Employee burnout rates in the healthcare sector were exceptionally high even before COVID-19. Burnout has a significant adverse influence on clinicians' overall well-being, as well as their sense of job fulfillment, which results in higher employee turnover rates, lower quality patient care and decreased patient satisfaction.
Over the past year, clinician wellness has taken on greater urgency as the pandemic has exacerbated burnout and mental health issues among healthcare providers nationwide. Becker's Hospital Review spoke with two experts who are tackling these challenges head on:
- Stephanie N. Sudikoff, MD, ACC, executive director of simulation, SYN:APSE Center for Learning, Transformation, and Innovation, Yale New Haven (Conn.) Health
- Sharon Sloane, Co-Founder and CEO, WILL Interactive
Dr. Sudikoff and Ms. Sloane discussed how leading healthcare organizations can help support clinician well being through comprehensive programs and innovative training technologies.
Holistic well-being programs must address the workplace environment
"Emotional well-being among healthcare providers is a serious problem," Dr. Sudikoff said. "In addition to burnout, physician suicide rates are much higher than the general public and they continue to increase."
The New England Journal of Medicine highlighted the crisis in a recent essay called "My Intern." The author recounts how one of his interns committed suicide and it has taken him six years to process the trauma and talk about it.
In response to mounting concern about clinician wellness, Yale New Haven Health has developed a portfolio of proactive measures. The organization has an excellent family resource program that focuses on individuals and includes many components like counseling options, mindfulness and meditation exercises, health coaching and lots of other useful programs.
"While all of those things are incredibly important, if you aren't also addressing the general workplace environment that's causing some of the issues, you won't succeed," Dr. Sudikoff said. "A comprehensive well-being program needs to be multifaceted and very holistic."
To examine specific concerns raised in survey feedback, Yale New Haven Health formed committees with physicians and other relevant staff members. One group focused on the usability of the EMR and how many clicks were required to complete tasks. Other groups looked at improving process efficiency to make clinician workflows smoother and easier. For example, the organization has implemented virtual scribes for interested clinicians to decrease the amount of time that they spend on documentation.
"By talking about these issues with the people who can fix them, we've made great strides," Dr. Sudikoff said. "But no one measure alone will change the culture and create a true sense of community. We felt we needed something else, which is where The Thriving Clinician project has come into play."
Innovative learning systems designed to create a better workplace environment for clinicians
Yale New Haven Health and WILL Interactive had collaborated in the past on Common Ground Healthcare, a program designed to prevent sexual harassment and abusive conduct. "The idea for The Thriving Clinician program arose during a dinner between our leadership team and WILL Interactive," Dr. Sudikoff said. "We already had a successful working relationship and knew that the WILL Interactive team had worked with the military on suicide prevention."
WILL Interactive describes its approach to behavior change as "Training 2.0." The company's Choose Your Own JourneyTM methodology is built on four key pillars of positive behavior change. It leverages the neuroscience of learning, which explores how humans learn and make decisions. WILL Interactive also incorporates the power of story to engage people in memorable conversations, the appeal of video and the interactivity of gaming.
"Through the use of technology, we integrate these elements in a way that enables users to become the lead characters in what is often described as an interactive movie," Ms. Sloane said. "In The Thriving Clinician, healthcare providers make decisions that alter the storyline and lead to different outcomes. They become highly immersed in the stories, because they are based on actual events that mirror their own lives."
Individuals make choices and experience the consequences of those decisions in realistic and authentic situations. They can also view events from multiple perspectives. The Thriving Clinician engages users both cognitively and emotionally. It gives people the opportunity to walk in others' shoes and to see themselves as others see them.
"We can change people's defaults and their 'muscle memory,' if you will. All of this helps clinicians make better choices when they confront real-life situations that are similar to those in the program," Ms. Sloane said. "It's universally understood that experience is the best teacher. Experience in a safe environment is a powerful and effective way to approach clinician wellness."
Historically, organizations have delivered training in formal ways. They've given employees knowledge, information and skills, and then hoped they would apply them. Continuing to rely solely on this traditional model, however, is not effective. WILL Interactive has found that bringing people's stories to life and making learning user-centered offers a completely different way of delivering learning.
Since patenting its interactive behavior modification system over two decades ago, WILL Interactive has partnered with leading organizations to address healthcare issues of national concern. The company has educated providers and patients about unsafe opioid use. It has also assisted in the reduction of healthcare-associated infections, improved the patient experience, helped prevent sexual harassment and abusive conduct and advanced diversity, equity and inclusion in the healthcare sector. In the area of mental health, WILL Interactive's work has reduced Army suicides and helped address PTSD.
"We are delighted to partner again with Yale New Haven Health on a topic of such crucial importance as clinician wellness, because it falls squarely into our company's sweet spot," Ms. Sloane said. "Over the years, some of our greatest impact has occurred at the intersection of healthcare and positive behavior change in complex and stressful environments."
Yale New Haven Health has just started its rollout of The Thriving Clinician initiative and feedback from a small group of early evaluators has been positive. They have found the experience to be very powerful, relevant and needed.
"People in this early adopter group are watching the videos largely by themselves as a preview, and even in that situation, they have found it very powerful," Dr. Sudikoff said. "I think the real power of The Thriving Clinician, however, lies in the group conversations that follow the videos. Those are essential to achieving a culture of mutual support and respect which aligns with our organizational values. Our hope is that the program will serve as a tool to destigmatize mental health and create an environment in which it is safe to both need and ask for help."
When faced with complex employee challenges, visionary leaders seek next-generation solutions
WILL Interactive's effective approach to learning and behavior change resonates with leading organizations. "The more visionary the executive team is, the more they are looking for next-generation solutions," Ms. Sloane said. "This has been the case at Yale New Haven Health, the Army Medical Command and the National Institutes of Health."
Although clinician burnout and well-being have been problems for years, the pandemic has raised the visibility of these issues. "We need to understand that it will take a multipronged approach to achieve the kind of cultural change that we're hoping to see over time," Dr. Sudikoff said. "That means considering the individual and the workplace issues that may add to clinicians' daily stress and detract from their well-being. To move the culture forward, we need to work on all those pieces simultaneously."
Clinician wellness isn't just an individual issue and an organizational issue; it's also a high-priority public health issue for the nation. "As we see the results of the pandemic play out, we have to stay at the forefront and help everyone who is trying to stay well physically, emotionally and spiritually," said Ms. Sloane.