Physician burnout is a hot term in healthcare, but it’s much more than a buzzword: It’s a massive issue. A letter written by CEOs of some of the top health systems in the country asserts that burnout is becoming a “national public health crisis.” Almost half of 13,000 doctors surveyed in 2021 said they experienced burnout – including 60 percent of emergency room physicians and 56 percent of critical care providers. Top reasons for burnout included too many bureaucratic tasks, spending too many hours at work, feeling like just a cog in a wheel, and increased computerization of practice.
Physicians aren’t the only ones experiencing burnout: nursing burnout increased from 30 to 50% pre-pandemic to 40 to 70% during the pandemic. Doctors and nurses alike are working longer shifts, caring for more patients, and completing more documentation for those patients. This all happens while being intensely scrutinized and measured, adapting to new technology, and generally feeling like they have less control over practicing medicine.
To help raise awareness about physician and nurse burnout during, we’ll explore what burnout means for caregivers, hospitals, and patients; detail technology’s role in burnout; and most important, share how health IT can actually help reduce and prevent burnout to help physicians and nurses love their jobs again.
The symptoms of burnout
We’ve discussed several of the reported causes of burnout, but what does burnout look like? How can you tell if your staff or your colleagues are experiencing burnout? The leading measure of burnout for more than 25 years, the Maslach Burnout Inventory (MBI), has been adapted for medical personnel. The survey addresses three scales:
- Emotional Exhaustion: measures feelings of being emotionally overextended and exhausted by one’s work. This could range from feeling consistently anxious and stressed to clinically depressed.
- Depersonalization: measures an unfeeling and impersonal response toward patients. This could be illustrated by “cynicism, sarcasm, and the need to vent about your patients or your job,” and has also been described as “compassion fatigue.”
- Personal Accomplishment: measures feelings of competence and successful achievement in one’s work, or lack thereof. Clinicians may begin to feel that no matter how much they do, it’s not good enough, or may doubt the meaning of their work.
Burnout can be prompted by a significant event, like a malpractice lawsuit, devastating medical error, or personal tragedy, but for most, it’s a slow grind that may take a long time for clinicians themselves or others around them to recognize.
Why everyone needs to care about burnout
It’s obvious that burnout is undesirable for any healthcare professional—it can take a serious toll on their physical, emotional, and mental health. But its effects reach far beyond the individual level and can directly impact colleagues and patients. Burnout can lead to reduced focus, effort, empathy, and bedside manner, which in turn, “could foster misdiagnoses and other medical errors and suboptimal care.” The adverse effect on care delivery underscores the importance of taking measures to prevent burnout in addition to responding to it.
Approximately 94% of respondents to a recent survey believe levels of burnout have increased at least moderately since the start of the pandemic.
How the right technology can help
When it comes to burnout, health IT gets a bad rap. EHR systems are often cited as a primary cause of burnout, but it’s more the documentation and administrative tasks that take physicians away from direct patient care rather than the EHR directly. A report by MobiusMD showed that time physicians spend on administrative tasks has steadily risen since 2014 when just one-third of physicians spent 10 hours a week doing these tasks compared to 15.6 hours on average in 2021.
Clearly, technology can’t fix everything, and EHRs have yet to fulfill their promise of making clinicians’ lives easier. There’s no silver bullet, no matter how shiny the software seems. But there are ways technology can enhance clinical workflows and give valuable time back to physicians and nurses. As Dr. Rasu Shrestha, chief innovation officer at University of Pittsburgh Medical Center, said: “It’s not just technology for the sake of technology.” Here’s how technology can be part of the solution:
1. Connect care teams
Technology can help eliminate the silos of information within a hospital by supporting centralized sources of information that are accessible by all and are updated in real time. For example, an enterprise-wide directory that can reference up-to-date contact information and on-call schedules for everyone in the hospital makes it much easier to find the right person, even if you don’t know their name. With a communication platform like Spok Care Connect, an admitting physician can easily look up and connect with the ED physician for a patient admit, even if they don’t know the ED physician’s name. They can also close the loop by viewing the status of the message delivery to ensure it was read—message accountability helps close potential holes in the Swiss cheese model of patient safety errors.
2. Save steps
All of the little manual steps in a workflow can add up to a lot of time. Reporting critical results of tests and diagnostic procedures on a timely basis is a Joint Commission National Patient Safety Goal. Yet the most common problem with critical test results is that the patient didn’t receive the test results, and the second-most common problem is that the clinician didn’t receive the test results. With over 400 million medical imaging procedures and 13 billion lab tests performed annually in the U.S., that’s a lot of missed results. Communication failures and delays are commonplace in this workflow because the process tends to be manual at most hospitals: The physician orders an X-ray, the results come back critical, and then the radiologist and the physician (and sometimes the nurse) play phone tag until they can discuss the results—delaying treatment for the patient and frustrating the clinicians. Clinical communication software can automate this process so when the results come back critical, the information is immediately sent to the ordering physician’s mobile device. From there, the physician can view the results in the mobile PACS viewer, and their acknowledgment of the results is noted in the patient record.
3. Gain focus
Constant interruptions are a big part of day-to-day clinician frustration. Technology can help limit that by providing an indicator to your colleagues when you’re unavailable. With a secure messaging solution, you can set your status so your colleagues know when you’re off work, in a meeting, in surgery, busy with a patient, or something else. This helps prevent interruptions when you’re enjoying some well-deserved time off or are having a difficult conversation with a patient. Your organization can build in escalations to ensure that if your status is unavailable and the message is critical it can be addressed by another caregiver.
4. Delegate non-clinical tasks
Technology can help doctors and nurses “practice at the top of their license” when it comes to patient care by sending patient requests and alerts to other staff members when applicable. For example, a patient may request a glass of water while a nurse is with another patient. Rather than receiving an alert with no context and having to leave the room to see what the request is, the nurse can see on his mobile device that the request is for a glass of water. He could forward that request to a non-clinical staff member to address. Another scenario is a battery low alert on a telemetry alarm. Technology can route that alert directly to a biomed staff member so they can evaluate and fix the alarm without ever interrupting the patient’s nurse.
5. Give time back to the bedside
As previously mentioned, one of the biggest contributors to burnout is clerical work and other items that detract from the face-to-face time with the patient. Technology can help allocate more time at the bedside by delivering actionable information—information that has clinical context—and facilitating care team conversations. For example, a patient alert can provide clinical context from the hospital’s admission, discharge, and transfer (ADT) system so the caregiver doesn’t need to stop and look up additional information and can treat the patient more quickly. Secure messaging technology also helps all members of the care team connect about the patient’s treatment, so decisions can be made more quickly. For example, if a nurse has concerns about her patient’s sudden change in status, she can quickly and easily contact the right team member to discuss what she’s seeing. She doesn’t have to leave the bedside and waste valuable time searching for the right contact information to start this conversation and get help for her patient right away.
Technology alone can’t extinguish burnout
In addition to technology, process and culture are key to helping reduce and prevent burnout. We highly encourage hospitals to take steps to make sure physicians and nurses are at the table for technology decisions that impact their workflows and patient care. This not only includes evaluating new tools, but also making changes to existing ones. Determine what challenge you’re trying to solve, then work with your clinicians to find out if the technology change, and the supporting process change, have the right components to solve the challenge and truly affect that change. If it doesn’t, it’s just adding to the clinicians’ workload and is unlikely to have a positive impact on patient care.