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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As hospitals and healthcare organizations work toward better patient care, they can begin by taking a closer look at their internal processes and technology. A reliance on disparate systems that fail to share data efficiently puts organizations at risk of falling short of the demands of modern healthcare. The Agency for Healthcare Research & Quality stated that one of the three most critical challenges facing today’s healthcare organizations in their mission to improve patient care is “establish[ing] an integrated data, analytics, and information platform, along with the necessary technical expertise, to capture a 360° view of the healthcare system.”
The healthcare claims process, too, can benefit from a single integrated healthcare risk management system. Having incident reporting and claims management functionalities working seamlessly in one platform offers three major advantages.
1. Increased efficiency and accuracy
Just as working with a single insurer is easier than working with several, integrating healthcare incident reporting and healthcare claims administration into one system can be easier than tracking each in separate systems. But unlike insurance, where receiving multiple coverages from the same insurer may not be possible, hospitals can integrate incident data and claim data with ease through healthcare risk management software like Origami Risk.
Having all data in one system adds convenience for healthcare risk managers who may have previously had to toggle between systems to follow along with the claim lifecycle—from the initial reporting of an incident to the closure of the claim. A daily reality that the article Improving Claims Management with Advanced Integration summarizes as “the need to switch between multiple software systems in order to find all the relevant information on a specific claim. It’s critical to have all pertinent data in one spot to reduce and/or eliminate this quest for data.”
Navigating between two systems also results in detrimental switch costs, the fractions of seconds that occur when moving back and forth between systems. These switch costs rapidly compound, leading to wasted time and increased errors, including misaligned data. With an integrated healthcare risk management system, healthcare risk managers no longer have to bounce between systems throughout the claim lifecycle. If an incident turns into a claim, they can monitor it or move it further along in the process without losing the original incident record.
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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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A 2016 analysis published in BMJ revealed that medical error is the third-leading cause of death in the United States. This includes process errors, planning errors, and failures to act. Martin Makary, a health policy expert at Johns Hopkins and an author of the analysis, explains that the “complex medical system” in the U.S. “sometimes lacks transparency that results in the wide variation in quality of medical care that is the endemic problem in safety.” Makary also notes that “safety nets are missing and standardization is lacking.”
At the heart of this standardization problem lies outdated technology and confusing systems. Many healthcare providers continue to use lagging systems that don’t efficiently collect or analyze data. Furthermore, a mix of legacy and new systems makes for potential conflicts that add to the confusion and fortify workplace silos. Without the sharing of information, organizations fail to see big-picture strategies and solutions that could help prevent medical errors and increase patient safety.
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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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Every seven seconds, a worker is injured on the job, totaling 4,500,000 injuries per year. Astounding statistics. The worst part? Many of these injuries are preventable.
Loss reduction efforts and improvements in safe workplace behavior require the cooperation of everyone in an organization. When incidents and near misses aren’t reported, injuries occur that might have been prevented—at a significant cost to injured employees, their families and communities, and their employers. An effective approach to incident management encourages an expansion in the reporting of incidents and near misses by both workers and their supervisors.
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Workplace incidents are far more numerous and costly than most people realize. The National Safety Council estimates that the average cost of a medically consulted injury in 2015 was $31,000. The average cost of a fatality, $1 million. That year, on-the-job injuries numbered approximately 4.4 million. 4,190 on-the-job fatalities were reported.
In many cases, workplace incidents are also entirely preventable. As pointed out in the EHS Today article “Sustainable Safety Management: Incident Management as a Cornerstone for a Successful Safety Culture”, studies show that a significant number of workplace accidents occur “as the consequence of minor lapses, and usually of not just one lapse but the sequence of minor failures. A combination of minor lapses can create a safety gap that can lead to major accidents.”
An effective approach to incident management is one that encourages reporting of all workplace incidents. Risk managers and safety leaders can then draw from that information to identify, analyze, and correct hazards with the goal of preventing future occurrences. … read more
This is the second in a series of five brief articles on key data issues identified by several prominent risk managers at leading UK and European companies. In April, they participated in a roundtable on future-proofing management information (MI). The event was co-hosted by Gallagher Basset and Origami Risk.
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Risk Managers and Claims Adjusters know how important it is to collect detailed incident data. Many companies have unstructured collection methods, though, ranging from phone and e-mail to fax and paper. This can lead to inaccurate and inefficient incident data collection, causing challenges that might result in higher claims costs.
A modern RMIS enables clients to easily capture structured data in a manner that is understandable to the field and can include supporting documents and pictures. The key benefits of using a RMIS for incident collection are:
- Managing claims earlier
- Ability to analyze incidents
- Flexibility to change the data collected
All of these benefits can play a part in reducing workers comp litigation as employees can receive communication earlier and companies can better prevent injuries. … read more