Rates of burnout among doctors and nurses are below the national average.
in Allegheny Health Networka six-year effort to improve the health of physicians, advanced practice providers and other staff has produced positive results.
Donald Whiting, MD, CMO of AHN and president of Allegheny Clinic, says there are three main reasons CMOs should care about physician happiness: Promoting happiness is essential to physician retention, physician happiness is linked to the overall quality of patient care, and well-rounded physicians do their jobs better than those who struggle with happiness, Whiting said.
“As a CMO, we want our clinicians to come to work and focus their energy on patient care,” Whiting says. “And to do that, we need to address both their basic and advanced needs.”
About six years ago, Thomas Campbell, MD, MPH, approached Whiting about creating a physician wellness program. At the time, Campbell was the chief of emergency medicine at AHN. He now serves as vice president of wellness for the Pittsburgh-based health system.
“I had been researching burnout and wanted to launch a wellness program for physicians,” Campbell says. “Dr. Whiting wanted to expand the reach beyond just physicians to include others. So we created a program for physicians, residents, advanced practice physicians, and nurses. The goal was to expand the program to all employees.
AHN has launched dozens of health promotion initiatives and has made great strides in improving the health of its staff. In recent years, physician burnout has trended 10 percentage points lower than the national average. In 2023, AHN will recognition He received an award from the American Medical Association in recognition of his efforts to improve clinician wellness through proven efforts to address work-related stress and burnout.
“Physician and nurse burnout rates are below the national average,” Campbell said. “National surveys have shown physician burnout rates as high as 62 percent. The highest physician burnout rates are about 52 percent.”
To promote clinician well-being, CMOs and other leaders need to start by understanding the environment clinicians are in and the stressors they face, Whiting said. Masu. “When we launched our wellness program, we first surveyed physicians and advanced practice providers in several categories regarding the components of wellness. Maslow’s hierarchy of needsThere were specific questions about safety in the workplace, working hours, whether people could take meal breaks, and respect for coworkers.”
health interventions
AHN has begun the initiative to promote the wellness of clinicians and nurses by focusing on “low-hanging fruit,” Campbell said.
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The health system’s first annual health survey showed that many clinicians and nurses were unaware that behavioral health assistance was available, so leaders touted the fact that behavioral health services are offered to all employees through AHN’s Employee Assistance Program and are also available to non-employed independent clinicians.
- AHN’s internal behavioral health group has established a 24/7 helpline for employees. “It was a huge success, and it has been since the inception of our wellness program,” Campbell said. “This is a basic program.”
- Early annual health surveys found that several basic needs were not being met. Staff did not take meal breaks and did not take breaks to drink water, resulting in dehydration. “We really pushed doctors, residents and nursing staff to help people focus on meal breaks,” Campbell said. “Our parent organization, Highmark, gave us a grant to install water stations at convenient locations within the hospital.”
- The annual health survey found that female clinicians had higher burnout scores than male clinicians, which was consistent with national data. Because of cultural responsibilities impacting female clinicians, such as having to get children to school in the morning, health systems introduced flexibility in start times and work sharing capabilities.
Over time, after achieving the low-hanging fruit, Campbell says, AHN began to tackle the harder aspects of promoting well-being. “We’re working on the harder initiatives, like creating a caring culture where we look after each other. We’re trying to figure out ways for people to take time off despite the staffing shortages. We’re trying to make sure our physicians can take time off. They’re going on vacation without checking the patient messages in their electronic inboxes.”
Some adult cavernous welfare initiatives launched during the coronavirus pandemic have become permanent.
“We now have ‘decompression rooms’ where people can go when they’re feeling stressed. These are quiet rooms with massage chairs and resources that people can reach out to when they need help,” Campbell says. “We’ve also created another 24/7 helpline for people in emergency and critical care departments, and we’ve launched a peer support program so doctors and nurses can get help when they’re at their breaking point. If you’re hesitant to reach out to a clinical professional, you can reach out to a colleague.”
In recent years, AHN has launched several new and innovative employee benefits initiatives.
The health system has hired health managers at each facility for its medical staff, Campbell said. “These health professionals are a panel of experts in fields such as surgery, obstetrics and gynecology, family medicine, and internal medicine.Nearly all of these health professionals have gone through a program on burnout and have attended Stanford University I completed a health course in medical school.”
Last year’s AHN Health survey showed an improvement in burnout scores related to electronic health record work, Campbell says. “We asked a specific question about the inbox because we knew that inboxes were a cause of burnout. What we found was that EHR inbox burnout got better for physicians but a little worse for advanced practice providers. Some of the work got pushed onto APPs, and now they need help.”
Campbell said AHN has recently shared some success stories with a group of clinical trainees. “For example, residents complained that there was a lot of administrative work and interruptions to their work schedules that made their lives difficult. Instead of giving them pagers, we gave them cell phones so they could communicate by text message,” which is less disruptive than a page, especially when they’re at home. We also provided healthy meals in the resident lounge.”
Regarding APP, Campbell says AHN has initiated several initiatives because it is critical to getting the job done. “To make sure their voices are heard, we established the APP Council. Additionally, every hospital has an APP representative on its medical staff executive committee, so their voices can be heard in those forums. They are more integrated with the leadership of the institute.”
