Creating a supportive culture: the power of small changes

In this editorial, two authors with longstanding expertise in anaesthesiologist well-being offer their response to the manuscript 'A quality improvement initiative to improve operating room well-being: The Microaffirmations in Perioperative Personnel Project (The MAPP Project)' by Kilgallon and colleagues as it pertains to creating a culture of support in anaesthesiology. We outline how team dynamics are at the heart of a highly functioning team and that both microaggressions and microaffirmations can have profound impact on that culture and unit cohesion. The MAPP project offers a unique approach to instilling intentional gratitude practices into a work environment and highlights how these small changes can lead to sustainable and impactful changes to the occupational milieu. Our only suggestion for improvement is the use of the Wellbeing Influencers Survey for Healthcare metric to better show impact for future investigations. Ultimately, the MAPP intervention is low cost and scalable, offering a potential solution to many anaesthetic locations looking to improve overall culture.