Combatting Clinician & Physician Burnout: A Guide for Healthcare Leadership

Clinician and physician burnout has emerged as a critical issue in healthcare, posing significant challenges to both providers and organizations. The demands of the profession, coupled with administrative burdens and a rapidly changing healthcare landscape, have contributed to alarming rates of burnout among clinicians. 

However, there is hope. Addressing burnout not only improves the well-being of providers but also has profound implications for patient care and organizational success. Prioritizing clinician and physician wellness can lead to reduced turnover, improved quality of care, fewer errors, and increased engagement. It shows a commitment to supporting your team, builds trust, and enhances problem-solving during challenging times.

In this article, we explore the multifaceted issue of clinician burnout, uncovering its causes, consequences, and most importantly, the preventive measures that healthcare leadership can undertake to address it. By prioritizing clinician and physician wellness, organizations can foster a supportive and thriving work environment that benefits all stakeholders involved.

Join us on this journey to combat burnout and foster a healthier future for healthcare providers and patients alike. Together, we can make a meaningful difference and build a stronger healthcare community.

How Cognitive Load Affects Burnout

Cognitive load plays a significant role in burnout as excessive cognitive load can overwhelm and exhaust individuals, leading to increased stress and the potential for burnout. When healthcare professionals experience high levels of cognitive load, it taxes their cognitive resources and working memory. They may be juggling multiple tasks, managing complex patient information, making critical decisions, and dealing with distractions and interruptions. This constant mental strain can contribute to feelings of overwhelm, exhaustion, and frustration.

Excessive cognitive load can arise from various sources within the healthcare environment. For example, healthcare professionals may face challenges related to electronic health records (EHRs), such as burdensome documentation requirements, complicated interfaces, and excessive information overload. These factors can increase cognitive load and impede efficient workflow, leading to increased stress levels and decreased job satisfaction. Moreover, heavy workloads, time pressures, lack of resources, frequent interruptions, and the need to multitask contribute to cognitive overload and hinder cognitive functioning. 

Cognitive load can be categorized into three types: intrinsic, extraneous, and germane.

1. Intrinsic load: This pertains to the inherent complexity of the task itself. It is determined by the difficulty of the content or problem being tackled. Tasks with higher intrinsic load require more mental effort to understand and process.
2. Extraneous load: This refers to the unnecessary cognitive burden imposed by the instructional design, environment, or external factors unrelated to the task. It encompasses distractions, excessive information, irrelevant details, and complicated instructions that hinder learning or task performance.
3. Germane load: This refers to the cognitive effort used to construct mental schemas, develop expertise, and integrate new information into existing knowledge. It represents the productive cognitive load that enhances learning, problem-solving, and performance.

The goal is to optimize cognitive load by reducing extraneous load and promoting germane load. By minimizing distractions, simplifying instructions, organizing information effectively, and providing adequate support, individuals can allocate their cognitive resources more efficiently, leading to improved learning, task performance, and reduced mental strain. Extraneous cognitive load, particularly from EHRs, has become a prominent challenge in healthcare. Burdensome billing requirements and excessive documentation demands within EHRs contribute significantly to extraneous cognitive load. Constant interruptions, inbox overload, redundancies, staff needs, desktop management, economic demands, and workload were also cited as key sources of extraneous load. Furthermore, recognizing the value of germane load, which involves continuous learning and integration of new information, is important. Maximizing germane load contributes to clinician expertise and adaptability. (Harry, 2021)

To optimize cognitive load, it is important to focus on standardization, redundancy, and split attention. 

• Standardization as a Solution -- Standardization promotes consistency and reduces the need for cognitive effort. Steve Jobs' practice of wearing the same outfit every day exemplifies the concept of reducing decision-making burden. By establishing routines and habits, tasks can become automatic and stored in long-term working memory. 
• Streamlining Processes and Reducing Redundancies – While redundancies are often perceived as protective measures, they can contribute to cognitive load. Having multiple methods to perform tasks or receive critical information can lead to confusion and inefficiency. Streamlining processes and establishing reliable methods for notifications and handoffs reduces cognitive burden and improves evaluation and decision-making. 
• Consolidating Data and Reducing Split Attention – To decrease cognitive load, healthcare professionals should strive to bring all relevant information together in one place. This can be achieved by consolidating data, such as central line kits or disease-specific tabs in EHRs. Accessing necessary information without extensive searching and gathering from various sources reduces cognitive effort and allows for a more focused and efficient workflow.
• Process Coupling and Interruption Management – Process coupling, where related tasks are performed together, reduces cognitive load by transforming routines into habits. Healthcare teams can establish agreements on when interruptions are warranted to protect crucial cognitive processes. Adopting practices from aviation, such as the person who interrupts taking responsibility for getting the interrupted individual back on track, minimizes the impact of interruptions and reduces attentional blinks.
• Addressing Cognitive Load at Different Levels – Managing cognitive load requires collective efforts at individual, work unit, and organizational levels. Healthcare professionals can create personal and professional routines to reduce extraneous cognitive load. Work units can establish interruption agreements and standardize processes within teams. At the organizational level, efforts should focus on standardizing interdisciplinary rounds and other procedures, promoting consistency, and reducing cognitive burden. (Harry, 2021) 

