Change fatigue is a pressing issue and healthcare leadership is taking notice. A critical priority in every healthcare organization is building systems to ensure a capacity to recover quickly from difficulties, and building a business model that allows for bouncing back and staying the course.
We are noticing a disturbing trend in healthcare: our front line caregivers are suffering.
Most know that in turbulent environments, it is vital for leaders to create competencies which can withstand rapid pivots. These are responsibilities to steward in any industry, but are especially vital to healthcare. Like any sports team with a consistent win record, there is wisdom in knowing victory is attained through consistent attention to the basics: again, and again, and again. We don’t become what we wish to be — we become by the daily choices we make.
Narrowing Our Focus
Creating resiliency in business models and organizational systems is all well and good. Yet there is something more prominent to address in healthcare which cannot be found in any other sector. There is a need to ensure and steward resilience among a group of highly educated, committed professionals who are central and irreplaceable.
This reality does not diminish the importance of every member of the team. It does not diminish the importance of administrators, finance analysts, housekeeping or front desk team members. It is simply a fact: providers are uniquely central to all healthcare is, and all healthcare offers. And the current reality is many are burning out. Many want to leave the profession. Some are leaving the profession. And most tragically, some are even dying.
A recent Cleveland Clinic survey found that more than one in three physicians met the criteria for burnout. This finding was so compelling that in his first State of The Clinic address as new CEO, Dr. Tom Michaeljevic announced he will establish a new Office of Caregiver Experience to ensure caregiver wellness, fight burnout, and support career development.
Ensuring wellness and fighting burnout is not an easy task. There are as many reasons for burnout as there are individuals wrestling with the reality. In the March 2018 edition of The Hub, Patrick Lencioni identified The 5 Big Causes of Burnout, concluding with this thought:
Every one of these different causes of burnout is potentially painful, and all people who are experiencing burnout need compassion, empathy, and encouragement to reestablish balance in their lives. However, if we don’t understand the underlying causes, it is difficult to provide the help that people need.
One Size Does Not Fit All
Each of us has a different journey, filled with different experiences. One size does not fit all. However, in my work with providers, I’ve found five themes that are consistently present. And they are often directly attributable, or can be markedly improved, by senior leaders.
- I’m not heard. “I’m uncertain who I should speak with and I’m uncertain who makes decisions. When I do voice a concern, I’m uncertain where it goes and who will follow up.”
- I’m not informed. “Changes happen that I know nothing about. It seems others make decisions without my knowledge or input. I really don’t understand where our organization is going or why.”
- I’m not efficient. “I’m spending hours on the EHR in the evenings/weekends. Making referrals, placing orders, ensuring smooth hand offs to others should be easy, but these seem really hard.”
- I lack resources. “I don’t have enough (fill in the blank). I was told we would get (fill in the blank) but I’ve not heard anything. I can’t even get anyone to talk seriously with me about (fill in the blank).”
- I’m not adding the greatest value I can. “I’m shuffling too many papers, inputting too much data, and need to attend too many meetings. I’m not working at the full scope of my license and frustrated with swimming upstream.”
Finding Joy in Work
There is nothing more important in a healthcare organization than to ensure the health of those most important to our patients. Providers are central to every patient encounter and every service offered. In a recent Journal of Healthcare Management article entitled ‘Why Focusing on Professional Burnout is Not Enough, the authors concluded the following:
“Ultimately, senior leaders are accountable for developing a culture that encourages and fosters trust, improvement, and joy in work — and for promoting that culture at all levels of the organization.”
Here are some practical steps we can take as leaders to be part of the solution, not the problem.
- Listen, listen, listen. Know first names. Know the backstory. Ensure collaborative structures are in place (preferably with dyad leadership) and get out and walk around. Have a method for consistent follow up. Under-promise and over-deliver. Genuinely care.
- Communicate: in writing, email, video, town hall meetings, dinner meetings, one-on-one, and then do it again and again. Be aware that everything in leadership communicates. Not just words. Remember also that communication is not simply sharing information. True communication is achieving shared understanding. Know key stakeholders, know influencers, and consistently check feedback loops.
- Charter formal teams and structures with providers to address operational systems and everyday workflow. As much as possible, display transparency about existing limitations in resources, timing issues, or other external forces. Also, display authentic humility about failures. Having a big hat with no cattle fools no one.
Provider burnout is a complex topic fraught with varying perspectives, internal nuances, and external factors. Basic leadership attention is not the sole solution to provider burnout. However, there are concrete and clear action steps leaders can take to avoid adding to the problem.
Building resilience is about strengthening relationships. And relationships are strengthened by knowing the value of a first name, sincere attention in communication, and building trust through consistency in action. As leaders, let’s choose wisely to reduce our contribution to provider burnout.