It’s December. All around us are reminders that this is the season for joy: colorful lights, familiar carols and cherished family and friends. But if you read health care news, or speak with your staff, you know that joyful isn’t always the way our workplaces are described.
Almost weekly, we see new and startling studies stating how burnout has taken root in our hospitals, stealing the joy from one of the most noble career pursuits - being a caregiver. A few fast stats reveal:
- Seven out of 10 physicians would not recommend health care as a profession to a friend or family member
- In a 2017 survey of nurses, 63 percent said their work had led to burnout
- The odds of unsafe behaviors, unprofessional behaviors and lower patient satisfaction double with physicians suffering from burnout syndrome
Leading burnout researcher Christina Maslach, PhD, who developed the widely used Maslach Burnout Inventory in 1981, defines professional burnout as a “psychological syndrome involving emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment that occurs among various professionals who work with other people in challenging situations.”
Vizient launched the Joy in the Workplace collaborative in 2018. During this project, we united 58 hospitals and health systems to develop interventions to increase joy in their workplaces. Projects were focused in three areas: workplace safety and wellness, supportive workplace culture and workplace efficiency. We gathered monthly to talk through our challenges and support each other in the work. We measured our success by studying turnover rates and employee engagement scores.
During many of our collaborative conversations, we discussed the fact that 80 percent of burnout is attributed to organizational factors and 20 percent to a person’s own resilience. Many participants shared that burnout was talked about and addressed openly, but the very structure of their organizations was contributing to the exhaustion, fatigue and frustration of caregivers. Examples included too many clicks and alerts in the EHR, not having structured breaks built in for nurses and pay scales not being adjusted after mergers, which led to staff doing the same role at different pay rates.
One of our big lessons learned is that leadership support for this type of work is critical. Knowing this, the big question is: what is your organization doing to bring joy back to your workforce?
Here are a few ideas that were implemented during our collaborative. Consider the following as gifts to your workforce in 2019 to increase their sense of joy:
Identify quick wins that show you are listening. One project team focused first on the ED, and found that not being able to find pillows, quickly or easily, on the floor was a major dissatisfier for nurses and patients. After a couple of quick phone calls, pillows were relocated to a more convenient location and restocked more frequently. The collaborative team began looking for more quick wins across the organization—now termed “pillow projects.”
Build in support for staff after traumatic events. One hospital found that many members of their staff needed a way to decompress after traumatic events with patients. It established a “zen den” for staff to use to reduce their stress and anxiety, along with a Code Periwinkle process that offers support from a trained team for staff after they experience traumatic events.
Encourage a focus on the positive. One hospital implemented a formal program that encouraged staff members to write down three positive things that happened each day. Employees who participated earned a discount on their health insurance through the employee wellness program.
Connect employee engagement with patient satisfaction and customer service. One participant put all staff members through a training program that focused on the power of the individual to improve the patient experience. Patient experience did improve, and so did employee engagement.
Watch or establish indicators that could point to burnout. Most EHRs enable you to pull reports that show after-hours log-ins by your clinicians. One study published in a 2016 JAMA found that family physicians who spend time at home working on EHR tasks may be more vulnerable to burnout. One of our subject matter experts, Marie Brown, MD, FACP, recommended using this list to reach out to those who are doing after-hours work and find out what additional support they need, such as more training or scribe services, to return their work-life balance.
And what should you expect in return from your staff after bestowing these gifts? Look for a more engaged and productive workforce, higher patient satisfaction and lower turnover rates. After analyzing and comparing participants’ initial pre- and post-collaborative physician turnover performance, we found participants reduced their own physician turnover rates, on average, by 3.7 percent, avoiding up to $56 million in physician turnover-related costs overall. Now that’s a gift that keeps on giving.
About the author. Kelly Randall is a knowledge transfer director on the Vizient Performance Improvement Collaboratives team. She has more than 20 years of experience in improving organizational effectiveness through strategic communications.