Solutions to Burnout

Where are the burnout success stories?

Written By: Zach Beasley

Nobody can be blamed for indulging in a little cynicism these days. We have been collectively overwhelmed by a deluge of negative headlines and worrying trends. Among the most distressing of those trends is the burnout crisis among health care staff.

For our nation’s health care staff those alarming headlines describe a harsh reality for their work. They describe understaffed hospitals and care facilities, slammed by surges in Covid-19 cases. They describe long, stressful hours with few breaks. They describe conditions that have pushed health care staff up to their breaking point and in many cases far past it

That is why, for many, the current burnout crisis is not a surprise, but an expect result of long-term and near-term trends. Numerous studies have already illustrated the tremendous cost and strain this crisis is placing on the U.S. health care system and how it is fueling a dire staffing shortage in the health care field.

A staffing shortage, by the way that both exasperates and is exasperated by staff burnout, creating a horrible feedback loop.

So, it would seem at first glance that we have very little to be optimistic about in the health care field right now and with regard to burnout in particular. However, that doesn’t mean there haven’t been any success stories in the battle again burnout. It just takes a little deeper dive into the coverage to find them.

The Front Lines of the Battle with Burnout 

Thankfully organizations have not been sitting idly by when it comes to fighting burnout. In fact, many have already instituted interventions designed to address the issue. Some of the more common interventions have included meditation/mindfulness training, journaling and individualized coaching.

But aside from some evidence that mindfulness training and seminars can be helpful, there is little significant data that these individual-focused interventions are broadly effective, as this recent study found.

That may sound an awful lot like more pessimism again, but it’s important to remember that these negative results are still valuable results.

Learning that individual-level interventions are not, at least so far, proving to be the most effective solution to burnout.

The primary difference between an individual-level and an institution-level intervention is the way they target burnout. Individual-level interventions offer a wide-variety of resources and programs that workers can access when they are in need. These services are typically voluntary and accessible on an ad-hoc basis. Institution-level interventions, on the other hand, target structural changes to systems and policies and generally affect the entire workforce. These interventions are designed to be more fundament changes to how an entire organization operates.

While the research is still ongoing, there have been some promising results that support the efficacy of institutional-level interventions. For instance this review, commissioned by Public Health England (PHE), found that while there is less available data on institution-level interventions to address burnout, the research conducted so far is incredibly promising.

Specifically, the authors noted that institutional interventions seem to have significantly longer-lasting effects when compared to individual-level interventions. When considering whether to invest in a program designed to reduce burnout, durability will certainly be an important consideration for any health care organization.

Another important consideration is that those individual-level interventions, according to what limited data we have, seem to only help with treating and reducing the effects of burnout. Institutional interventions, on the other hand, show far more promise in stopping burnout from happening in the first place.

Making those fundamental institutional policy changes may help inoculate your staff against being burned out in the first place, a far more desirable result than simply treating its symptoms.  

Two Australian Hospitals Go After Burnout

A fascinating case study discussed in the PHE review involved two medical institutions in Australia that implemented institutional reforms in order to combat burnout.

The main pillars of their strategy involved tracking the workloads of their staff, using that data to make assessments, and increasing staffing numbers to enable a reduction in overall workload for their staff.  

The hospitals in the study made used workload tracking technology to track hyper specific data about much each of their individual clinicians was worker, when and if they are taking breaks and generally tracking the demands that were being placed on them by work.

This valuable data was used in order to ensure that no individual clinician worked excessively, a key contributor to burnout.

But as the institutions in this study also recognized, it does little good to monitor workloads if there is not adequate staff available to keep those workloads reasonable. That’s why both hospitals also launched aggressive recruitment campaigns to help ensure they had adequate staffing.       

Both hospitals saw significant gains in job satisfaction and a reduction of work-related stress and exhaustion, critical causes behind burnout

In the end the solutions for these organizations turned out to be rather simple, they diagnosed the core problem and then offered a treatment that addressed that core problem directly and definitively.

If the solutions are there, why haven’t they been adopted?

The obvious question, though, is how any institution would implement such programs today, given the massive staffing shortages in health care and the many concurrent trends and crises such as COVID-19, contributing to those shortages.

Despite all of those issues, there are certainly options out there, including bringing in temporary or contract staff to help fill gaps. There are also other creative solutions to consider such as implementing team nursing programs, modified Baylor shifts, or expanding telehealth offerings that could allow for available staff to be used more efficiently.

However, making large changes to strategy and policy in the midst of a crisis feels akin to asking somebody to take a calculus test while running a marathon. Many hospitals and health care facilities are struggling just to keep themselves above water.

But the Status Quo is Also Risky

That is where the optimism comes in though. We have to remember that the pandemic will end. Eventually the world will return to normal order or at least something closer to it. Thankfully, when it does, we will be armed with a more complete understanding of how to combat burnout.

Organizations must keep that truth in mind, and not lose sight of the human and material costs of burnout. Yes, change can be costly, but the current situation is unsustainable. And any institution that is serious about creating a healthier, more productive work environment needs to be open to taking risks.

Many organizations, because of the pandemic and hazy data, seem to be in a holding pattern. However, if a new policy doesn’t work, it can always be reversed. It is much harder and, in some cases, impossible to bring back workers who burn out and walk away from the industry entirely. While the data is starting to favor institutional reform, we are already aware of the least effective solution for employee burnout, do nothing.

Nobody can be blamed for having a little bit of cynicism when it comes to this crisis or any one of the other challenges, we are currently facing both inside and outside of our health care system. But what they can be blamed for is using that cynicism to justify inaction. Our nation’s health care workers certainly didn’t hesitate when they answered the call during one of the most challenging moments for our nation and the world. Now, it is our turn to take decisive action.