Imagine this scenario: You are a hospital CEO walking the halls of your facility when you overhear a group of physicians or nurses talking about the stress, exhaustion and frustration of their jobs and the system. One of them states without hesitation that she can't wait to leave the profession entirely, and would make sure her son or daughter never considered medicine as a career. Would you have faith that she could devote her full attention to administering care to your patients?
Whether you are privy to those conversations or not, your physicians, nurses and many other medical professionals are likely reporting widespread job dissatisfaction and burnout. In the Medscape Physician Lifestyle Report 2015, 46 percent of physicians responded they had feelings of burnout, a significant increase from 2013 (39.8 percent). As a result, fewer physicians and nurses are choosing to stay in health care.
The 'Quadruple Aim'
Advocates of health care reform often talk about the Triple Aim — improving population health, elevating patient-centered care and reducing costs. However, there is a key component missing from that model: restoring joy to the practice of medicine. When thinking about new ways to transform health care, we must extend our approach to the "Quadruple Aim," that is, to ensure we focus on solutions that prevent initiative fatigue and burnout for our nurses, physicians and other care team members.
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The reasons for taking this approach go beyond just keeping doctors and nurses from quitting. It's about humanizing health care for all as a means to improving quality and safety and creating an ideal experience that drives loyalty and growth. When a patient chooses a health care provider, it is often based on personal relationships and peer recommendations, so when our health care professionals bring joy and compassion to their interactions, they are much more likely to build trust and relationships that improve patient engagement and compliance.
Organizations that want to improve the health care experience for patients, families and staff members must map the gaps in efficiency and empathy. We must identify the factors contributing to burnout and fatigue and remove them. We must also find ways to restore the human-to-human connection and provide services that optimize physician and nurse well-being and performance. The secret to caring for patients is caring for our caregivers.
Examples in Health Care
Many forward-thinking organizations are making commitments to elevate the staff and physician experience in conjunction with patient-centered strategies. Several military health systems have made improving experience a top priority. At one naval hospital, the commanding officer steadfastly committed to improving the human experience for active-duty warriors, retirees and their families. The hospital created a chief experience officer role, deployed programs to boost dialogue and collaboration for military and civilian staff members, and taught the galley team how to improve patient and staff well-being through the food they serve.
San Mateo Medical Center in the Bay Area also aims to empower staff and elevate well-being. The hospital implemented a leadership system that supports daily check-ins with staff to ensure that their needs are met and their voices are heard. The hospital's engagement committee measures the effectiveness of the leadership system on both staff engagement and patient experience. After implementing the program, San Mateo employees reported improved communication and a more meaningful connection to their work.
At the Lucile Packard Children's Hospital at Stanford, the leaders have integrated quality and performance improvement efforts with a redesign of both the patient and staff experience. Employee well-being and support is at the center of the pilot "lavender alert" program implemented in the prenatal intensive care unit. The program originally was conceived for patients and families who were going through difficult moments, but lavender alerts also extend rapid response teams to provide emotional support for employees and physicians during times of high stress.
Another important factor in restoring joy to the practice of medicine is ensuring that organizations have an operational infrastructure that allows doctors and nurses to focus on delivering care. When too much of our caregivers' valuable time is spent at a computer or trying to track down information, supplies or co-workers, health care leaders must find a way to help all partners perform their jobs more efficiently.
An effective combination of technologies and processes can reduce frustration and fatigue. For example, something as simple as better communication tools can improve workflows, relationships, collaboration and job satisfaction. All these factors in turn affect patient care and safety.
Organizations that achieve the greatest success recognize that patient experience and quality of care are directly linked to staff experience and employee empowerment and engagement. By improving communication and building cultures that restore empathy and compassion, care teams will be able to deliver the best patient experience and drive better outcomes.
Bridget Duffy, M.D., is chief medical officer of Vocera, San Jose, Calif.