Clinician burnout, and how to prevent it, has become a hot topic in health care in recent years. Researchers continue to study causes and methods to stifle it.
One such effort is taking place at San Francisco-based Dignity Health, which partnered with HopeLab in Redwood City, Calif., to conduct behavioral science research to understand how nurses’ work environment contributes to both resilience and burnout.
“We worked closely with clinicians to understand the root causes of frustration that lead to burnout,” says Page West, R.N., senior vice president and chief nurse executive at Dignity. “This enabled us to build in mechanisms and processes to prevent burnout from actually occurring.”
Some causes of nurses’ frustration they identified include a lack of control over their environment and things that matter to them, not taking the time to debrief after a traumatic event, and being unaware of what is happening among their teammates and throughout the hospital.
After identifying these contributing factors, Dignity developed three prototypes to help prevent these frustrations from occurring. They include a “unit-based digital forum,” which provides nurses and administrators with an online, secure communication channel that allows for discussion and decision-making across days and shifts, West says.
Second, nurses can use a “debriefing codes card” to facilitate a post-code debriefing to identify clinical improvements and tend to staff members’ emotional needs. Finally, a “weather report” provides a digital snapshot of important data about the hospital and hospital floors, such as the number of patients waiting in the emergency department, and the number of nurses, patients and sick calls on each floor.
Dignity is currently evaluating the effectiveness of these prototypes.
Given the national burnout epidemic, Roanoke, Va.-based Carilion Clinic surveyed its practicing physicians to determine if burnout was an issue — and indeed it was.
“This was a call to action to do something,” says Mark Greenawald, M.D., a family physician, who says that the first step was to acknowledge that a problem existed.
Carilion’s Professional Well-being Committee, which Greenawald chairs, has pursued ways to address and prevent burnout. One way is to enable physicians to optimize their time. With electronic health record systems being cumbersome, hiring scribes and using voice recognition software was viewed as a solution. Another strategy is to delegate physicians’ paperwork.
Finding ways for colleagues to connect also is important. “Health systems can help create cultures that encourage camaraderie,” Greenawald says.
In addition, physicians should be taught tools to better manage the stressors of health care. “Physicians must learn how to more effectively navigate emotionally taxing situations, such as using mindfulness or relaxation techniques,” Greenawald says.
Other components to address include finding lifestyle balance, learning how to cope with traumatic events and employing time management strategies.