I've been researching burnout amongst clinical staff and the results are scary. Burnout continues to grow in healthcare at an alarming rate, linked to poor work life balance.
People have been working since the 60's to develop ways to automate the rostering of clinical staff. But scheduling people with an algorithm isn't working. Burnout from poor work life balance and pressure in the 'office' is impacting clinicians like never before and the problem is growing. We are studying the causes and finding new ways to address them through our software. Here's some of our findings.
People are continually asked to achieve bigger results with fewer resources and there is perhaps no more obvious place where that's happening than in healthcare.
The fact is, that healthcare workers have been challenged to introduce efficiencies or find new ways of dealing with work stressors for a long time. We are now reaching a tipping point where step changes are not helping improve to clinician experiences and this in turn could have a significant impact on better patient care.
In their reflection on burnout, "From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider" Bodenheimer and Sinsky noted "The Triple Aim—enhancing patient experience, improving population health, and reducing costs—is widely accepted as a compass to optimise health system performance. . . . Burnout is associated with lower patient satisfaction, reduced health outcomes, and it may increase costs. Burnout thus imperils the Triple Aim."
Burnout is also growing at a dangerous rate. Tait et al noted clinician burnout runs at something like double the rate of the general population, a figure that has been noted to be growing in followup studies. "Font Line" staff including including emergency department physicians and general internists are especially impacted.
There's evidence too that the clinical situation has a lot to do with stressors that lead to burnout. McHugh et al noted "We found much higher job dissatisfaction and burnout among nurses who were directly caring for patients in hospitals and nursing homes than among nurses working in other jobs or settings"
So, what to do? Well going back to studies they found that work life balance played a significant part in reducing burnout, but what this looks like is closely tied to the individual (Greenhaus).
This bears out with discussions we've had talking with clinicians. Understanding what they want from their jobs, we saw a huge variation in what they see as a good fit for them. Some like working weekends, some need a parent home for the kids, almost everyone we spoke with was happy to do their bit with "unsocial" shifts because it was the fair thing to share those around with everyone. Something interesting we found was shift preferences being dictated by travel. Those on public transport didn't like later shifts in the winter because they could be travelling in the dark, others lived some distance from work and driving during peak hour made some shifts hours longer door to door.
Varner et al. noted that employers creating an environment where staff are supported in their needs and planning with staff to find the right balance can not only retain the staff member who has conflict, but this this reduces stress on the team overall. Improving everyones risk of burnout. This makes sense when you think about turnover taking time to be resolved, finding staff and training them .
So what do we do?
We are serious about finding new ways to combat burnout and improve people's work life balance. CoRoster is designed to allow for individual preferences to influence shifts but in a measured way. We use workplace requirements along with staff requests to build a balanced roster. Uniquely, we then apply fairness tests that ensure staff are equally allocated unsocial shifts and no one can unduly bias a roster outcome.
This lets everyone see the roster is an open and transparent process and lets them micro-manage their preferences if they wish, building the best outcome for everyone. This saves schedulers time and builds a high quality roster that people will stick to.
Thomas Bodenheimer, Christine Sinsky, From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider, ANNALS OF FAMILY MEDICINE ✦ VOL. 12, NO. 6 ✦ NOVEMBER/DECEMBER 2014
Tait D. et al., Burnout and Satisfaction With Work-Life Balance Among US Physicians Relative to the General US Population ARCH INTERN MED/ VOL 172 (NO. 18), OCT 8, 2012
McHugh et al. Nurses’ Widespread Job Dissatisfaction, Burnout, And Frustration With Health Benefits Signal Problems For Patient Care , Health Aff (Millwood). 2011 February
Greenhaus et al., The relation between work–family balance and quality of life, Journal of Vocational Behavior 63 (2003) 510–531
Varma et al. Enhancing healthcare quality by promoting work-life balance among nursing staff, Journal of Hospital Administration 2016, Vol. 5, No. 6