IAFP Schweitzer Conference March 17 2017 Claudia Finkelstein MDCM Director Faculty Wellness Programs University of Washington School Of Medicine Faculty Disclosure Financial none Title and life dont overlap 100 ID: 586803
Download Presentation The PPT/PDF document "Burnout Risks, Prevention and Resilience" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Burnout Risks, Prevention and Resilience
IAFP Schweitzer Conference
March 17, 2017
Claudia Finkelstein, MDCM
Director Faculty Wellness Programs
University of Washington School Of MedicineSlide2
Faculty Disclosure
Financial none
Title and life don’t overlap 100%Slide3
Objectives
Participants will define burnout syndrome and
the (increasing) incidence
Participants will become familiar with some tools used to assess and identify burnout and some risk factors for burnout
Participants will learn strategies that promote individual, team and institutional resiliency and prevent burnoutSlide4
Define
emotional exhaustion
- being emotionally overextended and exhausted by one's work
depersonalization
- unfeeling and impersonal response toward recipients of one's service
decreased sense of personal accomplishment
– lack of feelings of competence and successful achievement in one's workSlide5
Tait D. Shanafelt MD, Omar Hasan MBBS, MPH, Lotte
N. Dyrbye MD, MHPE, Christine
Sinsky
MD, Daniel
Satele
MS, Jeff Sloan PhD and Colin P. West MD, PhD
Mayo Clinic Proceedings, 2015-12-01, Volume 90, Issue 12, Pages 1600-1613,
Trends
Incidence
-Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014Slide6
From:
Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population
Arch Intern Med. 2012;172(18):1377-1385. doi:10.1001/archinternmed.2012.3199
Figure 1. Burnout by specialty.
Copyright © 2012 American Medical Association. All rights reserved.Slide7
Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014 Slide8
MBI-A- Emotional ExhaustionSlide9
MBI-B DepersonalizationSlide10
MBI-C-Personal AchievementSlide11Slide12
MBI vs Single Item
Measure: Ask Yourself How Often?
I feel emotionally burned out or emotionally depleted from my work
I have become more callous toward people since I took this job — treating patients and colleagues as objects instead of humans.
.
West CP, Dyrbye LN, Sloan JA, Shanafelt TD.J Gen Intern Med. 2009 Dec;24(12):1318-21 Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionalsSlide13
More Tools
Physician well being index
Mini Z Burnout SurveySlide14
Risk Factors
Our personalities
Precise specialty
Age/career stage
Marital status (2 career-2 docs)
Young kids- and 19
yr
old youngest kidSlide15
Resiliency: Definition and Strategies
Slide16
Definition
The capacity to respond to stress in a healthy way such that goals are
achieved
at minimal psychological and physical cost; resilient
individuals
"bounce back" after challenges while also growing stronger
.
Resilience
is a key to enhancing quality of care, quality of caring, and
sustainability
of the health care workforce. Yet, ways of identifying
and
promoting
resilience have been elusive. Resilience depends on
individual,
community, and institutional factors.
Epstein and Krasner Academic Med 2013 March 88(3) 301
Slide17
Executive Leadership and Physician Well-being
Shanafelt, Tait D. et al.
Mayo Clinic Proceedings , Volume 92 , Issue 1, 129 - 146
Although burnout is a
system issue
, most institutions operate under the erroneous framework that burnout and professional satisfaction are
solely the responsibility of the individual physicianSlide18
Individual Factors: Start w BasicsSlide19
Individual
Resilience Strategies
Get On Your Own Schedule: Time Management
Sleep
Nutrition
Exercise
Meditating/reflecting/writing/reading
Grow –learn something new
Joy/funSlide20
A Quick Reflection CME: Why Are You Here?
Check off box to renew license
Information not available elsewhere
A blocked out chunk of time to learn
Chance to travel (w or w/o family)
Opportunity to ask questions
Opportunity to network
Opportunity to meet friends and colleaguesSlide21
Individual Factors To Reflect On
Connection-compassion-empathy
Gratitude: journal
Meaning: thank you notes, patient stories
Hope
Emotional
regulationSlide22
More on Reflection: Fearless Honesty
Identify your core values (exercises online)
Institution values and overlap?
What do you really value?
