As the hospital burnout crisis continues to make headlines, healthcare organizations are in need not only of solutions that address the consequences of burnout, but also strategies for preventing burnout in the first place. As discussed in part 1 of this series, the right healthcare risk management technology can play a role in efforts to ensure physicians are more fully engaged. Physicians who feel connected to the core purpose of their work are less likely to burn out, and more likely provide quality patient care.
Another approach to addressing clinician burnout is the establishment of an organization-wide plan to monitor, analyze, and, ultimately, prevent the condition from occurring. Efforts to mitigate burnout will likely come from many directions within an organization, but to streamline the process and get everyone on the same page, a logical but perhaps unexpected place to start is with the hospital risk management team. Healthcare risk managers can play a crucial role in successfully preventing burnout by viewing burnout like the other risks they manage, developing a healthcare enterprise risk management (ERM) framework, and leveraging the technology they already work with on a daily basis.
A healthcare ERM program is ideal for addressing a systemic problem like burnout because it shifts the focus of an organization from a reactive mindset to a proactive one. By accurately monitoring for the specific causes/symptoms of physician burnout, hospitals can be one step ahead of the problem. Additionally, reporting on the results of an ERM program will hone strategy and demonstrate progress to a staff that sorely needs the morale boost.
In the development of a healthcare ERM program that helps prevent clinician burnout, there are some key elements to consider:
Establish the strategic goal related to burnout
The first step in developing a healthcare ERM program to significantly reducing or eliminating burnout is getting staff at every level to acknowledge the problem and its far-reaching consequences, and understand the importance of addressing it head-on. The article A simple strategy helps doctors fight burnout. Could it work for the rest of us? puts it this way:
“Doctors, nurses, and caregivers have a special role. In literal matters of life and death, they are seen as the gatekeepers to health, to freedom from the hospital, to freedom from pain. It’s an enormous responsibility that comes with great reward on the best days and great challenges on—well, on pretty much all the days.
The old school way of dealing with it was, ‘We’re the best, we’re tough, we don’t sleep, aren’t we great,’” a doctor at Kaiser said. “But now I think its different. The newer generation is saying, ‘Hello, I’m a person, too.’”
As mentioned in part 1 of this series, burnout not only affects clinicians on a personal level, but also leads to staff turnover, an increase in patient safety events, and potentially millions of lost dollars for hospital systems. Healthcare risk managers can analyze the many ways burnout is affecting the organization, its staff, and its quality of care—and then use that to shape important conversations with leadership, as well as develop strategic goals like reducing patient safety events by 10% in the next five years.
Once the strategy has been established, it’s crucial for healthcare risk managers to get continued buy-in at every level. As the article GRC: Where to start? Productive healthcare ERM tools states, “ERM thrives only when ownership of the program is shared across the entire organization (hence the enterprise in enterprise risk management), and when core strategic goals have been properly communicated with those various departments.”
Create risk assessments
The next step in creating a healthcare ERM program to combat burnout is using the right technology. Hospital risk managers with access to healthcare risk management software can leverage several functionalities to monitor staff burnout, including the risk assessment.
Origami Risk’s healthcare risk management platform allows for the creation of customized risk records so organizations can highlight the factors most vital to their strategic goals and receive tailored data. The assessments could, for example, include fields for the symptoms of burnout as defined by WHO: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.
To prevent burnout before it begins, the evaluations should delve as deep as necessary. A Penn Medicine pilot study, for example, found that, “shortening the length of rotations in a medical intensive care unit from the traditional 14-consecutive day schedule to only seven days helps mitigate burnout among critical care physicians.” Shorter rotations, “not only led to lower burnout rates — by as much as 41 percent — but the change also resulted in increased job fulfillment.”
Within a healthcare system, individual hospitals can discover ideal rotation lengths (along with other contributing factors) by analyzing the data gathered through customized risk assessments. If, say, data indicates that further reducing rotations from seven days to six days leads to another big reduction in burnout symptoms, the change may be worth it.
Customized risk assessments and evaluations only work if they’re followed by corrective actions or further investigation. As the American Hospital Association’s Well-Being Playbook: A Guide for Hospital and Health System Leaders states, “Beware of the trap of worsening burnout by administering a survey and not providing follow up. Frequent follow up to survey participants for issues raised, even if to explain why a particular issue is not currently solvable, is critical.”
