22 Dec Burnout Prevention Plan: Caring Connections and Resiliency
There has been little to no focus on creating an actionable burnout prevention plan.
Why wouldn’t we want to be healthcare providers? We get to help people. We are generally well-respected and considered the “white hats” by the general population and legislators. We get steady reimbursement and healthcare coverage. So why are there so many reports, studies and articles describing as many as 50% of healthcare providers experiencing “burnout?” Because there has been little to no focus on creating an actionable burnout prevention plan.
Medical students and healthcare trainees are chosen for their good grades, not necessarily for their ability to connect with people or to communicate. Medical training stresses competition and “being tough” instead of being resilient or compassionate.
Clinical skills that generate high charges are valued more than equally important communication skills that allow providers to build strong teams and alliances with patients, families and colleagues.
Burnout is real. Too many studies have shown this. Mayo Clinic studies led by Dr. Tait Shanafelt clearly document the existence and toll of burnout. “Burnout and satisfaction with work-life balance among U.S. physicians are clearly getting worse. American medicine appears to be reaching a tipping point with more than half of U.S. physicians experiencing professional burnout.” (Mayo Clinic Proceedings. December 15, 2015; 90(12): 1600-1613.) A Brigham and Women’s Hospital study recently addressed the increased incidence of depression in medical trainees. (Dec 9, 2015). Professional burnout is not unique to physicians. It can indiscriminately affect and extend to all healthcare providers.
Two systemic changes have significant potential to help address the problem of health care provider burnout: Support systems and strategies to help build resiliency, and institutional changes to provide skills in the culture of caring communication.
Elizabeth Crane, Founder and Chief Vision Officer of It’s All Good Here, recently delivered an excellent presentation to a multi-disciplinary group studying burnout. In her talk she described the exciting research that has been done in the past 20 years which has proven that people can train their brains and build new neuropathways in their brains to help them be more resilient, optimistic and grateful.
Steve Cole, Vice President, Research & Development of HopeLab also presented and described three important factors that are required to build resilience. Resiliency depends on a recognized purpose, a feeling of connection and a sense of some control. Burnout has been called a failure of resilience. We must build relationships with each other and patients to help re-engineer our lives and work to nurture resilience.
Healthcare providers who are resilient are better able to carry joy and compassion into their daily work. Compassionate care must be built on a strong base of communication with patients and colleagues. Healthcare providers must also be able to leave their work at the end of the day and return home and be present and compassionate with friends and families.
What are some of the tools in the essential tool kit of excellent caring communication? Being present with undivided attention is key to prevention of errors.
The healthcare provider who can be totally present with work activities is less likely to be distracted, less likely to make errors and at the same time, more able to form an alliance and communicate with full intent and compassion. The skill of mindfulness is directly related to being present. These skills can be learned and have been demonstrated to improve “burnout” scores.
Another essential basic communication tool is active listening. Listening as a learned skill may almost seem too basic but how many people listen actively and with the intention to truly understand?
On the average, a physician will interrupt a patient in less than 18 seconds. Most people do no better with colleagues or friends. It is difficult to feel valued if you think no one is listening to you!
Medical students are not selected for their compassion. Perhaps the candidates “emotional intelligence quotient” should be regarded as highly as their MCAT scores. Physician behavior sets the tone for the behavior of the entire team.
Nearly 29 percent of residents worldwide will experience depression during their residencies, according to a meta-analysis published Wednesday, December 9 in the Journal of the American Medical Association. A Boston Globe article addressing this report quoted the co-author of the report, Dr. Douglas Mata of Brigham and Women’s Hospital in Boston.
Dr. Mata has several excellent suggestions for training, including establishing a support system, providing opportunities to vent, and providing supervision when trainees “have to carry out more difficult parts of their training, like speaking to relatives of patients who have died.” He also stresses trainees “need mentors to talk with about those experiences.”
Dr. Mata has recognized the essential need to value the ability to communicate and connect with colleagues for support. We cannot ignore these crucial skills if we are ever going to really address the issue of burnout. They cannot just be a part of training but must be a continuing career-long skill set that can be honed and improved and ultimately enjoyed by healthcare providers who feel support, connection, and value.
Healthcare providers should share a common purpose of helping our patients in their quest for better health, but also helping our colleagues as well as ourselves in a quest to stay resilient and consider implementing a burnout prevention plan to avoid depression and burnout.
The Institute for Healthcare Excellence (IHE) has been instrumental in cultural change in more than 35 organizations through a program that educates physician and allied health leaders to train their own teams. These teams then bring knowledge and skills to their institutional colleagues that can help to build joy and resiliency and diminish burnout.
Skills such as mindfulness, presence, active listening, and recognition and acknowledgement of emotions are the very skills that encourage teamwork, connection with colleagues, and recognition of common purpose. The IHE programs are designed to improve patient experience while simultaneously building connections and building joy and resiliency in physician and allied health partners.