“Upfront Engagement”: The Tactics CIOs Can Leverage to Address Clinician Burnout

It’s safe to say that the massive IT outage triggered by the CrowdStrike update left many industries shaken — and healthcare was one of them. But it also proved quite enlightening for some organizations, including Penn Medicine.

During one of the many debriefs that have been held, leaders asked clinicians to describe their experience during the outage. And while those who were newer to the practice were understandably rattled, many of the seasoned clinicians relished the time offline. “They told us, ‘It was really nice. We went back to paper, and we spent more time in front of our patients. It was like the old days,” said Michael Restuccia, who serves as CIO at the 6-hospital system, during a recent panel. “There’s a balance between complexity and practicality, and the CrowdStrike scenario really brought that to light for us.”

For IT teams, it was a critical reminder of the enormous burden faced by physicians, nurses, and other care providers — one that has only increased with the advancement of digital tools and the ever-growing list of compliance regulations. It has also served as a call to action to “reduce the burden,” noted Restuccia. “How do we engage our clinicians so that they’re more involved with the development of our systems? How are we leveraging technology and AI to reduce some of the redundancy and repetitiveness that exists?”

Rather than continuing to ask more from physicians, he believes it’s time to “give something back” — specifically, “more knowledge and more time to spend with their patients.”

The question, of course, is how to approach what has proven to be a complex problem. During the discussion, Restuccia and co-panelists Audrius Polikaitis (CIO & Assistant VP of HIT, UI Health), Nick Culbertson (Co-Founder & CEO, Protenus) and Marc Tobias, MD (Founder & CEO, Phrase Health) shared thoughts on what they’re seeing and how they hope to turn the tide.

It starts, according to Polikaitis, with understanding how it affects individuals and going right to the source. “Burnout is a persistent thing,” he said. It’s an onslaught of activities and demands that seemingly never stops.” It can even feel as if “you can’t pick up your head and get some air.”

Community engagement

Although it is certainly multi-dimensional, one of the key factors is inefficient workflows and processes, Polikaitis continued. “Part of the challenge may be simply a gap in knowledge,” which means leaders need to identify those who struggle to use tools and are falling behind, and “figure out a way to engage with them to understand why.”

There’s a lot that can be done to more effectively configurate workflows, but it can’t be done without involvement and input from those on the frontline, whether it’s through committees, rounding, or other means, the panelists noted.

“You have to engage with your end-user community, gather that input in some way, shape, or form, and react to it,” said Restuccia. One way is through committees, which offer “an opportunity for clinicians to get involved in the decision-making process” rather than being something that’s done to them. “If you’re bringing in new technology, you better understand how it fits in with everything you have and how it impacts the way things will get done. If you’re not paying attention to that, you’re almost being negligent.”

Another highly recommended course of action is rounding, which has been a game-changer at UI Health. “It’s about getting out and having your governance groups get a pulse on what’s happening and what are the areas of satisfaction and dissatisfaction,” said Polikaitis. In his experience, it has brought struggles to light and enabled his team to take action.

The challenge with that, however, is convincing already stressed clinicians to give even more of their time. “It’s an interesting paradox,” Polikaitis said. “If they invest 20 minutes to get a little bit more educated on what they’re doing and how they’re using the tool, they might save themselves four hours a week. But it’s a hard sell.”

Culbertson seconded the importance of training, noting his organization has observed that clients who provide “robust” training on new tools see much more effective (and one can assume less burned out) users. “We can see it on the time-in-record, and it’s not equal across all organizations because of differences in training.”

The Power of CMIOs

This is where CMIOs and other clinical informatics leaders can play a key role, noted Polikaitis, who urged CIOs to formulate close relationships with these individuals. “The CMIO has a lot of power. Leverage that capability, whether it’s a formal CMIO or a physician leader — that’s the conduit,” he said, adding that most physicians feel far more comfortable sharing concerns with their peers.

Tobias agreed, adding that having a CMIO who’s “empowered to engage with clinicians to understand workflow and ensure that tools are implemented appropriately” can make a huge difference. “Sometimes tools don’t perform as expected. The people who have their ear to the ground in these clinical environments are the ones who are going to be able to enact that iterative improvement.”

They can also provide the type of support that can only come from those who have been in the trenches, noted Restuccia, who is a big advocate of leveraging clinical informatics teams for shoulder-to-shoulder support. “They want someone who really knows what they’re doing and can say, ‘you can do this in two clicks versus eight clicks,’” he noted. “That person is valuable to them.” And although it’s extremely beneficial for IT leaders to observe tools being used in action and make adjustments, “it’s even better when we have frontline people out there.”

Tobias concurred, noting that clinical informatics teams are “often under-resourced,” despite the key role they can play in improving usability as well as satisfaction. The ability for these individuals to “understand local workflows and empower users with resources is incredibly important.”

Taking action

And the way to do that, plain and simple, is through “upfront engagement and one-on-one conversations,” noted Restuccia. “That’s where we get the most feedback.” It also helps build credibility for IT departments, which “deliver a heck of a lot of value and effort,” despite having to contend with so many requests.

What’s important, he added, is for leaders to emphasize that, although it may seem overwhelming dealing with so much input, the ideas coming in are all intended to help improve care and efficiency and optimize workflows. “They’re all trying to do their job in the most effective manner,” Restuccia added. “It’s up to us to work with our colleagues to prioritize and then implement. But that engagement is really key.”

Polikaitis agreed, adding that it’s imperative for leaders to set the right tone and ensure they’re “constantly open to feedback,” rather than getting defensive. “We need to be able to put things into action in a quick matter that makes people feel like they’re being heard.”

And in doing so, help provide some much-needed relief from burnout.

To view the archive of this webinar — How IT Departments Can Battle Clinician Burnout with Presence, Transparency & Action (Sponsored by Protenus and Phrase Health) — please click here.