6 Steps You Can Take Today

1. Prioritize burnout prevention: Recognize the impact of burnout on clinicians, physicians, patients, and overall organizational performance. Demonstrate commitment to fostering a supportive work environment.
2. Establish a Wellness Committee and appoint a Wellness Champion: Form a team comprising practitioners, administrators, and representatives from various disciplines. This committee will collaborate with organizational leaders to measure burnout levels, analyze data, and develop targeted interventions. The Wellness Champion can serve as a role model and advocate for wellness resources and positive behaviors.
3. Conduct regular wellness surveys: Implement annual surveys to assess clinician burnout levels. Use the data as a benchmark to track progress over time and provide a platform for clinicians to express themselves.
4. Foster open dialogue and collaboration: Encourage regular meetings to discuss data, intervention strategies, and innovative approaches, creating a safe space for open communication and collectively developing solutions. Recognize providers' accomplishments and establish mechanisms for ongoing feedback, such as dedicated time at staff meetings, office hours with leaders, and comment boxes.
5. Implement evidence-based interventions and continuously evaluate: Prioritize interventions that address the underlying causes of burnout, such as workflow redesign, improved communication channels, and tailored quality improvement projects. Regularly review the effectiveness of implemented interventions through follow-up surveys and feedback loops, celebrating successes and identifying areas for improvement or additional support.
6. Invest in tools, resources, and support systems: Allocate resources to implement strategies that reduce burnout. Collaborate with vendors and IT departments to enhance EHR templates for consistency, readability, and clinical relevance, streamlining documentation processes for clinicians. Additionally, offer eLearning opportunities to enhance providers' proficiency and effective system usage, empowering them to make the most of available technologies and minimize administrative burdens. Invest in new technology and seek emerging solutions for automation. See below for a list of resources Futura offers to support organizations in their efforts to combat burnout and promote provider wellness.

The Time is Now

Addressing clinician and physician burnout is crucial for healthcare organizations to promote well-being, improve patient care, and ensure organizational success. By prioritizing burnout prevention and establishing a Wellness Committee, healthcare administrators can create a supportive work environment. 

By taking decisive action and implementing the seven steps outlined in this blog, you can create a supportive work environment where clinicians feel valued and empowered. Establishing a Wellness Committee and conducting regular wellness surveys will ensure you stay attuned to the needs of your healthcare team. Embracing evidence-based interventions and continuously evaluating their effectiveness will fine-tune your approach, leading to tangible results.

But it doesn't end there. Investing in resources and support systems will show your unwavering commitment to tackling burnout head-on. And as a healthcare organization that prioritizes provider wellness, you'll be at the forefront of a growing national trend, setting a positive example for others to follow.

Your dedication to addressing clinician and physician burnout will not only lead to improved job satisfaction and retention rates but will also foster a culture of excellence, resulting in better patient outcomes and organizational success.

Now is the time to take action and make a lasting difference. Reach out to us at Futura Healthcare to explore how our solutions can make a significant difference in creating a more supportive work environment for your healthcare providers. We value collaboration and are eager to work together in tackling this pressing issue. Our expertise and resources are at your disposal to help you navigate this journey toward a healthier, more resilient healthcare environment.

How Futura Can Help

• Strategic Cost Management (SCM) – Through our time-and-motion studies, we analyze where your clinicians are spending their time, and when necessary, re-allocate job functions to other skilled workers to free up the care-givers time, and ensure they are working at the top of their license. By optimizing staffing levels and ensuring proper utilization of time and skills, clinicians can experience a more balanced workload, reducing the risk of burnout from being constantly overwhelmed.
• AI Powered Clinical Decision Support Software – AI's ability to auto-draft and update clinical notes can significantly reduce the burden of documentation. While AI cannot replace the human touch in healthcare, integrating AI as a supportive co-pilot can alleviate burnout by streamlining tasks, enhancing decision-making, and providing valuable support to clinicians in their daily practice.
• Clinical Care Variation – Our systematic approach to clinical variation reduction is a crucial step in addressing burnout. By minimizing unnecessary variation in medical practices and outcomes, organizations can standardize care protocols and promote evidence-based practices. This standardization creates a more predictable and streamlined workflow for clinicians, reducing stress and uncertainty in decision-making. Implementing clinical pathways, guidelines, and decision support systems based on best practices helps physicians and clinicians make informed decisions quickly and efficiently.
• eLearning – Futura's eLearning opportunities are designed to enhance providers' proficiency and effective usage of various systems, empowering them to optimize their workflows and reduce administrative burdens. By becoming proficient in these systems, providers can streamline documentation processes, access patient information more efficiently, and improve communication among the care team. 

About Futura

Futura Healthcare has supported Hospitals and Health Systems for over 20 years improving patient and staff experiences through technology and services. As members of CHIME and KLAS, we prioritize continuous education and evolving with the needs of our complex industry with our advisory, consulting, and technology solutions. We are vendor agnostic and help healthcare institutions achieve their strategic goals of improved patient outcomes, operational efficiency, and enhanced clinician engagement.

Resources

AMA. Practice Transformation Series: Burnout. 2015.
AMA. Steps Forward Series: Preventing Physician Burnout. 2020.
Harry, E., Sinsky, C. Cognitive workload: A modifiable contributor to physician burnout (2021, March 2). AMA STEPS Forward. Webinar. https://www.ama-assn.org/practice-management/physician-health/elizabeth-harry-md-christine-sinsky-md-discuss-findings