Defeating Clinician Burnout

With the release of the long-awaited COVID-19 vaccines last December, many US citizens anticipated a welcome end to a raging pandemic. Yet months later, the virus is alive and well in America, and clinicians are as burned out as ever.

In July, KLAS held its annual Arch Collaborative Summit, and one major buzzword was burnout. In an effort to help health systems combat clinician burnout and enhance wellness, KLAS held a panel with three experts in the field: Dr. Melissa Briley, a family practitioner from University of Utah Health, who championed their Home for Dinner program; Dr. Leslie Kohman, Upstate Medical University’s Chief Wellness Officer; and Joel Gordon, CMIO of Community Practice at the Mayo Clinic, which is well known for their emphasis on clinician well-being.

Burnout Is Real

Toward the beginning of the panel, Dr. Briley detailed a meeting she had with an urgent care provider who had all the symptoms of burnout. At the end of the meeting, Dr. Briley told the provider, “I don’t think you can work.” She advised them to go on leave due to the severity of their burnout symptoms. Dr. Briley concluded her story by saying, “[Burnout] is very real. There is a stigma to it, and there is some embarrassment…[but] the likelihood of not getting burned out in our career is slim to none.”

All the panel members echoed that clinician burnout is a reality and that it cannot just be handled at the personal level. Dr. Gordon stated that the Mayo Clinic handles clinician wellness at national, organizational, work unit, and personal levels.

Where to Start

Dr. Kohman and Dr. Gordon asserted that the first step to organizational clinician wellness is getting leadership buy-in. And a great way to do that is with an Arch Collaborative survey. The survey responses will reveal the most telling weaknesses that are contributing to burnout in an organization and will offer concrete data that health system executives can get behind.

Harnessing Technology

Dr. Gordon stressed that addressing problems in the EHR to combat burnout is part of the solution but not a huge part, and if organizations focus all their efforts on IT issues, they may only see limited improvements. While many comments from the panelists were focused on using technology to improve clinician well-being, there were also several suggestions that were not related to IT.

IT suggestions included incorporating speech recognition tools, FHIR apps, disease management and learning dashboards, email integration, and accessible analytics. The Mayo Clinic uses screen savers to share messages and reminders. They also have a tile on every website that connects people to wellness resources ranging from help for serious problems like substance abuse to preventative help like trainings on resilience. Dr. Briley talked about specific IT help used to decrease stress during COVID-19, such as telehealth trainings and interfaces with state immunization databases.

The Power of People and Programs

The panelists shared that one of the biggest connections to burnout is a clinician’s relationship with their direct supervisor and team. In connection to improving the relationship between clinicians and their leaders, Dr. Gordon stated, “People aren’t born leaders; you have to make them—particularly when it comes to wellness.” Dr. Kohman spoke about AMA’s Joy in Medicine program, which recognizes health systems for working toward the well-being of their clinicians. One of the questions in the survey for that program is “What are you doing to train your leaders?”

Decreasing financial stresses can be a key contributor to recruitment and retention, particularly for new graduates. Dr. Briley noted that her organization recently loaned money to an OB/GYN graduate to pay off student loans. That graduate is paying back the hospital interest-free. At Dr. Briley’s first job, she was offered 25% of her salary up front for the first two years specifically to buy a house. Some healthcare organizations have housing departments specifically devoted to helping new hires find places to live.

Dr. Gordon and Dr. Kohman testified of the simple gesture of sharing a meal together. When people get together and talk, relationships and peer support form organically. Dr. Gordon participated in a physician engagement group called COMPASS. Doctors got together and ate a meal paid for by the organization. When many clinics moved their work to a remote environment, those meals became remote as well. That opened up opportunities for barriers to be broken between doctors in different areas of the country.

Another program that Dr. Gordon discussed is critical event management. A team is created in the hospital that is trained to handle a critical event. For example, maybe a child dies in the nursery, or there is a gun fight in the emergency room. The critical incident responders are there to help people process the emotional event.

Nurse Wellness Matters Too

An audience member asked the panelists to speak more to the needs of nurses. The panelists agreed that nurse wellness is just as important as provider wellness. They also mentioned that many of the same principles and programs work for nurses as they do for doctors. However, Dr. Gordon said that there is a business case for starting organizational wellness initiatives that focus on providers and engage nurses later on. He also said that work-life integration is more difficult for nurses. Dr. Briley stressed the importance of doctors allowing nurses to be engaged in patient care beyond just taking vitals. She said that when nurses are a part of writing notes and making care decisions, they become more engaged with their jobs and enjoy them more.

A Focus on COVID-19

These days, wellness initiatives have very much turned into helping clinicians deal with COVID-19. While all of the suggestions already mentioned can certainly help prevent burnout and turnover during the pandemic, Dr. Briley’s program has gone a step further and done trainings on how to address patients, help them with their emotional well-being, and respect their wishes. For example, doctors are trained to ask patients what they want them to do if their illness continues to decline.

The panel was a success and perhaps a launching point for many organizations in creating their own wellness initiatives. If you would like to follow suit and help your organization defeat burnout, please reach out to the KLAS Arch Collaborative to get started. We are in this together.

Photo credit: H_Ko, Adobe Stock