September 7, 2021: By William J. Maples, MD; Read G. Pierce, MD; and Ronald Paulus, MD, MBA
Over the past decade, there has been increasing awareness and a growing belief that physician, nurse, clinician and health care leadership burnout is real and has significant consequences on both the impacted caregivers and the essential mission of our health care institutions.
Numerous well-designed studies have demonstrated that patient safety and patient and caregiver experience are compromised significantly by burnout. This unfortunate reality has been exacerbated by COVID-19 and the growing nurse and physician shortages.
Yet invariably leaders are unsure where or how to begin to address what often appears to be a large and amorphous challenge. As such, clinicians and leaders need a clear, integrated roadmap on how to not only reduce burnout but also optimize caregiver well-being.
The National Taskforce for Humanity in Healthcare (NTH) focused on understanding this dilemma by working with a broad group of U.S. physicians, nurses, clinicians, patients and health care administrators between 2015 and 2020. NTH initiated a series of national collaborations and a pilot program that is described in the September 2021 issue of The Joint Commission Journal on Quality and Patient Safety. Below are the key takeaways from this important work:
Significant Improvement in Well-Being
Following implementation of this four-step approach, we witnessed statistically significant improvement in emotional exhaustion (48.1% decreased to 34.5%, p=0.037) at approximately one year, which was equal or superior to any reported interventions in the literature.
We also observed a statistically significant improvement in the likelihood to recommend. There was a trend toward improvement in emotional thriving and recovery, but we expect it will take somewhat longer for those improvements to reach statistical significance than our six-month intervention followed by remeasurement at one year allowed.
Leadership support of this work is critical. The expected ROI is estimated to be conservatively 5:1 driven by improved safety, efficiency, clinical outcomes, experience culture (value-based care) and decreased turnover.
Eliminating burnout and creating emotional thriving is essential for our clinicians and health care workforce. It also is crucial for our patients and families. The NTH has created new validated measures to assess burnout and thriving along with a specific approach to targeted interventions that when combined with a holistic approach deliver impactful results. It is time to move from discussing burnout to creating emotional thriving in all our teams. We welcome you on that journey together.
William J. Maples, M.D. is the President and Chief Executive Officer at the Institute for Healthcare Excellence in Ponte Vedra Beach, Florida. Read G. Pierce, MD, was Vice President of Culture Transformation at the Institute for Healthcare Excellence and is Chief of the Division of Hospital Medicine, Department of Internal Medicine, at Dell Medical School, University of Texas at Austin. Ronald Paulus, MD, MBA, is President and CEO of RAPMD Strategic Advisers in Santa Monica, California.