essential, and transformative undertaking.


in its impact, because the number of employees, patients, and community members your system serves are likely to be in the hundreds of thousands.


because every health system needs to care for the whole person.  This means you not only treat an individuals’ illnesses but also help preserve their health and improve their wellbeing.


because applying a holistic perspective to your patients and communities will significantly and positively change not just your patients, their families, and communities, but also you and your family and your clinical and administrative teams and their families!

With the SSCI system, SOHL provides you with a customized, comprehensive evidence-based system for adopting and sustaining self-care practices.  We teach, coach, and provide web-based resources at the individual, group and organization-wide levels.  We use the 7 Sources of Health (7SOH) framework to teach evidence-based self-care skills as well as to support your health system’s strategic Sustainable Self-Care Initiative (SSCI).  We teach the 7SOH framework and implement the SSCI system using the 5-step model below.

A Sustainable Self-Care Initiative Involves:

Hover Over The Icons To Learn More


with patients to positively impact their health at a time and place when they are not actually receiving care, as well as when they are receiving care.


in evidence-based self-care practices using a proven model.


the entire community: health system leaders, staff, clinicians, patients, non-patient community members to make the SSCI sustainable and benefit all.


impact and benefits on a continuous basis, all while.


the health and wellbeing of all health system stakeholders.

Why does my health system need a SOHL SSCI?

Preserving health and optimizing wellbeing is an essential part of your health system’s future.

Enhance the Population Health of your community.

A SOHL SSCI optimizes the wellbeing of high-risk populations, limits rising risk populations, and preserves the existing health of low-risk populations.  The SSCI team works with your PopHealth team to build relationships with all stakeholders and community partners.  Depending on your PopHealth team’s current goals and capacity, we can optimize existing relationships and develop relationships with new partners using SOHL’s self-care skills building and technology.

We are aligning health with the healthcare system. We want to roll it out to a larger population but are starting with our healthcare system.

CEO, Healthcare System, Senior Executive Wellness & Self-Care Study Participant

Develop profitable, innovative Alternative Payment Models (APMs).

Practicing self-care skills decreases healthcare costs.  Using SSCI measures and assessments, you can negotiate value-based care and APMs for your health system. SSCIs can decrease LOS and cost of pain management and increase patient satisfaction scores, making the SSCI an essential component of a value-based bundling approach.  At the population level, the SSCI increases patient responsibility, engagement, and satisfaction, making the SSCI crucial to a successful global payment strategy.

Eliminate clinician burnout.

The research shows that approximately half of all clinicians suffer from burnout.  And, the cost to replace each physician because of burnout is about $1 million.  At the executive level, 50% of leaders last less than 18 months after a job change or promotion and the replacement cost for them is 213% of their salary.   A system-wide SSCI has been found to increase retention and decrease burnout.  Not only do patients benefit from more satisfied and engaged clinicians, your organization is likely to be more profitable and productive with a 40% reduction in turnover.

Extend the Patient Experience 360 degrees.

The best health systems are partnering with their customers constantly, not just when the customer is sick.  Your SSCI is a whole-person system that extends into every area of your customers’ functioning:

    • Motivation: Offers practices and strategies to address and validate life purpose
    • Wellness:  Optimizes and supports the body, mind, emotions, and creative self
    • Holistic:  Considers how individuals function within their community and environment

You want your customers to think of you as their favored healthcare provider. With the SOHL SSCI, they’ll also think of you as their trusted partner in living their best possible lives. This shift in perception to a whole-person model of care will lead to increased patient retention, satisfaction, and market share.



At SOHL, we are a full spectrum group of collaborative, expert professionals partnering with you:

  • Clinically, as physicians, nurses, psychologists, nutritionists
  • Administratively, as healthcare executives, human resources and communications professionals
  • Technologically, as system and instructional designers, EHR designers, and enterprise wide-application developers.
  • Supportively, as project managers, health and executive coaches

SOHL team members have been working together for decades bringing efficiencies and exemplary teamwork to stakeholders.  Every health system has unique needs.  We staff SCCIs to ensure both consistency in the evidence-based parameters of an initiative as well as for customization to meet your health system’s specific needs.


