Managing the risk of employee burnout in hospitals

Managing the risk of employee burnout in hospitals

Now, more than ever, the dedication and efforts of physicians, nurses, and other hospital staff are at the forefront. In times of crisis, healthcare staff continue to provide care to patients every day, even if that means putting their own safety at risk. As highlighted by the National Institute of Occupational Safety and Health (NIOSH) a division of the Centers for Disease Control and Prevention (CDC), these situations can also compound the risk of burnout due to excessive workloads, extended work hours, a higher influx of critically ill patients, and increased work stress.

Given between one-third and one-half of U.S. clinicians experience burnout, the financial consequences to the healthcare field are mounting. In fact, a recent study in the Annals of Internal Medicine marks the cost of physician burnout at between $2.6 billion and $6.3 billion a year — with a calculated baseline of about $4.6 billion.

With growing estimates like these, the prevalence of burnout means that patient safety and staff wellness are both in jeopardy. According to NIOSH, healthcare workers experiencing fatigue could jeopardize their own health and safety, which increases their susceptibility to infectious diseases, work-related muscle injuries, and being involved in serious patient safety events.

Identifying the causes of burnout

“Burnout” is a syndrome that’s characterized by a high degree of emotional exhaustion. This leads healthcare workers on a path to feelings of depersonalization, cynicism, and futility, as well as an overwhelmingly low sense of personal accomplishment from their work.

Many factors can prompt burnout, of course, but some carry greater intensity in the healthcare workplace. These include:

  • Excessive workload – including work hours, overnight call frequency, and nurse-patient ratios.
  • Perceived organizational environment of a hospital or health system that prioritizes business results over quality of care.
  • Reliance on technology – including the high demands of the Electronic Health Record (EHR) – becoming a barrier to relationships with patients and colleagues.

How healthcare organizations can help reduce the risk of burnout

To help reduce the negative effects of burnout, all areas of the health system must actively share the responsibility to help control the risks of injuries and incidents associated with fatigue. While some issues can be addressed at the individual-location level, others are broader in scope and require systemic change. Here are five strategies that are at the forefront of the healthcare industry’s focus.

  1. Look at burnout from a systems perspective.

    According to a recent report from the National Academy of Medicine, clinician burnout is a serious nationwide problem­, and it’s one that must be solved at the institutional – not personal – level. “It is critical to address burnout not as an individual issue,” the report notes, “but rather as a systems issue that emanates from workplace culture, health care policies and regulations, and societal expectations.”

  2. Explore flexible scheduling.

    When possible, limit scheduling staff for extended shifts (greater than 12 hours). It’s also important to for staff to take short breaks every two hours during their shifts, including short naps and longer breaks for meals. In times of crisis, provide a minimum of 10 hours off in between shifts (each 24-hour period), and one full day of rest per seven days for adequate sleep and recovery.

  3. Foster open communication.

    While employees’ focus may be on providing the best care possible to patients, it’s important to remind them that their health and safety is also important and should not be overlooked. Encourage and provide opportunities for staff to communicate their needs. As operations begin to stabilize after a crisis, provide support to staff in the form of open discussions, stress debriefings, and counseling.

  4. Cut down on duties that do not improve patient care.

    Federal and state policies can contribute to clinician burnout with increasing numbers of tasks around compliance and record-keeping. Over time, that can become cumbersome. While this is not a problem that healthcare organizations can solve on their own, they can advocate for change. The National Academy of Medicine report says, government agencies and departments of health “should systematically assess laws, regulations, policies, and standards to determine their effects on clinician job demands and resources as well as the effects on patient care quality, safety, and cost.”

  5. Pinpoint ways to ease the technology burden.

    The design and demands of EHR are directly associated with greater stress and burnout among clinicians, according to what’s believed to be the first study documenting this cause and effect. Improving factors like clinically unnecessary information, slow system response times, excessive data entry, slow navigation, note bloat (unnecessarily long cut-and-pasted progress notes) and even workstation ergonomics may help lower the level of stress on the job. While technology plays a critical role in providing care, healthcare administrators can raise key issues to begin the conversation at the industry level.

Making a plan to address burnout

Organizational leadership, culture, policies, technology, and care responsibilities all play a role in burnout and wellbeing as well as patient safety and care. Liberty Mutual has deep experience with complex risk mitigation in the healthcare industry and can help your team develop targeted protection solutions. Learn more here.

Additional resources:

Q2, 2020 Focus on Healthcare newsletter: Managing fatigue and clinician burnout in a time of crisis

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