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December 14, 2018

Your questions: What to do about nurse burnout and tightening margins

Daily Briefing

    Every week, more than 400 hospital and health system leaders submit their questions to our Expert Center. Do you have questions of your own about hospital best practices? Send them to us at, and we'll provide a customized, actionable response.

    "I've noticed high stress among nurses in our hospital and I'm worried it might lead to burnout. What can we do to combat this stress and reduce nurse burnout?

    -CNO and VP of Operations at a Midwest Hospital

    Your hospital is certainly not alone in facing this problem. Nearly three out of four nurses report concerns about stress and overwork—and 70% report feeling burned out. To understand why, our experts conducted extensive research with nurses and nurse leaders around the country.

    They discovered that many nurses felt burnt out because their basic needs weren't being met. In particular, they identified four main "cracks in the foundation" that were undermining nurse resilience and leading to burnout. These cracks were:

    • Violence and point-of-care safety threats which have become commonplace in health care settings;
    • Nurses' feeling that they have to make compromises in care delivery;
    • Staff bouncing from traumatic experiences to other care activities without time to recover; and
    • New technology, responsibilities, and care protocols that cause nurses to feel "isolated in a crowd."

    To build a more resilient nursing workforce, leaders must repair these four cracks. To learn how, with executive strategies and best practices for addressing each, review our report on Rebuilding the Foundation for a Resilient Workforce.

    To hear our experts explain these strategies, watch our webconference series, which includes:

    "Our margins have been steadily decreasing and we need to improve them. What's your best research about how to contain costs?"

    -CEO of a large health system in the South

    The challenge you're facing is occurring at many hospitals and health systems across the country. And, as today's revenue pressures—direct pricing threats, site-of-care shifts, new payment models, and more—are likely to endure, cost containment is more important than ever to maintaining margins.

    Our research has found that the most successful organizations at reducing existing cost burdens have pursued a three-pronged strategy that combines an aggressive menu of short-term savings opportunities with ongoing efforts to slim fixed-cost structures and reduce costly unwarranted clinical variation. Learn how to bring this strategy to life with our Finance Leader's Resource Guide. Specifically, find included:

    • 20 essential cost-savings tactics (on pages 35-41);
    • Ideas for fixed-cost restructuring (on pages 47-51); and .
    • The financial case for reducing unwarranted clinical variation (on pages 52-56).

    Next, we'd suggest looking at the long-term cost containment strategies laid out in our study, The New Cost Mandate. This presentation outlines strategies to contain long-term costs in the following ways:

    • Rebase spending on supplies, pharmaceuticals, and purchased services. Take advantage of factors such as vendor competition and managed utilization to capitalize on cost saving opportunities (pages 21-44); and
    • Create a cost-effective workforce. Instead of using tactics such as mass reductions or benefit changes, take a proactive approach to slowing the growth of administrative and clinical labor expenses (pages 48-74).

    Finally, consider requesting our customized Margin Improvement Intensive. This program combines a custom data analysis with a live workshop session to help you take actionable next steps towards a new margin strategy that's right for your organization.

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