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Creating a Resilient Workplace: Solving for Organizational Causes of Burnout

Oct 24, 2018 06:00AM ● By Alyssa McGinnis

By Anne Geske

The data are clear: there’s an upward trend of burnout in medicine, particularly among physicians, who experience professional burnout at twice the rate of the general population.1 Burnout isn’t just a problem—it’s a crisis. It affects patient safety, teams and organizations—and it’s costly.

So, there’s been a lot of attention on individual resiliency skills of late. But the primary drivers of burnout occur at an organizational level, so focusing solely on what individuals can do to manage stress will fall woefully short. Organizational issues include high workloads, inefficiencies related to electronic health records (EHRs), loss of meaning and social isolation at work, and loss of clinical autonomy.2,3

The stakes are high because physicians and other clinicians are voting with their feet, according to Dr. Laurie Drill-Mellum, chief medical officer of Constellation/MMIC. “Millennials stay two to four years in an organization, on average,” she says. “If they aren’t engaged in being part of something greater than themselves, if they aren’t seen for what they can contribute, they aren’t staying. The workforce shortage plays in this, too. If we don’t treat people differently, we’re going to have to close our doors.”

Dr. Drill-Mellum’s work focuses on clinician well-being and its effect on patients and organizations. As an officer of a professional liability insurance company, she knows that clinicians who are burned out are at risk of making medical errors and therefore at risk of getting sued. And she sees the organizational drivers of burnout as eminently solvable.

The first step leaders can take, she says, is to administer a measurement tool like the “Mini-Z” Survey” Minnesota Hospital Association members deployed for the past two years. “Now is the time to apply a quality improvement approach to address burnout and promote resiliency,” says Dr. Drill-Mellum. “This involves commitment from leadership to use a validated measurement tool, analyze the results, and engage those surveyed on how they want to address opportunities for improvement.”

It’s crucial to engage the frontline clinicians who were surveyed for their ideas about how to solve any issues that surface. “No one group of people is going to solve this problem—it has to be done in collaboration,” Dr. Drill-Mellum states. “When working together, you find ways to solve problems. With consensus on a plan and organizational support for it, you inform everyone what you plan to do. Then, you do it and measure again to look for impact.”

Many tools are available to tackle specific pieces of workflow issues like prescription refills, lab and image result reviews, and documentation. “It’s not rocket science,” Drill-Mellum explains. “It’s a simple quality improvement program for care teams. You’re only going to get so far improving patient experience, outcomes and costs without attending to the work environment and experience of the people who deliver the care.”

The interconnection between organizational culture and individual well-being is huge, Dr. Drill-Mellum says. The question to ask is: Does the organizational culture support individual resiliency? There are practices to stop, like asking staff to work double shifts. And there are those to start, like creating flexible scheduling, supporting people to take vacation time, and offering onsite daycare and exercise or relaxation facilities.

For true organizational resilience, what’s needed is a leadership culture that cares about people, engages them, and does what they say they’re going to do in terms of mission, vision and values. 

This article originally appeared in the September-October issue of MetroDoctors.


References

1. AHA, 2018. Be Well: Cultivating Resilience to Address Health and Well-Being.

2. AMA Steps Forward, 2018. Creating the Organizational Foundation for Joy in Medicine.

3. The Physicians Foundation, 2016. 2016 Survey of America’s Physicians Practice Patterns & Perspectives.


See also, Physician Burnout: The Other “Healthcare Crisis”