How do you spend your time and overlap?
Legacy?Slide23
More Questions?
Academic v. Private
Solo v. Group v. Employee
Junior v. Senior
Gender?
Partnered?
Kids?
Happy?
Fulfilled?Slide24
Individual Resilience Strategies: Perspective (peers or professionals can help)Slide25
Perspective
The days that crawl by
The years that fly bySlide26
Individual Resilience Strategies: Support
Family
Friends
Peers
Groups
PHP
Coach/therapist/psychiatristSlide27
Individual Resilience Strategies: Emotional Regulation Slide28
PracticeSlide29
Paying Attention-TechnologySlide30
Individual Resilience Strategies
Time management
Reflection
Perspective
Support
Emotional regulationSlide31
Team Resiliency: ConnectionSlide32
Team Resiliency: Shared PurposeSlide33
Team Resiliency: CommunicationSlide34
Team Resiliency: Value Different Strengths/StylesSlide35
Team Resiliency: Clear Expectations
Huddles
Coverage
Fairness
Support
HierarchySlide36
Team Resiliency
Connection
Purpose
Communication
All styles welcome
Expectations –clear, explicit, fair Slide37
Institutional Resiliency
Culture
Values
Practice environment
Scheduling
Norms- parental leave, part time, vacationSlide38
No Hidden Curriculum
Excellence:
Everyone wants to be a part of something meaningful. Organization leaders should establish constructive relationships with
physicians
“If
physicians
are treated as employees or cost centers, that is how they will behave
, if
they are treated as partners in delivering the needs of patients,
physicians
will ignore their job descriptions and skyrocket discretionary effort.”Slide39
Organizational: 2 studies
Quality of Patient Care Drives Physician Satisfaction; Doctors Have Concerns About Electronic Health
Records-
http://www.rand.org/news/press/2013/10/09.html
In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices
Ann
Fam
Med. May 2013; 11(3): 272–278.Christine A.
Sinsky
et al Slide40
Practice Environment -From The Triple Aim
enhancing
patient
experience
improving
population
health
reducing costs
widely
accepted as a compass to optimize health system performance. Slide41
Ann Fam Med. 2014 Nov-Dec;12(6):573-6
to Quadruple Aim: care of the patient requires care of the provider
Physicians and other members of the health care workforce report widespread burnout and dissatisfaction.
Burnout is associated with lower patient satisfaction, reduced health outcomes, and it may increase costs.
Burnout thus imperils the Triple Aim.
This article recommends that the Triple Aim be expanded to a Quadruple Aim, adding the goal of improving the work life of health care providers, including clinicians and staff.Slide42
Institutional Resiliency
Provide flexible scheduling options for providers, such as:
Consistently schedule support staff (e.g., MAs, RNs, etc.) with the same providers.
Outsource time-consuming tasks, such as coding, to other departments or other staff members in the organization.
Pilot a call “cap and trade program” in which providers are compensated more if they are willing to take more call time. This may relieve the burden on providers who find it difficult to take call shifts because of personal obligations.
Source: AMA. Practice transformation series: burnout. 2015Slide43
Institutional Resiliency
Implement clinic changes, such as regular care team huddles.
Work with occupational health or organizational development departments to hold training sessions on building trust and respect within the team.
Recognize accomplishments of providers at staff meetings or through one-on-one recognition.Slide44
Institutional Resiliency
Provide a mechanism for providers to give ongoing feedback, such as:
Begin
meetings by sharing patient case studies.
Work
with your electronic health record (EHR) vendor or IT
department.
Provide additional EHR training to providers to improve proficiency and ensure they have skills needed to use the system effectivelySlide45
Institutional Resiliency
Realistic expectations of humans
Help people work to top of license
Opportunities for professional developmentSlide46
Summary
You now know what burnout is and some ways to measure it
You are aware of national trends in burnout
You know what resiliency is
You are aware of individual, team based and organizational ways to enhance resiliency
You have practiced one mindful practice
So….perhaps this is the “what” you learnedSlide47
Ask Yourself
Do I want to improve my resilience?
Do I want to try individual/team/organizational approach?
What is one step I can take in this direction?
Put this on your calendar as a reminder-Weekly? Daily? Monthly?