Symposium Presentations
Several symposium speakers have agreed to make their presentations on burnout available.
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Clinical Optimization and Medical Documentation Breakout Session
Gurur Biliciler-Denktas MD
These sessions provide symposium participants an opportunity to share their organizations' experiences in addressing key drivers of burnout. What has worked? What hasn't? What are the challenges in marshaling support from organizational leadership? What resources are needed? What strategies have proved effective in changing the culture of the organization? How can local and national organizations collaborate to address the key drivers of burnout? UT System faculty leaders will take notes and report a synopsis to the symposium on Tuesday morning
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Addressing the Key Drivers of Burnout: Transforming Ambulatory Practice
Thomas Bodenheimer MD
Clinician burnout is associated with a number of factors, including clinicians spending a great deal of time doing work that is below their level of training and thus unsatisfying and inefficient. One structural antidote to these factors is the building of teams that truly share the care with clinicians. Professional team members - in particular nurses, pharmacists and behaviorists - are capable of independently caring for many patients in a typical ambulatory practice panel. Unlicensed team members, in particular medical assistants - if at least two are available per clinician and if properly trained - can assume responsibility for electronic medical records (EMR) documentation, population management, and health coaching. Some exemplar primary care practices have succeeded in creating effective teams that reduce burnout and have constructed a business case to support those teams. Lessons from primary care can help to inform transformation in specialty ambulatory practices.
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Summary of Physician Leadership
Suman Challa BDs
These sessions provide symposium participants an opportunity to share their organizations' experiences in addressing key drivers of burnout. What has worked? What hasn't? What are the challenges in marshaling support from organizational leadership? What resources are needed? What strategies have proved effective in changing the culture of the organization? How can local and national organizations collaborate to address the key drivers of burnout?
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Can Changing the Value System and Re-aligning the Financial Structure of the Institution Prevent Clinician Burnout?
Darrell G. Kirch MD
Growing clinician burnout in the U.S. is nearing public health crisis levels. Each year, 400 physicians commit suicide, a rate more than twice that of the general population. Nearly one-third of nurses are emotionally exhausted. The traditional culture of health care - characterized by hierarchy, autonomy, competition, and individualism - has created an environment that makes it difficult for physicians to ask for help or seek care when they need it. The effects of this problem extend beyond the individual health care worker - burnout has been shown to lead to impaired professionalism, high staff turnover, a decrease in patient satisfaction, and an increase in medical errors. How are we to care for others if we cannot care for ourselves? Clearly, we must do a better job of creating environments that strengthen resilience and support the well-being of clinicians and other health care workers. Dr. Kirch will present a framework outlining the domains influencing clinician well-being, including the work environment, learning environment, and personal and professional factors. He will then delve into causal factors in each of these domains, including administrative and regulatory burdens, power differentials and mistreatment, and isolation and work-life imbalance. He will also examine the positive forces at work in each domain that promote wellness, social support, and group connectedness. Finally, Dr. Kirch will review the growing national momentum behind efforts to identify and implement evidence-based solutions promoting clinician well-being and combating burnout, depression, and suicide among U.S. health care workers. While much work remains to be done to create a healthy and resilient clinician workforce, addressing this problem at a national level will make a difference in the lives of clinicians, in the cultures of our institutions, and ultimately, in the outcomes of our patients.
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Effects of 2- vs 4- Week Attending Physician Inpatient Rotations on Unplanned Patient Revisits, Evaluations by Trainees, and Attending Physician Burnout: A Randomized Trial
Brian P. Lucas MD, MS
Colin West and the Mayo team recently published a meta-analysis of "Interventions to Prevent and Reduce Physician Burnout" (Lancet 2016; 388: 2272-81) and found that only three "randomized studies of structural or organizational interventions" have been reported in the literature. Brian Lucas et al. examined the "Effects of 2- vs 4- Week Attending Physician Inpatient Rotations on Unplanned Patient Revisits, Evaluations by Trainees, and Attending Physician Burnout" (JAMA 2012). The second organizational intervention was the Healthy Work Place (HWP) study by Mark Linzer et al: "Interventions to Improve Work Conditions and Clinician Burnout in Primary Care" (J Gen Intern Med 2015). Third, Christopher Parshuram et al studied "Patient Safety, Resident Well-Being and Continuity of Care with Different Residents Duty Schedules in the Intensive Care Unit" (CMAJ 2015). The panel will discuss the findings of these four studies and what further research is needed to determine the most effective interventions for preventing and reducing physician burnout.
