Checklist for Health Care Leadership to Take Action Against Clinician Burnout
Taking Action Against Clinician Burnout: A Systems Approach to Supporting Professional Well-Being, a 2019 report from the National Academy of Medicine, identifies clinician burnout as a threat to the quality of patient care. Mounting system pressures within the U.S. health care system have contributed to an imbalance in which the demands of the clinician’s job are greater than the resources and supports available to them.
A chronic imbalance of excessive job demands and inadequate job resources can lead to burnout – a workplace syndrome characterized by high emotional exhaustion, high depersonalization (i.e., cynicism), and a low sense of personal accomplishment from work.
In large part, the balance of job demands and job resources affecting clinicians and learners is under the direct influence of the health care organizations (HCOs) in which clinicians work and train. Organizational leadership’s decisions on resources, constraints, incentives, and demands shape the work and the behavior of people in the organization.
The report calls on leaders in HCOs and health professions educational institutions to prioritize the creation of positive, healthy clinical work and learning environments in all settings, and thereby mitigate clinician burnout and foster professional well-being across all disciplines.
Key actions for health care leadership to take to mitigate clinician burnout:
Engage governing boards, executive officers, senior leaders, department chairs, and administrative leaders in a shared commitment to create and maintain a positive and healthy work environment
Create and maintain, at the executive level, a leadership role and function responsible for improving and sustaining professional well-being across the organization
Identify and address those aspects of the work and learning environments, institutional culture, infrastructure and resources, and policies that erode professional well-being and contribute to burnout
Advocate for needed regulatory reforms
Eliminate barriers that prevent or discourage access to professional and personal support programs for individual clinicians and learners
Allocate resources in ways that address clinician burnout
Create conditions in work and learning environments that equip clinicians and non-clinician staff with dedicated time, resources, and skills to advance clinician well-being
Develop, communicate, and coordinate a shared focus on improving patient care across the organization
Mutually consider requirements, constraints, and unanticipated consequences of organizationally separate entities
Align organizational goals and resources
Commit to a culture of teamwork, collaboration, and adaptability in support of continuous learning
Monitor clinician well-being using validated instruments to measure burnout at a minimum annually
Evaluate how business and management decisions may affect clinicians’ job demands and job resources, patient care quality and safety, and levels of burnout within the organization – adjust decisions and their implementation accordingly
Assess total workload and the complexity of the work expected of clinicians (including continuing professional education, maintenance of certification, required institutional learning modules, and work performed outside of scheduled hours)
Target reports internally, including to leadership, managers, and clinicians, to share transparently within the organization
Avoid any perception of blaming frontline staff for results or exerting pressure for them to remediate results
Create incentives for, and lower barriers to, the development and implementation of new ideas, approaches, and technologies that have the promise of enhancing professional well-being as well as improving quality of care
Co-create solutions with clinicians, rather than imposing them, to increase the likelihood of meaningful and sustainable progress
Share successes within the HCO as well as the field at large to accelerate improvement
Addressing the factors contributing to clinician burnout and the barriers to professional well-being using a systems approach will ultimately help health systems improve patients’, families’, and clinicians’ experiences and outcomes.