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Clinician Well-being and Resilience

By Jay Bhatt, D.O., and Maureen Swick, R.N., Ph.D.
December 15, 2016

The rapid pace of change in health care, from delivery redesign to risk-based payment models to increased data reporting and interoperability, has clinician attention divided among many competing priorities and challenged to meet changing requirements while improving care delivery for a more diverse population. Numerous studies show clinician stress is associated with lower patient satisfaction, a negative impact on health care quality, overuse of resources and increased costs. Patient care is impacted by the increased burden of burnout. Achieving high-quality care is critical, and that aim emphasizes the importance of a resilient and well-supported clinical team.

For that reason, the AHA is one of the inaugural sponsoring members of the National Academy of Medicine’s new Action Collaborative on Clinician Well-being and Resilience. This program will build a collaborative platform for supporting and improving clinician well-being and resilience by advancing solutions that reverse current burnout trends and, ultimately, improve patient care.

Studies have identified two key paths to reduce stress and burnout: individual approaches that address personal resilience and mindfulness in practice and organizational approaches that reduce stressors. Specifically, the Healthy Work Place Study showed workflow redesign and clear care team roles, protocols to improve communication between providers, and quality improvement projects that target bottleneck processes all reduced organizational stressors and led to lower rates of burnout.

Many organizations are considering approaches to address the individual and organizational factors that drive stress and burnout. For example, Stanford Medicine’s WellMD is a comprehensive collection of resources and classes on mindfulness and burnout for individuals to assess their stress and make positive changes. Some hospitals have employed renewal rooms to give clinicians space to recharge. The University of Rochester Medical Center has developed a curriculum in mindful practice for not only the clinical staff but also students. These are just a few examples; we hope you will share what you are doing so, together, we can create a culture across health care that values well-being.

It became clear to Novant Health that burnout could impact the organization’s ability to consistently deliver quality care to the patients they serve. In partnership with a coach, Thomas Jenike, M.D., created a comprehensive program to help clinicians achieve better work-life balance; enhance leadership skills; and amplify resiliency and wellness. Data has shown improvement in patient satisfaction, fulfillment and alignment with mission.

Writing in 2001, Christina Maslach, the first to define and study job burnout, described it this way: “What started out as important, meaningful and challenging work becomes unpleasant, unfulfilling and meaningless. Energy turns into exhaustion, involvement turns into cynicism and efficacy turns into ineffectiveness.” Clinicians and hospitals must work together to support the needs of those caring for our communities every day.


Topic: Quality and Patient Safety
Tags: physician issues, physicians, culture of safety, leadership, nurses, workforce

Jay Bhatt, D.O., is senior vice president and chief medical officer of the AHA and president and CEO of AHA’s Health Research & Educational Trust. He is also a practicing internist. Maureen Swick, R.N., Ph.D., is senior vice president and chief nursing officer of the AHA and CEO of AHA's American Organization of Nurse Executives.

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