Workplace burnout has become so common across industries that, as of May 2019, the World Health Organization (WHO) recognizes it as an occupational phenomenon in its International Classification of Diseases Handbook.
In the healthcare industry, burnout is a reality and is described by those on the front line in alarming terms. According to a NEJM Catalyst survey Immunization Against Burnout, “83% of respondents — who are clinicians, clinical leaders, and health care executives — call physician burnout a ‘serious’ or ‘moderate’ problem in their organizations.” Based on survey results like these, a report titled A Crisis in Health Care: A Call to Action on Physician Burnout called physician burnout “a public health crisis.”
Burnout has reached crisis level for many reasons, including its prevalence and its effect on staff turnover. But it’s had unexpected consequences for patient care, as well. A JAMA Internal Medicine study concluded that physician burnout doubled the odds of an adverse patient safety event. According to the report, this includes “unsafe care, unprofessional behaviors, and low patient satisfaction.”
In the first part of a two-part series, we examine the main drivers of hospital staff burnout, its far-reaching consequences for healthcare organizations and patients, and how the right technology can play a key role in reducing its widespread nature.
Understanding burnout and its consequences
The WHO officially defines burnout as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- feelings of energy depletion or exhaustion;
- increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
- reduced professional efficacy.”
Burnout affects clinicians on an individual level, delivering the mental and physical exhaustion mentioned above. Far from being only a staff issue, burnout has serious effects on hospitals and patients in profound ways.
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In November 2018, Baylor St. Luke’s Medical Center in Houston made two medical errors, the second of which lead to the death of a 75-year-old patient. After an investigation by the Houston Chronicle and ProPublica, the Centers for Medicare and Medicaid Services issued a report in early 2019 that outlined a pattern of blood labeling errors at the hospital. A ProPublica article on the report states:
Dr. Ashish Jha, an expert in hospital quality, reviewed the government’s findings and said it appeared St. Luke’s was struggling to meet basic care standards. The labeling mistakes, he said, seemed indicative of ‘a broader systemic problem.’… St. Luke’s appeared to miss warning signs in the months prior to the deadly mistake, according to the government report.
The “broader systemic problem” Dr. Jha mentions is, unfortunately, not unique to St. Luke’s. Many hospitals and healthcare systems face organization-wide, process-related issues, especially in a modern healthcare landscape that’s rife with change. Mergers, multiple technology platforms, and changing healthcare policies, to name just a few, contribute to widespread miscommunication and a lack of transparency. This, in turn, jeopardizes the overall quality of care within these organizations.
Hospitals can stem the scope of these issues by implementing a healthcare enterprise risk management (ERM) program. Healthcare ERM establishes a standardized framework for identifying risk across an organization, encourages cross-departmental collaboration, and shifts hospitals from a reactive clinical risk program to a proactive holistic risk management program. A straightforward process, along with the right technology the leverages healthcare analytics, can help to make this shift effective.
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Adverse safety events—some that lead to serious harm—occur every day, affecting people across entire health systems. The ability to collect and analyze this data is crucial for preventing future incidents and improving patient safety. Yet, according to a 2008 study, “only 13% [of U.S. hospitals] have broad staff involvement in reporting adverse events.”
With a full schedule of patients and life-or-death situations a part of daily life in hospitals, reporting efforts, not surprisingly, may end up taking a back seat. Sometimes, however, the issues that impact reporting run deeper. Hospital staff may fear repercussions from reporting safety events. In other instances, the reporting process may be so convoluted and time consuming that, despite good intentions, staff is discouraged from doing so. Or maybe, the biggest issue comes after reporting, with hospitals failing to share or apply healthcare analytics in a way that positively impacts the quality of care provided and makes staff feel a part of something bigger.
No matter the reason, any issue that negatively impacts patient safety event reporting has consequences for every person associated with a hospital or health system—especially the patients. In fact, the ECRI Institute listed “standardizing safety efforts across large health systems” as one of the top 10 patient safety concerns for 2019. Even events that seem minor have the potential to result in grave harm. The Joint Commission reported medication error and product and device events in the list of top 10 most frequently reported sentinel events in hospitals in 2018.
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Winter Storm Harper took its toll on large parts of the Midwest and Northeast, causing several deaths, hundreds of car accidents, and power outages that affected tens of thousands, according to the Weather Channel.
