Long hours. High stress. Not enough time to stop and regroup.
These are the causes of burnout, and more than half of responding doctors reported feeling its effects in a 2014 survey by Mayo Clinic and the American Medical Association.
With Labor Day approaching, we thought we’d take a look at five ways hospitals are trying to make the workplace better to stave off an “epidemic” of clinician burnout.
At Hennepin County Medical Center in Minneapolis, administrators created a “reset room” where employees can grab a quiet moment to themselves or take a quick nap.
Fashioned out of vacant office space, the room creates a calming ambiance with LED lights, flameless candles, and a sound machine. Caregivers at the hospital, which is designated a Level 1 trauma center, can flip on the “in-use” sign to steal a private moment during a hectic day.
“There is nowhere to go in a hospital to just stop for a minute before you go back to your typical 12- or 14-hour day,” said Mark Linzer, director of the office of professional work-life at Hennepin. “The idea really is just to sit.”
Tapping the spiritual
At MD Anderson Cancer Center in Houston, physicians and nurses visit a prayer labyrinth to recover from a sad or stressful episode in the facility, Wellness Officer William Baun said.
“Let’s say you’re a physician that just did eight surgeries today, or actually lost someone — you’ve got to be able to let go of that grief,” Baun said. “So you can go to this prayer labyrinth and walk for five minutes with the intention of doing that.”
Baun said M.D. Anderson, whose campus consists of 85 buildings, also maintains elaborate gardens and outdoor spaces that offer respite from the hospital’s fluorescent-lighted hallways and operating rooms. “We have a prairie that looks like Texas looked like when there were no buildings,” he said. “You see rabbits and birds — all the flowers you don’t have to plant that come out of the ground in Texas.”
Arts, crafts, and live music
Hospital arts programs are going beyond pinning a few colorful paintings on the walls.
At MedStar Georgetown University Hospital in Washington, D.C., nurses and doctors listen to live music, dance, and work on a wide range of projects, from bracelet making to creative writing. Julia Langley, director of the hospital’s Lombardi Arts & Humanities Program, said it is crucial for front-line caregivers to have a creative outlet.
“There is an unbelievable amount of stress in health care,” she said. “What we provide with visual art, music, and dance are moments that can take their attention away from the stress.”
The hospital holds creative writing sessions, some as short as 20 minutes, where caregivers can explore their thoughts away from the office. It also uses dancers and yoga teachers to lead five-minute stretching sessions in units throughout the facility. That service is particularly popular with nurses who are constantly moving, lifting, and pushing, Langley said. “This gives them a chance to stretch and breathe,” she said.
Relieving information overload
Cleveland Clinic administrators are targeting a primary source of stress for physicians: the electronic medical records system.
Record-keeping requirements force most physicians to spend more time working on computers than treating patients, which is not why they joined the profession, said Dr. Sumita Khatri in the Cleveland Clinic Pathobiology Department.
Khatri said she is working with a panel of physicians to redesign daily workflow to help relieve the burden of record-keeping requirements. The effort involves creating customized software and delegating some EMR work to physician’s assistants, among others.
In addition to logging interactions with each patients, doctors must respond to emails, phone calls, lab reports, and requests from administrators, colleagues, and patients.
“It’s something that never ends,” Khatri said. “It’s like quicksand: you can go in and never leave. And for people who are perfectionists and want to finish tasks and do their best, that can be a source of anxiety. So this campaign is part of making IT disappear and become part of the fabric of our work.”
Taking a deep breath
Hospitals are also placing a greater emphasis on physical activity for staff members. Instead of just opening a gym in the basement, many administrators are finding ways to incorporate exercise into the work day.
M.D. Anderson places exercise equipment in the corridors of its buildings, allowing caregivers to get workouts in between meetings and other duties. It calls the mini-workout spots “stress buster” stations, which usually consist of an elliptical machine and other cardio equipment.
“You can take two minutes and stretch out your tight shoulders, or jump on an elliptical and take away the stress you were feeling just a few minutes ago,” said Baun, the wellness officer at M.D. Anderson.
Baun said, however, that physical exercise is only one component of helping people deal with stress, noting that M.D. Anderson also offers “breathing circles.”
“These are short, 12- to 15-minute segments where we sit down as a group and teach people how to use breathing to relax themselves,” he said. “It gets people out of their heads and into their hearts. It’s amazing to watch.”
Excellent article, and kudos to the team. 🙂
It is often confusing to healthcare leaders when they see different organizations taking very different actions to lower stress and prevent burnout … and ALL of them work. The CEO then says, “If all this stuff works, what is the best practice?” What is happening is a fundamental labeling error of the nature of burnout itself
Burnout is not a problem. Problems have solutions. You apply the solution and the problem goes away. Burnout is a never ending balancing act. Burnout is a DILEMMA. You can’t solve a dilemma and make it go away. You manage it with a strategy: 3- 5 new actions you turn into habits to maintain the balance that you seek.
If you are looking for components of a strategy … then having more options to choose from the better. We teach 117 ways to prevent burnout. All you will need is 3 – 5 of them. What is missing though is the understanding that none of the single interventions above is a strategy and none of the organizations above are teaching the concept I just typed into this comment box. The problem – dilemma distinction is fundamental to understanding and managing burnout. All of the interventions in the article are people thinking they have a solution … when what they have is one component of a fraction of their peoples’ ultimate strategy.
My two cents,
Dike Drummond MD
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