The Origami Risk solution allows for not only the creation of highly configurable risk assessments that are easy to assign and complete, but also automated monitoring and alerts that can track important data points and assign corrective actions. Healthcare risk managers can set up an exception-based reporting structure, where metrics that fall outside of a certain range trigger notification. For example, if clinicians check two of the three symptoms of burnout, supervisors can receive immediate notification so they can properly intervene and take corrective action, such as adjusting a staff member’s schedule or changing overall caseload. These automated corrective actions keep accountability high and ensure nothing falls through the cracks.
Taking corrective action on symptoms as they occur, and before they result in full-fledged burnout, goes a long way to improving physician well-being and hospital culture. But lasting change comes from a more proactive and holistic approach. Healthcare analytics functionality can take data to the next level, using it to inform strategy and trigger preventative action. The article GRC: Where to start? Productive healthcare ERM tools states, “The real power of an ERM program comes from turning healthcare data into insight. While collecting data and sharing it with the right parties is a crucial piece of the puzzle, analyzing that data to inform better decisions is what moves healthcare organizations and their quality care efforts forward.”
Origami Risk’s healthcare risk management software provides risk managers with built-in healthcare analytics functionalities that can help combat systemic burnout at its source.
Origami Risk leverages several root-cause methodologies to help make better strategic decisions in the development of ERM programs. These proven tools will go far in the fight against burnout, too. The RCA2 method and the 5 Whys method allow healthcare risk managers to dive deeper into the cause-and-effect nature of burnout. Visual displays like the Fishbone diagram make the data easy to digest and share. The information gleaned from these root-cause methodologies tell healthcare risk managers what to keep an eye out for, and how to help guide organization-wide strategy.
Noticing an off-balance ratio can lead to corrective measures that can stop burnout before it starts and save hospitals millions of dollars. Such data points are known as leading indicators, which, according to The data-driven risk manager, are “metrics that foretell potential risks or negative outcomes” and “tend to be the most actionable type of information. Rather than looking at the after-effects of actions taken in the past, leading indicators predict events in the future.”
For example, nurse-patient ratio may be a key data point to monitor. According to the Nursing Standard, instituting nurse-patient ratios in Queensland, Australia, led to decreased burnout. “Data showed that introducing a maximum nurse-patient ratio of 1:4 on a day shift and 1:7 on a night shift had improved outcomes,” the article states. “Since the ratios were introduced a total of 145 patient deaths, 255 readmissions and 29,000 extra hospital days had been avoided, amounting to a saving of US $20 million (£15.9 million).”
In Origami Risk, dashboards can be tailored to automatically send notifications to the right people when a threshold is exceeded or a particular set of data points spikes. If a hospital detects a sudden increase in patients per nurse—or a gradual trend in that direction—they can intervene immediately, directing resources accordingly and reassuring nurses that they’re being looked out for. Cleveland Clinic has gone even further, implementing an initiative known as Code Lavender, which provides rapid emotional support to nurses in need.
Leading indicators not only lead to much-needed action, but also act as the starting point for important discussions, leading hospital executives to ask staff on all levels: What areas should we observe more closely? What is responsible for our current state? What measures can we take to make sure this doesn’t happen again?
The final piece to a successful healthcare ERM program that significantly reduces or eliminates burnout is keeping all parties involved and invested. The Well-Being Playbook states, “Regular updates to leaders and staff during meetings or creating an easily accessible dashboard of well-being projects will help keep all engaged and continue to focus organizational effort on well-being.”
The executive team must know if the strategic plan initially laid out is working. Origami Risk’s flexible reporting functionality allows healthcare risk managers to create tailored reports that deliver to stakeholders the information most relevant to them, demonstrate progress, and keep everyone on-strategy. Not only are these reports easy to create and run, but they can also be scheduled for automatic distribution. Such timely, consistent communication keeps the organization focused on its ultimate goal of reducing burnout and helps make the case for healthcare ERM.
Origami’s healthcare risk management software makes preventing burnout possible
Healthcare staff burnout is a major problem with many layers to unpack. While efforts to reduce or eliminate it must be organization-wide, healthcare risk managers can play a big role by using the tools at their disposal to automate the identification and management of this critical risk, and coordinating enterprise-wide initiatives designed to monitor, analyze and, ultimately, prevent burnout. Risk assessments and healthcare data analytics can provide fuel for a healthcare ERM program that dives deep into the root causes that lead to burnout, and built-in automation makes sure those efforts stay on track.
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