Our technology spans 3 essential areas:

  1. Learning process uses best practices such as self-efficacy, micro-learning in 2-3 minute bursts, and the CAMP™ method to optimize sustainability.
  2. Enterprise-wide applications make self-assessment and strategic measures available at the individual, team, department, and organization-wide level. 
  3. Strategic metric analysis incorporates continuous self-assessment, with individually customized practice suggestions for improvement.

You can't imagine the health of others if you don't practice (self-care) yourself.

CEO, Academic Medical Center, Senior Executive Wellness & Self-Care Study Participant

The Origins Of SOHL

SOHL roots began with a personal story.  In 2006, founder Ruthann Russo’s teenage daughter Emmalea was diagnosed with epilepsy.  After a year of unsuccessful treatments and uncontrolled seizures, Emmalea’s NYC-based Harvard-educated neurologist recommended evidence-based self-care practices, also known as integrative health or mind-body practices. Emmalea’s seizures stopped after she began practices such as yoga, meditation, hypnosis, and began eating a plant-based whole-foods anti-inflammatory diet. You can hear more about the experience and Ruthann’s evolution from startup health information tech-CEO to licensed integrative medicine practitioner by viewing Ruthann's recent TEDx.

SOHL Research

In their initial efforts to apply the benefits of self-care practices to health systems and their communities, Dr. Russo joined with colleagues to compile a review of the economic benefits of self-care practices.  Their pioneering work, which summarized the evidence for self-care practices as an adjunct to conventional care, attracted the attention of the Healthcare Financial Management Association (HFMA). Russo and her team's research on the ROI of self-care practices was subsequently published by HFMA in 2015.

SOHL learning and technology design is rooted in research and project work with Intel, NYU Langone Medical Center, Memorial Sloan Kettering Medical Center, The Bronx Lincoln Recovery Center, and Beth Israel Medical Center.  Key research was conducted at Intel and Saybrook University, home to the first-ever doctoral program in Mind-Body Medicine. Research on using self-care practices to manage common chronic conditions was published by the Journal of SM Community Medicine.

Evidence Based Success

Continuing to validate the whole-person model of self-care, Dr. Russo finalized the SSCI model through research she conducted with healthcare leaders. The Senior Healthcare Executive Wellness and Self-Care Study, further demonstrate impact through:

  • Sustainable Leadership:  Health leaders believe that their own self-care practices impact not just them and their families, but also their employees and patients. 
  • Profitability:  Hospitals lead by executives who rated their self-care higher and supported wellness as a system-wide strategy were more likely to be profitable.

Armed with this decade-long history of R&D and application of both the 7SOH framework and 5-Step SSCI model, SOHL is dedicated to helping you increase your market share and customer experience by transforming your health system from a sick to a wellness model of care. 

What is the evidence and ROI to support a SSCI?

Sustainable Self-Care Practices have been found to:

Create ROI and support for Value-Based Care and APMs:

The Cleveland Clinic found an average decrease in cost of $3,200 per patient for patients undergoing inpatient colon surgery when the patients participated in guided imagery training and practices pre and post-surgery.  System-wide savings could be as much as $8 million per year. 

Decrease healthcare costs (incentivizing Value-Based Care and APMs).

The Massachusetts General Hospital found an overall 43% decrease in healthcare costs for patients trained in evidence-based self-care skills.

Increase patient satisfaction and behavior change.

The Universities of Indiana and Michigan and Colorado Medical Center found increased patient satisfaction and decreased depression and anxiety when patients were trained in self-care lifestyle management practices.

“Our organization is getting smarter about self-care for the long term. Nothing happens overnight. It’s an investment in the team.”

