Curb Clinician Burnout with This 4-Point Strategy

To decrease burnout and increase resilience, you must deconstruct burnout into its component parts, understand the interplay between stressors and rewards, measure clinician experience, and design interventions.

Clinician burnout is a complex problem that can be addressed with thorough examination of working conditions and carefully targeted interventions, according to a Press Ganey report released this week.

"The approach rests on the premise that the stressors and rewards that contribute to burnout risk derive from different sources, and the way individuals and teams respond to these stressors and rewards varies based on job responsibilities, personal values and professional experiences," the report says.

The report, "Burnout and Resilience: A Framework for Data Analysis and a Positive Path Forward," calls for a four-point approach to reduce burnout and increase resilience among medical staff:

• Deconstructing burnout into actionable components
• Understanding the interrelationships between burnout components
• Measuring the clinician experience as it relates to components of burnout
• Designing interventions that boost resilience and reduce burnout

1. Deconstructing burnout

The Press Ganey report deconstructs burnout by categorizing stressors and rewards as inherent to a caregiver's role or the result of external forces. "Deconstructing burnout into relevant component parts allows leaders and organizations to identify and manage each appropriately," the report says.

Inherent components of burnout and resilience:

• The emotional drain linked to providing care to the ill
• Witnessing suffering
• The daily pressure of making clinical judgments that affect patients' lives
• Rewards include the joy of helping people, doing meaningful work, and respect from patients, staff, and the community

External components of burnout and resilience:

• Documentation burden
• Working with electronic health record
• Low staffing levels
• Pressure for increased productivity
• Diminished autonomy
• External rewards include compensation, prestige, and recognition from patients

2. Interrelated stressors and rewards

The interplay between stressors and rewards is the key to understanding physician burnout, the report says. "These stressors and rewards define the clinician experience, and the balance between them influences clinicians' vulnerability to burnout."

It is crucial to not only identify components of burnout but also understand how those components interact, according to the report. "The balance is not a simple, linear equation. … The relationship is modulated by the dynamics of the different sources of stress and reward and their interconnectedness."

For example, physicians are admired for mastering medical knowledge, but keeping up with the flood of medical information can lead to anxiety and self-doubt.

3. Measuring the clinician experience

Addressing burnout requires collecting data on multiple measures, the report says.

"Leaders focused on reducing burnout and improving resilience in the clinician workforce should be prepared to measure engagement with sufficient thoroughness and frequency that the data allow segmentation, benchmarking and detection of change."

Press Ganey has developed an eight-point assessment tool to measure clinician resilience. The first four questions gauge capacity to disengage from work:

• I can enjoy my personal time without focusing on work
• I rarely lose sleep over work
• I can free my mind from work when I am away from it
• I can disconnect from work communications during my free time

The last four questions in the assessment tool measure engagement with work.

• I care for patients equally even when it is difficult
• I see every patient as an individual with specific needs
• The work I do makes a real difference
• My work is meaningful

4. Designing interventions

The report says there are four steps to developing an organization strategy for enhancing resilience and decreasing burnout:

• Communicate the gravity of burnout, accept responsibility for addressing external stressors, and offer resources for coping with inherent stressors
• Measure engagement and resilience of physicians, nurses and other key personnel, benchmark at unit levels, and monitor change as­sociated with interventions
• Promote inherent rewards to boost clinician engagement
• Foster a culture of wellness and resilience