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Confronting clinician burnout calls for a two-pronged approach

By Carol Boston-FleischhauerAllyson Paiewonsky

October 27, 2022

    Clinician burnout is a longstanding workforce challenge that is directly linked to clinician turnover, and negatively impacts quality, safety, and consumer experience. Despite overall covid stabilization, rates of clinician burnout have continued to rise.

    For example, researchers from the American Medical Association, Mayo Clinic, and Stanford Medicine report that physician burnout spiked to a new height of 62.8% in 2021, up from 38.2% in 2020, while various surveys report current RN burnout ranging anywhere from 38% to 69%, depending upon the RN's age and clinical specialty.

    To confront clinician burnout, many organizations have prioritized solutions that focus on supporting the emotional health and well-being of individual clinicians. However, in today's employment climate, providing personal self-help and coping tools for clinicians will not be enough.  A two-pronged approach that also includes targeted strategies to address systemic work environment challenges is essential to dissipating this growing workforce challenge.

    1. Individual-directed interventions

    Exposure to trauma and other emotionally challenging situations is part of working in health care. Health system leaders must continue to implement and sustain a variety of individual-level support services to address workforce burnout.

    Organizations need to not only provide comprehensive emotional support resources, but intentionally create a culture that allows employees to feel encouraged and empowered to utilize all available resources.

    Sample strategies to bolster support for acute and ongoing emotional and mental health/wellness needs of individual clinicians include:

    • Informal and formal peer recognition programs
    • Dissemination of patient recognition/kudos
    • Meaningful celebratory discussions and events
    • Accessible counseling and employee assistance programs
    • Facilitated debriefing sessions
    • Uninterrupted and guaranteed breaks and meals
    • Financial counseling services

    2. Organization-directed interventions

    No matter how robust organizational resources are for supporting clinician wellbeing, clinicians will continue to struggle with burnout if systemic, structural barriers in their work environment remain unaddressed.

    The importance of organizational investment in work environment challenges cannot be overstated. Such investment communicates to clinicians that leadership is taking organizational responsibility for clinician burnout and that burnout is not just a personal matter for clinicians to try and individually cope with on their own.  The organization must own environmental drivers of burnout and be prepared to make deliberate investments on behalf of its workforce.

    As leaders, don't presume you know the systemic drivers of burnout. Direct care clinicians are the best sources to identify work environment barriers contributing to their burnout. The role of leadership is to provide safe forums for these conversations to occur and the resources to address confirmed barriers.

    Sample strategies to mitigate organizational drivers of burnout include:

    • Flexible scheduling options
    • Targeted process re-design
    • Elimination of non-value-added work
    • Relief from burdensome administrative tasks
    • Leveraging technology to expedite clinical decision making
    • Multiple two-way communication methods and venues
    • Shared decision-making at the operational level

    Insights to inform this two-pronged approach include the following:

    • Don't conflate your engagement strategy with your burnout strategy. Classic characteristics of a burned-out clinician include emotional exhaustion, depersonalization, cynicism, and a greatly diminished sense of personal accomplishment and value.  However, the term "burnout" is often used interchangeably with employee dissatisfaction and disengagement. Be clear that all three employment states are unique with distinct, although sometimes related, solutions.
    • Burnout in one clinician population impacts all clinician populations. Because all clinician roles function interdependently, a clinician burnout strategy is most comprehensive if the needs of all clinician roles are addressed, both licensed and non-licensed.
    • Identify and address unique drivers of burnout within clinician populations. Burnout can affect an entire clinician population—for example RN burnout could be addressed with broad strategies put in place that cut across the entire nursing enterprise. However, specialties within a clinician population may have unique drivers of burnout that must also be addressed. For example, the drivers of burnout among RNs working on medical units may be different than those of RNs working in the ICU.

    Clinician burnout represents one of many workforce priorities that C-suites are challenged to invest in at a time when the business climate is tighter than ever. However, failure to strategically invest in this two-pronged approach will predictably cost more over the long term. Scaled investments that include equal attention to personal self-support and systemic work environment issues will require leadership prioritization and ongoing oversight.

    Given the severity of clinician burnout, multi-year investments to achieve sustainable results will be needed. Determining how to prioritize investments that reflect the documented individual and environmental needs of clinicians as well as evidence-based practices that mitigate root causes is the most prudent course of action.

    For additional guidance on mitigating clinician burnout and restoring the strength of the U.S healthcare workforce, check out the National Academy of Medicine's recently released National Plan for Health Workforce Well-Being

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