Report outlines systems approach to address clinician burnout

As many as half of all clinicians experience burnout as a result of a broken and constantly changing U.S. healthcare system and overwhelming job demands, according to a consensus study report by the National Academy of Medicine released last Wednesday.

The report states that between 35 percent and 54 percent of U.S. nurses and physicians have substantial symptoms of burnout, and the range for medical students and residents is between 45 percent and 60 percent. Experts say burnout seems to be a problem across all clinical disciplines and care settings, and results in increased risks to patients, malpractice claims, and significant financial losses.

A committee working on behalf of the National Academy of Medicine under the auspices of the National Academies of Sciences, Engineering, and Medicine examined the scientific evidence regarding the causes of clinician burnout as well as the consequences for both clinicians and patients, and interventions to support clinician wellbeing and resilience. They focused on evidence showing an association or strong relationship between specific system-level factors and burnout.

The committee found that numerous work system factors either contribute to the risk of burnout or have a positive effect on professional wellbeing. Work system factors were broken down into job demands and job resources, and include demands like excessive workload, unmanageable work schedules, and inadequate staffing, and resources such as meaning and purpose in work and organizational culture.

In the report, the committee also reviewed systems aspects largely focusing on the structure, organization, and culture in health care to examine clinician burnout and professional wellbeing. The committee introduced a conceptual model inclusive of clinicians and learners across healthcare disciplines to illustrate that the interactions of the care team, health care organizations, and the external environment influence the work system factors that contribute to clinician burnout and professional wellbeing. Decisions made at these three levels of the system strongly influence the work environment that clinicians experience in both negative and positive ways, the committee states.

To reduce burnout among clinicians, actions should target known work system factors that influence burnout and wellbeing. Learning and continuous improvement processes are necessary for identifying, evaluating, and implementing effective improvements at all levels of the system.

The report encourages healthcare stakeholders to initiate action to address and prevent clinician burnout. In summary, the committee recommends six goals and recommended system-wide actions to accelerate progress toward burnout prevention and reduction:

1. Create positive work environments
2. Create positive learning environments
3. Reduce administrative burden
4. Enable technology solutions
5. Provide support to clinicians and learners
6. Invent in research

Click here to access the full report.

Editor's note: Photo by jcomp courtesy of Freepik.