Writing for the Harvard Business Review, Leonard Berry, a senior fellow at the Institute for Healthcare Improvement, Rana Awdish, director of the pulmonary hypertension program at Henry Ford Hospital and medical director of care experience for the Henry Ford Health System, and Stephen Swensen, who is also a senior fellow at the Institute for Healthcare Improvement, recommend five ways health systems can combat burnout among health care workers—and help stave off the Great Resignation.
1. Leverage extended teams
According to Berry, Awdish, and Swensen, one way to prevent burnout is to leverage "[w]ell-executed, team-based care [that] honors clinicians' level of training and reduces the time and effort clinicians spend on the administrative tasks that they so often find physically and emotionally depleting."
For example, University of California San Francisco Medical Center created "triage playbooks" for different medical specialties to direct nonphysician team members in handling the most common types of requests, thereby protecting physician time. And Henry Ford Health System in Michigan tasks prior authorization specialists with acting as a liaison between clinician staff and insurers—a move that has minimized treatment delays and helped reduce the time physicians spend obtaining insurer approval.
2. Advocate for your staff
Health care systems can also protect employees' "emotional well-being" by providing "robust support," including "an institutional commitment to protecting their physical safety and economic security," the authors write.
For instance, at the start of the Covid-19 pandemic, Torrance Memorial Medical Center committed to a no-layoffs policy, which still stands today. The health system reallocated some staff from shut-down procedural areas to serve in other capacities. And while nearly 700 other staff had to be sent home, they still received 50% of their pay and were assured that their jobs would eventually return.
Similarly, when Henry Ford Health System had to implement temporary furloughs, the system established a Covid-19 employee relief fund and was eventually able to bring back about 92% of furloughed employees.
According to the authors, health systems might also consider "giving clinicians the time and space to replenish themselves during lulls in the pandemic," much like the U.S. military grants reprieve from active duty. "In health care, reprieves could include leaves of absence, temporary role changes, and reduced hours," the authors write, adding that without such measures, "[c]urrent health care workforce shortages are likely to worsen."
3. Foster a culture of kindness
According to the authors, some systems have also combated burnout by focusing on kindness. For instance, Mayo Clinic has prioritized developing leaders' kindness via an annual survey, open to all 73,000 employees, assessing leadership on five kindness-fostering behaviors that include inclusion, transparency, consistent solicitation of input from others, professional development, and recognition.
According to published research from Mayo Clinic, when leaders implement these five acts of kindness, employee satisfaction and fulfillment are higher, and there are lower levels of burnout among staff at every level.
4. Provide emotional support resources
Health systems must also combat "the relentless stress of health care work" by investing in emotional support resources, the authors write.
For example, Providence has taken several steps to mitigate emotional depletion, including:
- Providing staff with content on topics such as "compassion fatigue" and parenting during a pandemic
- Implementing its "No One Cares Alone" program, where teams of behavioral clinicians, social workers, and chaplains consult with staff members who serve on high-stress units—including ICU, emergency, respiratory therapy, and pharmacy—to offer them practical mental wellness suggestions
- Offering direct support to unit leaders to help them better understand the importance of creating psychologically safe environments that promote mental health and well-being among staff members
- Issuing an anonymous mental health checkup survey to assess anxiety, depression, burnout, PTSD, and suicidality among staff. Therapists review the surveys on a secure platform that allows them to communicate with the employee confidentially.
5. Prioritize valuable clinical interactions
According to the authors, "[h]ealth care systems that focus too narrowly on getting the most productivity possible out of each clinician risk depriving patients and their care teams of what matters most: a trusting, collaborative therapeutic relationship." This approach ultimately "disempowers patients and … depletes clinicians by diminishing their joy in work," they write.
Instead, the authors encourage health systems to foster "acts of connection and kindness" between providers and patients through "the design of the work." For instance, Kaiser Permanente encourages its pharmacists to visit patients receiving chemotherapy infusions, enabling them to learn about the patient experience and provide tailored recommendations and advice on managing side effects.
Ultimately, according to the authors, health systems should adopt multipronged approaches that can help "mitigate their workers' physical and emotional depletion, reduce burnout and turnover, and improve patient care." (Berry et al., Harvard Business Review, 2/11)