Combating burnout: How technology can strengthen the patient-provider relationship


During a webinar, hosted by Becker's Hospital Review and Vocera Communications, David Pryor, MD, executive vice president and chief clinical officer at St. Louis-based Ascension and Bridget Duffy, MD, CMO at Vocera, agreed one cannot enhance the patient experience without also improving provider and caregiver experience.

"We need to focus on how our people come to work everyday. Caregiver experience is linked to clinical quality and performance," said Dr. Duffy.

This conversation is particularly relevant at the moment, as caregiver stress and burnout are reaching unprecedented levels. Seventy-three percent of physicians would not recommend the medical profession to their children and physicians are more likely to commit suicide than the general population, according to a report on physician burnout co-authored by Dr. Duffy; Tom Cosgrove, founder of QPatient Insight; and William J. Maples, MD, executive director of the Institute for Healthcare Excellence, based in Omaha, Neb.

Historically, patient or staff experience were considered softer issues as compared to quality or financial issues, but burnout has "reached a point of crisis," said Dr. Duffy. The problem for many caregivers is the overwhelming pressure of competing priorities.

"We have wounded warriors in the trenches of our hospitals and clinics," added Dr. Pryor. "We have to fix the broken processes and system, and take some things off their plates so they don't have competing priorities."

Hospitals often implement technology without examining how it will affect clinician workflow.

"We implement technology and then ask the caregivers to change the way they work rather than first looking at how the technology will add to their existing workflow," said Dr. Pryor. "Many physicians find themselves staying late into the night to enter notes into an EMR because they can't manage doing that during the day on busy days."

Essentially, organizations are asking clinicians to work harder and faster with less money and "then asking them to look and smile at the patient," said Dr. Duffy.

Patients instantly feel the impact of having to interact with a burned-out caregiver. When patients arrive at the hospital, they are met by an employee who immediately asks them for their insurance information and whether they have a living will before even looking the patient in the eye.

"We need to re-humanize operational efficiency," Dr. Duffy said. "Most organizations aren't mapping the gaps in the human experience. Also, the words we use matters. Physicians aren't mechanics and patients aren't widgets. Allow physicians to come up with innovations to restore humanity in the patient encounter."

Here are five strategies to promote the patient-caregiver relationship and lower clinician burnout.

1. Focus on the quadruple aim. The oft-quoted triple aim of healthcare — enhancing patient experience, improving population health and reducing costs — is believed to form the basis of success for any organization. However, this equation misses one key element: a dedicated, resilient and satisfied workforce.

"When [clinicians] can interact with patients positively, it connects them back to why they entered the medical profession to begin with," Dr. Pryor said. "Implement programs to enhance that connection so the caregiver's work is elevated to more than a profession. Instead, it becomes a vocation."

2. Strengthen the bond between caregivers and patients. For medical professionals, true joy comes from forming a sacred relationship with patients. There are a number of opportunities to enhance this relationship and technology can help. For example, technology can extend the provider-patient relationship beyond the hospital when providers record discharge notes instead of written instructions.

"The human connection with the patient is healing for the caregiver as well as the patient and we need to create the opportunity for this," said Dr. Pryor.

3. Design an optimal healing environment to change the way patients engage. "We need to flip the hierarchy we have traditionally had to engage all stakeholders in a different way," Dr. Duffy said.

4. Eliminate the silos in healthcare facilities. The silos dominating healthcare facilities are one reason for the pervasiveness of caregiver burnout. The human experience in healthcare will be transformed when those silos are broken down and an individual owns that transformation, such as a chief experience officer.

5. Collect and respond to caregiver experience data multiple times per year. Organizations most successful in tacking caregiver burnout will also look at data points beyond an annual employee satisfaction survey. Dr. Duffy suggested conducting validated surveys to identify exhaustion and burnout more often, such as in pre-and post-deployment when implementing an organizational change or new technology.

"Healthcare leaders need to examine the health of their organization," she said. "We need to restore humanity in the patient encounter."

To access the presentation, click here.

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