There’s an epidemic sweeping our hospitals and health care organizations, and it is impacting patients, providers, their families, and medical staff. The problem is physician and provider burnout, and it can adversely affect an organization’s bottom line, and even prove fatal for the provider. Numerous studies, including one reported on Current Psychiatry.com, reveal that the suicide rate for physicians is higher than that of the general population. It’s estimated that between 300 and 400 physicians a year, or one or more doctors a day, kill themselves. While the initiatives covered in this article may not have an immediate and widespread impact on these troubling facts, it is important to raise the issue of provider burnout and highlight initiatives that have proven to help address these concerns.
There are numerous studies and surveys about physician burnout, including one issued in 2017 by Medscape Physician Lifestyle Report, an online publication, which reveals 60 percent of physicians report burnout, close to double the number from 2013 when the problem was reported at slightly under 40 percent. It’s not only doctors who experience burnout, but also nurses, clinicians, and anyone who cares for patients.
Provider Burnout Causes
Some of the causes of provider burnout include:
- Everyday demands and stresses of seeing patients
- Less autonomy due to government mandates
- Self-imposed high standards for perfection that can be difficult to achieve
- The need to perform at an optimal level while being cost-conscious
- Politics, both in the organization and in the community
- Work life/personal life imbalance
From Triple to Quadruple Aim
Faced with all of the tensions above, providers often fail to achieve the Institute for Healthcare Improvement’s Triple Aim. The Triple Aim includes:
- Improving the patient experience or care (including quality and satisfaction)
- Improving the health of populations
- Reducing the per capita cost of health care
When those three objectives are not met, it equates to lower patient satisfaction, reduced health outcomes, and because of those two factors, possible increased costs. Providers may feel disengaged and overworked, experience burnout, and become a detriment to patients and the organization. To avoid this, the Triple Aim has expanded to the Quadruple Aim, which includes improving the provider experience through better work/life balance. The idea is that if providers have a sense of well-being in their work and personal lives, then patients are more likely to have a better experience.
Four Steps to Achieve the Quadruple Aim
To successfully achieve the Quadruple Aim through improving the provider experience, we recommend a four-step process that includes:
- Assessing provider satisfaction
- Analyzing results
- Providing feedback
- Developing and implementing an action plan
Step 1: Assessing Provider Satisfaction
In order to avoid burnout, providers need to have a successful work and personal life balance. Establishing a baseline of the current level of provider satisfaction in both areas is necessary in order to target areas for improvement. Assessment questions such as those below can provide some insight:
- Do you feel valued?
- Do your beliefs align with those of the organization?
- Do you believe you are providing value to your organization and patients?
- Do you believe you are contributing to the greater good?
- Do you believe that you have control over your life?
- What areas of your personal life seem misaligned with your professional goals?
The questions can be answered through an electronic survey or via personal interview during leadership rounding. It may be beneficial to have a consultant skilled in coaching individual and professional growth conduct the assessment because he or she will be unbiased and in the future can also work through a personal development and action plan approach to address areas of concern.
Step 2: Analyzing Results
Once the level of satisfaction is assessed, the consultant or other executive who conducted the assessment analyzes findings and interprets them. This step is crucial since it lays the foundation for future success of this fourth aim of provider engagement.
Step 3: Providing Feedback
Once the results have been analyzed, the information should be shared individually and collectively with providers. It is important to allow enough time for the group to absorb the information, reflect on it, and brainstorm action items for improvement at the macro level in the organization as well as the individual level. Areas marked for improvement might include:
- Provider autonomy
- Provider effectiveness
- Provider value
- Patient acuity levels by provider
- Additional available resources
- Achievement of work/life balance
Step 4: Developing and Implementing an Action Plan
Once areas of focus are established, a plan of action that encompasses all areas of improvement should be developed and implemented. This may entail skill-building, personal and process improvement, and possibly executive coaching for providers, which offers them tools to manage workload, handle stress, and ensure a work/life balance that affects positive change and reduces burnout.
Addressing Provider Burnout as a Way of Working
The best way to reduce provider burnout is to incorporate steps throughout the care continuum to ensure a proper balance of personal and professional provider satisfaction. This starts with first understanding the unique issues that affect provider satisfaction and then implementing operational strategies to address these issues before they cause burnout. This creates environments that are meaningful places to work, have providers with a strong work and personal life balance, and promote improved care and strong patient satisfaction.
for more information on our process to reduce provider burnout and achieve the Quadruple Aim at your health care organization.