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Meeting the Challenge of Burnout
Christina Maslach PhD
There is growing evidence of the challenge that burnout poses for everyone in health care. But what is the evidence about the causes of burnout, and how can that be translated into effective solutions? Innovative answers to this challenge need to focus more on how to change critical sources of burnout within the job context, rather than simply helping people cope with the negative effects. These proposed solutions must be implemented and evaluated systematically, in order to establish what are truly the best practices for beating burnout. Such an approach will lead to a better vision of healthy workplaces for health care.
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Structural Interventions Against Physician Burnout: Resident Schedule
Christopher S. Parshuram MBChB, DPhil
Colin West and the Mayo team recently published a meta-analysis of "Interventions to Prevent and Reduce Physician Burnout" (Lancet 2016; 388: 2272-81) and found that only three "randomized studies of structural or organizational interventions" have been reported in the literature. Brian Lucas et al. examined the "Effects of 2- vs 4- Week Attending Physician Inpatient Rotations on Unplanned Patient Revisits, Evaluations by Trainees, and Attending Physician Burnout" (JAMA 2012). The second organizational intervention was the Healthy Work Place (HWP) study by Mark Linzer et al: "Interventions to Improve Work Conditions and Clinician Burnout in Primary Care" (J Gen Intern Med 2015). Third, Christopher Parshuram et al studied "Patient Safety, Resident Well-Being and Continuity of Care with Different Residents Duty Schedules in the Intensive Care Unit" (CMAJ 2015). The panel will discuss the findings of these four studies and what further research is needed to determine the most effective interventions for preventing and reducing physician burnout.
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In Search of Joy in Practice
Christine Sinsky MD
There is tremendous hunger among physicians and other health professionals to serve the needs of patients, without ignoring their own needs for work-life balance and career satisfaction. Professional satisfaction is a powerful driver of the Triple Aim, and as a result, it should be a critical concern of health system leaders and practicing physicians alike. Over half of all U.S. physicians exhibit some sign of burnout, increasing the likelihood of mistakes, patient dissatisfaction, and physician intent to leave practice. Improvements in clinical workflow, teamwork and communication are among the most potent anecdotes to burnout. This session will describe practice transformation approaches that can help physicians and staff re-engineer their practice to foster sound medical decision making, minimize error, increase provider quality time with patients yet go home earlier, and create an atmosphere that patients, staff, and physicians can enjoy
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Medical School and Residency Training Breakout Session
Dwain Thiele MD
These sessions provide symposium participants an opportunity to share their organizations' experiences in addressing key drivers of burnout. What has worked? What hasn't? What are the challenges in marshaling support from organizational leadership? What resources are needed? What strategies have proved effective in changing the culture of the organization? How can local and national organizations collaborate to address the key drivers of burnout? UT System faculty leaders will take notes and report a synopsis to the symposium on Tuesday morning.
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Adressing the Key Drivers of Burnout: Exploring Solutions in Education and Training
Colin P. West MD, PhD
Research has shown that medical students, residents, and fellows experience high rates of burnout, depression, and suicidal ideation. What is it about the educational and training environment that fosters these problems? What is the impact on trainees and patients, and what can we do to fix it? Dr. West will review the research to date and propose solutions and best practices for improving the ways we train future generations of physicians.
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Structural Interventions for Physician Burnout: What Do Evidence-Based Approaches Tell Us
Colin P. West MD, PhD
These sessions provide symposium participants an opportunity to share their organizations' experiences in addressing key drivers of burnout. What has worked? What hasn't? What are the challenges in marshaling support from organizational leadership? What resources are needed? What strategies have proved effective in changing the culture of the organization? How can local and national organizations collaborate to address the key drivers of burnout? UT System faculty leaders will take notes and report a synopsis to the symposium on Tuesday morning.
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Redefining and Advocating New Models of Care: Breakout Session
Shan Zhao MBA, FACHE
These sessions provide symposium participants an opportunity to share their organizations' experiences in addressing key drivers of burnout. What has worked? What hasn't? What are the challenges in marshaling support from organizational leadership? What resources are needed? What strategies have proved effective in changing the culture of the organization? How can local and national organizations collaborate to address the key drivers of burnout? UT System faculty leaders will take notes and report a synopsis to the symposium on Tuesday morning.
