Even physicians who aren’t themselves experiencing burnout see the massive scope of the crisis in the U.S. But leaders who want to tackle what can seem like an overwhelming problem may be struggling with where to begin. The AMA offers a clear, step-by-step process that emphasizes the most basic action: assessing clinician burnout.
The newly revamped AMA STEPS Forward® toolkit, “Assessment of Clinician Burnout: Construct a Process to Measure Burnout and Improve Well-Being,” lays out six steps with practical actions that organizations and leaders can take to move down the path to protecting physicians from some of the most damaging effects of work stressors, first by getting their arms around the problem.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
While acknowledging that “self-care” acts such as getting enough exercise and adequate sleep can help physicians, the toolkit emphasizes that organizational actions will always be more effective in preventing burnout. It says that research has shown that time pressure, lack of control, chaotic environments and organizational culture—factors over which organizations have at least some influence—drive burnout.
With that in mind, the toolkit offers concrete steps for assessing the impact of burnout in an organization and beginning to work to reverse its ill effects.
Establish quality indicators
Key to the process is displaying a commitment to tackling the problem. Include in core quality metrics well-being measures like job stress, burnout rate, intent to leave and job satisfaction.
Also educate leaders in the organization about the many ways that clinician burnout negatively affects the organization—impacts including reduced empathy and patient satisfaction, decreased patient adherence to treatment recommendations, clinician reduction in work effort and turnover.
The cost of physician turnover, in particular, can be directly measured in a way that shows how reducing burnout helps not just morale but also the bottom line.
Create a well-being committee
Most organizations are structured in such a way that they require a dedicated chief wellness officer (CWO). The CWO can serve as a point of contact for well-being related topics, spearhead planning and implementation, and communicate with leadership.
Use a validated assessment tool
There are several tested methods of determining the current state of well-being and burnout at an organization such as the AMA’s Organizational Biopsy®.
Though conducting regular assessments—typically once a year—is a vital part of the process, organizations that haven’t undertaken any major action since the last assessment should consider making changes before surveying again.
Share results with key stakeholders
After an assessment is completed, key stakeholders should be apprised of the results. These stakeholders include clinicians invited to participate in the survey, well-being committee members, senior executive leaders, departmental leaders, operational leaders, practice managers, finance team members, trainees (if surveying them) and program directors.
The presentation should take care not to identify any specific individuals, data should be shared across practices and information should be broken down by department in large organizations.
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Discuss results and build a plan
After the results have been shared, the next step is to meet with stakeholders to identify priorities and make recommendations for what interventions to undertake. The data provided should help determine the most pressing concerns, and which areas require the most urgent help. Departments with the highest levels of burnout should get the earliest attention, followed by those with the highest stress levels.
The most common efforts to tackle burnout include patient care workflow redesign, EHR optimization, deimplementation and reduction of administrative burdens and improved organizational support for individual clinician well-being.
Measure the effect of interventions
The work is not completed once action has been taken. It’s possible that some measurements may initially seem stagnant, though intermediate indicators—such as reductions in “pajama time” or work-outside-of-work after an EHR inbox redesign—may show quicker improvement.
Progress may be slow and steady, but blame should not be issued to units or leaders with high burnout rates. And all successes should be celebrated.
Ultimately, the impact of burnout on patients, physicians and organizations is clear, and assessing it and well-being is the first step in turning the tide.
AMA STEPS Forward open-access toolkits offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These resources can help you prevent burnout, create the organizational foundation for joy in medicine and improve practice efficiency.