Hospital CEO, Senior Executive Wellness & Self-Care Study Participant

Generate ROI for investments in employee health.

Johnson & Johnson long term impact study found a $1,100 per person annual savings in healthcare costs for employees who participated in the wellness and self-care program.  They also found an overall 48% reduction in healthcare costs for those same participants.

Improve the symptoms and cost of chronic disease.

The published review compiled by Russo and team identified 6 evidenced-based self-care practices [meditation, yoga, guided imagery, bio-feedback, qi gong, and acupressure] had been found to improve symptoms of the 8 most common chronic conditions [tobacco abuse, high blood pressure, obesity, inactivity, anxiety, depression, high blood sugar, and chronic pain].

Positively impact the profitability of the health system.

The Senior Healthcare Executive Wellness and Self-Care Research Study found that hospitals led by executives with higher self-care self-ratings were more likely to be profitable than those led by executives who rated their self-care on the lower end of the scale.

How are SSCIs related to Social Determinants of Health?

There is a positive relationship between the evidence-based self-care practices imbedded in a SSCI and social determinants of health. In fact, a SSCI addresses 40% or more of social determinants of health.


"In order to take care of the community, we have to take care of ourselves first."

COO, Health System, Senior Executive Wellness & Self-Care Study Participant

How do we implement an SSCI for our health system?

Research and experience show that the SOHL 5-part model supports the best outcomes for a SSCI for both the individual and the organization:


"We are trying to incentivize healthy behavior, but I believe it has to start with me at the top, modeling the right behavior."

  -CEO, Academic Medical Center, Senior Executive Wellness & Self-Care Study Participant

Begin with leaders.

Extensive research and SOHL experience show that involving leaders is key.  When leaders support and participate, the chances for success are improved more than 3-fold.  SOHL works with you and your executive team to identify the optimal self-care practice design for your culture, vision, and strategic plan.  We build out the SCCI implementation plan to include all stakeholders.

Use a proven framework:

The 7 Sources of Health [Life Purpose, Body, Mind, Emotions, Creativity, Community, and Environment] implemented using SOHL learning technologies [micro-learning, self-efficacy, and CAMP™ Method] produces sustainable learning, practice, and impact.

    • 7SOH framework is both prescriptive and flexible. 
    • SOHL provides you with a series of 150+ evidence-based practices. 
    • The library available to users in video, audio, and workbook/written formats, is a dynamic, continually growing and evolving resource. 
    • Customization is available. If your organization would like to create private-labeled training, these can safely be incorporated into the technology for your users. 


Use only evidence-based strategies and practices:

Every SOHL self-care practice is linked to a module that summarizes the evidence-base and latest science to support its efficacy. 

    • Evidence-based supports the impact or likely outcomes of the practice, such as decreased stress response, decreased feelings of anxiety or depression.
    • Science explains the mechanisms of action, such as promoting calm brain waves, increased brain size and/or neuroplasticity, improve immune function.

Learn and practice in community, live or virtual.

Practicing in community is essential to optimal and sustainable learning.  We will recommend the best implementation plan for your organization, which is likely to include a combination of both live and virtual training.  In addition, live training often works best when it is conducted out in the community. To facilitate this, SOHL can help forge partnerships with community-based groups to co-sponsor training. We use the group therapy/mind-body medicine evidence-based group coaching model for training in community.

Continuously assess and measure.

Every SSCI participant completes a web-based self-care self-assessment.  Based on an individual’s responses, the self-assessment generates a customized self-care training program for each participant.  Assessments are continuous and compared across teams, departments, the organization and patient populations.  Certain populations are more amenable to a simple, manual assessment, which we can accommodate.  These populations also tend to also be more responsive to live training.  In these cases, a train-the-trainer within the community approach is likely to be the most successful approach.

Who in my system will be involved in the SSCI?

Everyone in your community and your system will have the opportunity to optimize their health and wellbeing.