Extreme weather—from blizzards to hurricanes to wildfires—wreaks havoc on businesses in every region of the country, with damage having a lasting effect. In fact, according to the Insurance Institute for Business & Home Security, 40% of small businesses do not reopen after a severe weather event. This is in part due to a failure to have an actionable plan in place. As we discussed in Step up your disaster preparedness, don’t wait for the news report, organizations can get tripped up when there’s confusion over who should act and what those actions should be during a weather crisis. Without clear plans, practice, and timely alerts, critical resources may fail to execute.
Origami’s cloud-based RMIS continues to make weather preparedness a priority. With our new proximity search feature, audit functionality, and flexible data integration, you’ll be able to quickly identify major weather risks and effectively communicate how key parties can take action.
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Whether it’s boxes of paper forms that must be keyed into a system, pouring over spreadsheets to verify that critical requirements are met and up to date, or sending yet another email to request missing information, there’s almost always room for improvement when it comes to the management of vendor-related data and workflows.
From the submission of application forms through to the evaluation of vendor performance, businesses can add to the value of their risk management information system (RMIS) by using the system to transform their approach to vendor management. In this post, we look at four examples of how a cloud-based RMIS like Origami Risk can contribute to cost control, service excellence, and risk mitigation.
1. Streamline the vendor intake process
Simplifying the vendor application process reduces the amount of time staff spend engaged in time-consuming, repetitive activities like keying data and sending multiple emails to chase down missing details. This process can also be the first step in defining expectations and building a relationship with potential vendors. After all, as 6 essential steps for managing vendors makes clear, “A good vendor relationship starts well before you ever sign a contract with a vendor.”
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The importance of establishing a near miss culture is clear. The OSHA and National Safety Council Alliance, a cooperative program, puts it this way: “History has shown repeatedly that most loss producing events (incidents), both serious and catastrophic, were preceded by warnings or near miss incidents. Recognizing and reporting near miss incidents can significantly improve worker safety and enhance an organization’s safety culture.” Effective near miss programs can prevent more serious incidents from occurring.
A previous post highlights some of the challenges surrounding this issue. Fear of reprisal or embarrassment, difficulty in the reporting process, and a sense of futility if reports don’t result in tangible changes. Each challenge presents obstacles when trying to establish a near miss culture.
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A recent Business Intelligence article draws from a Redhand report claiming that “of all of the subsectors of the RMIS industry, the third-party administrator sector is the one that is the most in transition.” The article suggests this may be due to the fact that TPAs are trying to remain competitive while relying on fewer resources than insurers.
What is clear, according to the Redhand report, is that TPAs are trying to level the playing field with technology. “As will become obvious, there has been a lot of investment and improvement in the TPA sector regarding information technology…” The larger question is, are these substantial investments in upgrading systems even focused on the right area? A survey of customer data indicates this may not be the case.
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Munich Re reports that 2017 was the second most expensive year for natural disasters ever recorded, with overall global losses estimated at over $360B. For the U.S., last year’s severe storms resulted in a share of losses that was significantly higher (50%), than the long-term average (32%). A recently published Business Insurance special report cites estimates of insured losses of $15.4B–with $12B caused by inland flooding–stemming from Hurricane Harvey, alone.
Ernst Rauch, head of Munich Re’s Corporate Climate Center, holds that these patterns are likely to continue. “We have a new normal. 2017 was not an outlier.”
A quick look at the weather on the first day of Spring seems to underscore that point.
- Businesses in the mid-Atlantic and Northeast expect to be digging out from the fourth winter storm in 3 weeks.
- High winds and hail are causing damage across the Southeast.
- Flash flood watches have been issued by the NWS in parts of Southern California.
Is your business prepared for the “new normal”?
With large-scale natural disasters becoming increasingly common and more costly, a renewed focus on business continuity and disaster recovery is essential. Preparing for these events, along with the ability to rebound from them, are a factor on which businesses must now be able to compete. … read more
The competitive pressures facing brokers are unrelenting. In Zywave’s 2017 Broker Services Survey, conducted last summer with over 600 respondents, the results paint a stark picture of the competitive marketplace. Nearly 1 in 5 respondents changed brokers over the past three years. Approximately 70% indicate they would abandon their current broker for communication or service related issues. In fact, the top three stated reasons that would make respondents leave a broker were all communication related. In contrast, leaving for a broker who can lower premiums ranked a distant 6th place. Today’s broker has to compete on communication, or suffer the defection of clients to those who do.
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