MedCity Influencers

5 prescriptions for clinician burnout and workforce resiliency

With stretched resources and burnout rates reaching historic proportions, there are practical ways for leaders to invest in their most strategic asset: the workforce.

The settings may differ, but the realities are the same. At hospitals across the country, an influx in demand and limited resources have put so much pressure on the healthcare workforce that more than half of hospitals have over 100 job vacancies.

It’s a top-of-mind challenge for hospital and health system CEOs: “How can we create an environment that eases stress for existing staff and creates a culture where people want to come to work?” While much attention is given to the plight of physicians, nurses, and other frontline workers in this environment, the truth is that healthcare professionals at every level are stretched operationally, physically, psychologically and emotionally.

Typically, periods of intense acute care activity in hospitals and outpatient centers—such as during flu season—are followed by quieter periods. But periods of relaxed activity have been far and few during the Covid-19 pandemic. In fact, the effect of sustained stress on the healthcare workforce could be leading to post-traumatic stress disorder for some staff.

The ramifications of prolonged stress on workforce operations and culture run deep.

Today, nursing turnover rates are as high as 40% at some organizations. Meanwhile, health systems across the country now pay a cumulative $24 billion more per year for qualified clinical labor than they did pre-pandemic. A Mercer analysis projects a shortage of three million ancillary caregivers by 2026.

In this environment, half of healthcare employees say the demands of their work leave them feeling defeated. “Don’t do it unless you have a death wish,” one professional warned in a Fall 2021 survey of healthcare employees, while another cautioned new trainees, “Be prepared for extremely long hours and a stressful work environment.”

How can healthcare leaders better support staff while building strategies to attract top talent? 

Here are five prescriptions for positive change.

1. Get feedback on what employees want and act on it. 

Leading organizations establish “listening sessions” with frontline associates to understand their employees’ biggest challenges and uncover practical ways to address them. These might include alternative shifts and schedules that better meet employee needs and improve their mental health and quality of life. Listening sessions also offer an important opportunity for leaders to respond to concerns, such as the use of travel nurses, by explaining, “We may not want to pay a premium for these resources, but they help us meet the demand for care without tightening pressure on existing staff. They also strengthen our ability to provide high-quality, highly reliable care.”

By hosting forums where employees can offer and obtain honest feedback, healthcare leaders can gain a more nuanced view of and effectively take steps to address what employees want and need.

2. Help employees work at the top of their skillset. 

It’s not uncommon for care teams to be so short-staffed that managers must join employees on the floor. While staff appreciate leaders for stepping up, they also need managers to find time to engage with, check on, advocate, and care for them. When managers are unable to nurture employees during times of stress, it reinforces the feeling that the burden on their teams is severe and unsustainable.

As leaders look at the ways in which the healthcare landscape has evolved, it’s time to not only consider opportunities to reshape the composition of the workforce to adapt to near-term demand, but also ways to make work more fulfilling. For instance, how could new roles or the use of technology help scale care delivery and support existing staff? Reimagining work processes to optimize staffing and assure a top-of-license focus is key. It also necessitates reliable structures, systems, and workflows that can sustain teams during longer-term crises, including tech-enabled processes that lessen administrative burdens.

Some leaders use design-think huddles to establish near-term tactics that reduce consumption of resources in the acute setting. From there, they engage team members in designing processes and systems that create a nimbler and more durable operating model. It’s an approach that enables organizations to leverage their most valuable asset—their staff—as well as their infrastructure for optimal efficiency, quality of care, and employee experience.

3. Invite a more diverse and equitable workplace.

Employees demand more diverse, equitable work environments that reflect the communities they serve—and so do patients. Typically, when people think of diversity, race and ethnicity come to mind, and numerous studies underscore the benefits of racial and ethnic diversity in understanding patients’ belief systems and values, and in creating and sustaining a high-performing, supportive work environment. But it’s also important to consider generational diversity and diversity in sexual orientation and lifestyle, which impact the way people approach how and where they work.

In a recent study, health system CEOs cited that they are focused on training managers for diversity and attracting talent for diversity and inclusiveness this year. The greater the level of diversity within a healthcare team, the better positioned teams will be to understand differences between cultures and generations. This empowers leaders and teams to respond more effectively and more sensitively to the unique needs of employees and patients in a variety of circumstances. It’s also an important step toward transformational culture change that resonates with teams.

4. Invest in total reward innovation. 

Leaders often see the stats on mental health—such as 42 percent of nurses experiencing symptoms of post-traumatic stress disorder—and wonder: “Why aren’t they taking advantage of our employee assistance program?” It’s natural to want to engage employees in this resource, where employees can access services free of charge, often on demand.

However, there are other programs and benefits that can improve employee mental health and quality of life, such as alternative shifts and schedules. Taking a holistic approach to reward innovation enables leaders to create market-competitive, customized benefits and compensation. It also results in programs that promote greater joy in work.

For instance, at a time when more than 75 percent of the healthcare workforce is female, progressive organizations are thinking through how to put greater emphasis on benefits that support women’s health. They are also exploring avenues for caregiving assistance—both childcare and family caregiver resources and support—to meet whole-person employee needs.

5. Lean into empathetic automation to create a more satisfying work environment. 

Hyperautomation presents strong potential to create reliable structures and systems that can help sustain teams during long-term crises, strengthen staff retention, and reduce burnout. This type of technology enablement can help overhaul and streamline workflows, making work easier for staff while ensuring the right people do the right work at the right time. It can also instill durability within systems, remove low-grade administrative tasks, and help drive high-value patient experiences.

Empathetic automation means removing repetitive tasks from daily staff requirements, helping them focus on more meaningful work. This includes automating rules-based, repetitive processes, such as data management, report creation, and routine digital communications such as email and online chats. Processes like these are perfect for automation because they take a lot of time to perform manually, yet they are simple to automate. And, since every department or division can point to repetitive and manual tasks, employees are a great source for understanding where automation could drive the most efficiency.

There has never been a more important time to focus on the employee experience.

By reimagining processes, staffing, and benefits to transform the experience of work for healthcare professionals, leaders can create a healthier and more fulfilling workplace, today and for the future. Initiating these efforts may be uncomfortable, but real change often is.

Photo: gpointstudio, Getty Images

Edward Abraham, MD, is a Partner at Guidehouse with decades of physician leadership experience. He is the former CEO of the University of Miami Health System, Dean of the University of Miami, and Dean of the Wake Forest School of Medicine.

Sarah Markowitz, RN, is a Managing Consultant at Guidehouse with 20 years of bedside clinical experience. She received both a Master’s in Healthcare Administration and Law from the University of Pennsylvania. Guidehouse is a leading consultancy with expertise in management, technology, and risk. The Guidehouse Health team helps hospitals and health systems, government agencies, life sciences and retail companies, and payers solve their most complex issues, overcome unique market challenges, and deliver innovative services to their communities and customers.

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