5-second summary
- Research into burnout in the healthcare industry provides clues into how to avoid it in other industries.
- Burnout is an organizational problem, not an individual problem.
- The 4 main drivers of burnout are: feeling unable to perform your job well, inefficiency, a lack of recognition, and not being able to contribute your input.
- When executives tie their personal performance to the well being of their employees, meaningful change happens.
Burnout. No matter how much we love our jobs or our coworkers, we all run the risk of flaming out at some point in our careers. So how we can avoid it? And more specifically, how can managers insulate their teams from the dangers of overwork and overwhelm?
I head up our Ways of Working team at Atlassian, which is dedicated to understanding the mechanisms and frameworks that result in healthy teamwork. As part of my research, I’ve been speaking to leaders in multiple industries to understand what team effectiveness looks like to them. I recently sat down for fascinating conversation with Dr. Tina Shah, who has spent the last few years studying and implementing ways to reduce burnout in the healthcare sector.
Dr. Shah was appointed by President Obama to serve as a White House Fellow and Special Advisor to the Secretary of Veteran Affairs in 2016. And during the start of the COVID pandemic, she leveraged technology to help foster well-being and maintain patient access to care as Medical Director of Practice Improvement and Virtual Health at Wellstar Health System. Her findings provide insight into how burnout manifests and how it can be prevented in a variety of professional settings.
Here, I’ve compiled the most salient points from our chat. To hear Dr. Shah’s insights in their entirety, click on the audio clips throughout the article.
Elements outside our control are causing burnout
Dr. Shah: The truth is we all work in some sort of environment. And burnout and workplace environment are very closely tied together, almost like two sides of a different coin.
In the healthcare industry, about 85 percent of why people get burnt out – whether you’re the doctor or the nurse or the respiratory therapist – is due to things in your workplace environment. Not you, the individual, yourself. And I suspect that’s pretty true for your field, too.
Hear how burnout in is a problem in every industry:
Christine Dela Rosa: [By your description, environment] is not just the physical stuff, but it is the relationship to physical things and people and communication. How would you actually define a workplace environment?
Dr. Shah: Okay, well for starters there’s the obvious one: the people. Then, we move into the processes: how we do things. And finally, we get to the tools, and what we’re given to work with. So, if I’m given a computer that’s so antiquated that it takes me a minute to get through the login screen, that is absolutely going to impact my experience of the workplace.
Massage chairs aren’t the answer if people are too busy to use them
Dr. Shah: Many people would address the issue of burnout by placing stop gaps. For instance, I have heard many hospitals say, “We’re going to have this health and wellness room, we’re going to purchase these beautiful $10,000-massage chairs” and you know what? It doesn’t work because they didn’t structure the workplace environment in a way that their doctors could actually take a break and go there.
Burnout is a workplace environment issue and not an individual issue.
4 factors that contribute to burnout:
1. A lack of ability to complete your key job duties. Barriers prevent you from doing your work – they could be regulatory, technological, bureaucratic, or anything else that creates a block to finishing a task or project.
2. Anything that makes you inefficient. Outdated equipment or software, redundant processes, unnecessary meetings, procedures that create complications.
3. A lack of recognition. You do important work but no one seems to notice your contribution.
4. Lack of being able to give input to leaders. You feel that your voice isn’t heard.
Hear how these factors manifest in the healthcare field:
How do we create real change?
Christine Dela Rosa: So we’ve identified a problem and we know what we don’t want. But, is there something we do want, something we should be striving for?
Dr. Shah: It’s to achieve a culture of well-being.
We’re getting there, but we are not there yet. We still are trying to make the argument that burnout is fundamental to how healthcare works, and we must address it.
Hear how Dr. Shah ties burnout to business goals*
Dr. Shah: If the top-most level of your organization thinks this is a priority then things will really move.
This assumes that our executives have a financial stake in trying to reduce burnout. That’s going to make them start asking those questions.
How to get the C-suite involved:
Christine Dela Rosa: For those organizations ready to prioritize wellbeing, how do they get started?
Dr. Shah: Ask the question: what is not working well? And what would you do to fix it? If you ask enough people, that’s already going to give you the prioritization of what to work on first.
Now in a more rigorous manner, I would want to designate a senior person. They would also help streamline the work happening in silos. In an ideal world, you acknowledge that there’s a lot of good work being done in silos, and then you align all of that together.
Hear how siloed thinking, even when solution-minded, can cause “death by a thousand cuts,” by making simple processes needlessly complicated:
How can we improve practices in the real world?
Christine Dela Rosa: We’ve been talking pretty conceptually, but I wonder if you could talk a bit about a real-life example of practice improvement, something perhaps from your own work?
Dr. Shah: Last March I was working for Wellstar … and we knew COVID was coming. We went from having virtually no telemedicine across our 260 plus clinics to needing to just light-switch it on.
My timeline before COVID was, optimistically, that we would deploy telemedicine to all of our clinics over a two-year period, and we were able to do it in less than six weeks.
I spent hours and hours with our revenue cycle folks and our regulatory folks because what doctors need is something very simple. If you’re doing a video visit, “How do you do it – what’s the technology?” “What do you have to document in your note?” and “What do you have to [do so] you actually get reimbursed for it … ?” That’s all you need. And so what we did is, we made a three-by-three table. And it was deceptively simple, but that was it.
Do you need a Chief Wellness Officer?
How to prevent burnout when establishing new workflows
Christine Dela Rosa: But wasn’t this one more new thing? Like, how did you avoid process overload when there’s already so much paperwork doctors go through? What was your secret in protecting doctors from superfluous layers?
Dr. Shah: The secret sauce was we employed the tactics of well-being and that’s how we were successful. Was it clunky and was it not ideal? Yes, of course. We didn’t put out something beautiful; we really had a minimum viable product, but what we did do was actually implement something with the ideals and the framework of well-being.
We thought about all four drivers of burnout and we tried to address them when we rolled out this thing literally overnight. The first thing I thought about was, “How do we deliver quality care?”
Then the second thing was try and minimize inefficiency. Because we know that if you’re inefficient you’re going to burn out.
So then the next thing was: recognize good works. We actually had a weekly doctor-wide or clinician-wide call. And we would highlight the superstars.
And then the fourth one was input. And not only were we getting weekly input from these system calls … I would do the speaking circuit. I would jump on the primary care doctors’ call on Monday, the neurologist call on Tuesday, and I kept doing my rounds to say, “Here are the new things, and what do you need me to work on?” And so that is directly allowing several venues to give input.
So, thinking about the four things that drive burnout, and using that upfront as we tried to implement, I really think that led us to go from zero to 50,000 visits in six weeks.
Dr. Shah explains how each of the four factors were addressed in a healthcare setting:
*Editor’s note: The report “To Err is Human” was published in November of 1999.