National Academy of Medicine Tackles Healthcare Worker Burnout 'Crisis'

A new clinician burnout report from the National Academy of Medicine includes six recommendations to address the problem.

The National Academy of Medicine has released an extensive report on how the country can respond to burnout in the medical professions, with the president of the organization calling burnout an epidemic in need of urgent action.

Research indicates that about half of physicians nationwide are experiencing burnout symptoms, and a study published in October 2018 found burnout increases the odds of physician involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction. Burnout has also been linked to negative financial effects at physician practices and other healthcare organizations.

The new report was unveiled Wednesday at an event held in Washington, DC. Victor Dzau, MD, president of the National Academy of Medicine, made a passionate call to action.

"Our nation is facing an epidemic of clinician burnout. Over the past several years, the medical community has recognized an alarming crisis of physician burnout and suicide, although the public remains largely unaware of it. So, it is in the interest of ensuring quality patient care and well-being of our clinicians that today's report is released to shine the spotlight on the crisis and recommend solutions to prevent it," he said.

Burnout is widespread throughout the medical community, Dzau said.

"The epidemic of burnout affects both those in training as well as those in practice. Over 50% of physicians and 45% to 60% of medical students and residents have symptoms of burnout. Furthermore, physician rates of depression or suicidal ideation remain very high—as high as 40%. This issue is not unique to physicians. There are high prevalence rates of symptoms of post traumatic stress disorder and emotional exhaustion among nurses and many other health professionals."

Burnout among healthcare workers has significant implications for patient care and society at large, he said.

"Burnout has been linked to self-reported errors, patient dissatisfaction, a reduced ability to express empathy, increased familial problems, stress-related illnesses, automobile accidents, and substance abuse. Clinician burnout also is a threat to the quality of patient care."

The new report was crafted by the National Academy of Medicine's Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. To address burnout among healthcare professionals, the report makes six recommendations, which are highlighted below.

1. Foster positive work environments
 

Healthcare settings should be transformed in ways that prevent and reduce burnout, support professional well-being, and promote quality care.

For example, senior leaders of healthcare organizations should be committed to monitoring and improving the clinical work environment. "Specifically, governing boards should hold organizational leaders accountable for creating and maintaining a positive and healthy work environment," the report says.

2. Promote positive learning environments
 

Medical education and training should be improved to create learning environments that prevent and reduce burnout as well as promote professional well-being.

For example, learning environments should support quality patient care with a collegial approach to learning. "Enhance the ability of learners to contribute meaningfully to patient care while learning, and implement strategies that build relationships among and between learners, faculty, and other health professionals with the intent to build social support and interprofessional practice," the report says.

3. Decrease administrative burden
 

Actions should be taken to address the negative side effects of laws, regulations, policies, and standards set by government agencies, professional associations, and accrediting organizations.

For example, resources should be allocated to assess the impact of laws, regulations, policies and standards. "Formal assessment should be conducted both prior to and following implementation in order to evaluate how the requirements affect clinician workload and whether they are redundant or conflict with other requirements. Regulations, policies, and standards should then be modified accordingly," the report says.

4. Develop technology solutions
 

Health information technologies should be redesigned and improved in ways that help clinicians to provide high-quality care.

For example, health information technology enhancements should focus on improvements that support clinicians and other healthcare professionals. "Health IT vendors and healthcare organizations should design and configure systems to improve the clinical work environment, including attention to cognitive load and workflows that reduce the demand of clinical documentation and automate non-essential tasks," the report says.

5. Support clinicians and trainees

Efforts should be made to decrease prejudice against healthcare professionals who experience burnout and to tear down barriers to receiving support and services to address burnout.

For example, barriers to receiving burnout support and services in training settings should be identified and brought down. "Health professions educational institutions, healthcare organizations, and affiliated training sites should identify and address those aspects of the learning environment, institutional culture, infrastructure and resources, and policies that prevent or discourage access to professional and personal support programs for individual learners and clinicians," the report says.

6. Promote research
 

Funding should be allocated to support research of clinician professional well-being.

For example, federal agencies such as the Agency for Healthcare Research and Quality, the National Institute for Occupational Safety and Health, and the Health Resources and Services Administration should lead efforts to research burnout and burnout interventions. Federal agencies should work in public–private partnerships with a range of stakeholders, including professional associations, foundations, payers, healthcare organizations, and professional liability insurers.

"Organizations need to be willing to test, learn, and share in order to accelerate the pace of change," the report says.