Organizational Resources In Healthcare
Cherie Trojak
The realities of our health care system are driving many health workers to burnout. They are at an increased risk for mental health challenges and choosing to leave the health workforce early. They work in distressing environments that strain their physical, emotional, and psychological well-being. This will make it harder for patients to get care when they need it.
Workplace systems cause burnout among health workers. There are a range of societal, cultural, structural, and organizational factors that contribute to burnout among health workers. Some examples include: excessive workloads, administrative burdens, limited say in scheduling, and lack of organizational support.
Physician demand will continue to grow faster than supply, leading to a shortage of between 54,100 and 139,000 physicians by 2033. The most alarming gaps are expected in primary care and rural communities. (Source: The Association of American Medical Colleges, 2020)
Burnout, resource shortages, and high risk for severe COVID-19 infections have unevenly impacted women and health workers of color. This is due to pre-existing inequities around social determinants of health, exacerbated by the pandemic.
If not addressed, the health worker burnout crisis will make it harder for patients to get care when they need it, cause health costs to rise, hinder our ability to prepare for the next public health emergency, and worsen health disparities.
Burnout is characterized by a high degree of emotional exhaustion and depersonalization (i.e., cynicism) and a low sense of personal accomplishment at work. Anyone can experience burnout, yet it is especially worrisome among health workers because of potential impacts on our healthcare system and our collective well-being. Burnout is associated with risk of mental health challenges, such as anxiety and depression. However, burnout is not an individual mental health diagnosis. Burnout is a workplace issue that calls for systems-oriented, organizational-level solutions.
Check in with the health workers you know. Help them stay connected. Ask them how they are doing and how you can help them. Pay attention to warning signs that indicate that they may need professional support from a mental health provider. Common behaviors to watch out for are: increased irritability, withdrawal from friends and family, impaired judgment, excessive alcohol or substance use, reduced ability to manage emotions and impulses, and decreased personal hygiene.
To reduce strain on the healthcare system and health workers, take care of your health as much as possible and follow local public health guidelines. As a patient, be kind to health workers. Acknowledging the pressure that health workers are experiencing can go a long way.
Burnout among health workers has harmful consequences for patient care and safety. This includes decreased time spent between provider and patient, increased medical errors and hospital-acquired infections among patients, and staffing shortages.
We know that burnout is costly at a human and a systemic level, but it can be difficult to assess, and is not consistently measured. My advisory calls for the related organizations and institutions to regularly assess, measure, and intervene to prevent burnout.
The National Academy of Medicine Resource Compendium for Health Worker Well-Being offers a collection of evidence-based measurement tools for organizations to use. Data should be confidential and evaluated by race, ethnicity, age, departmental units, role, and levels of seniority to understand differences and help identify tailored interventions.
Health care organizations can implement evidence-based policies, programs, and solutions that identify, address, and help prevent burnout for health workers. There are many opportunities to strengthen organizational cultures and environments to be safer, more generous, and more just for all health workers.
We can begin by listening to health workers and seeking their involvement to improve processes, workflows, and organizational culture. Institutions can: build in time for and encourage all health workers on staff to take paid leave, sick leave, family leave, and rest breaks; establish a zero-tolerance policy for violence; prioritize adequate personal protective equipment; increase work schedule flexibility and autonomy; and combat bias, racism, and discrimination in the workplace. Download the advisory for further information.
This is a directory of workplace violence prevention resources developed by The Joint Commission, federal and state governments, and professional associations, such as the American Nurses Association and the American Hospital Association.
The AWARE suite of well-being resources (a video workshop, podcasts, and the ACGME AWARE app) is designed to promote well-being among residents, faculty members, and others in the graduate medical education community.
On this platform, student service providers, faculty, staff, and current medical students share personal stories of resilience, resources for maintaining well-being, and programs, practices, and strategies they have found to be effective for student well-being.
The National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience offers a collection of resources and tools for health care leaders and workers to reduce burnout and improve clinician well-being.
Ethical decision-making is required when the healthcare executive must address a conflict or uncertainty regarding competing values, such as personal, organizational, professional and societal values. Those involved in this decision-making process must consider ethical principles including justice, autonomy, beneficence and nonmaleficence, as well as professional and organizational ethical standards and codes. Many factors have contributed to the growing concern in healthcare organizations over clinical, organizational and societal ethical issues, including issues of equitable access and affordability, quality, value-based care, patient safety, disclosure of medical errors, allocation of limited resources, mergers and acquisitions, financial and other resource constraints, and advances in medical treatment that complicate decision-making near the end of life. Healthcare executives have a responsibility to recognize and address the growing number of complex ethical dilemmas they are facing, but they cannot and should not make such decisions alone or without a sound decision-making process that considers diverse viewpoints. The application of a systematic decision-making process can serve as a useful tool for leaders, staff and stakeholders in addressing ethically challenging situations.
Healthcare organizations should have resources that may include ethics committees, ethics consultation services, and written policies, procedures, frameworks and guidelines to assist them with the ethics decision-making process. With these organizational resources and guidelines in place, the best interests of patients, families, caregivers, the organization, payers and the community can be thoughtfully and appropriately evaluated in a timely manner.
Healthcare and community-based organizations (CBOs) across the country are increasingly working together to better address the root causes of poor health among low-income and vulnerable populations. Through support from Kaiser Permanente Community Health, the Center for Health Care Strategies and NFF collaborated to identify new strategies and resources to facilitate effective CBO-healthcare partnerships, building on work done under the Partnership for Healthy Outcomes project made possible by the Robert Wood Johnson Foundation.
Integrating to Improve Health: Partnership Models between Community-Based and Health Care Organizations
Outlines common partnership elements and establishes a framework to describe integration between community-based and healthcare organizations.
Value Proposition Tool: Articulating Value Within Community-Based and Health Care Organization Partnerships
Assists partners in articulating their value within an emerging or existing partnership through a series of reflection questions and considerations.
Health Care and Community-Based Organization Partnership: What Does It Cost?
Guides partnerships in estimating costs to help align goals, prioritize decisions, communicate with stakeholders, and advocate for funding.
To learn more, read the executive summary with takeaways on how to develop and sustain effective healthcare-CBO partnerships, and case studies featuring partnerships between a diverse array of CBO and healthcare partners working together to address social needs and improve health outcomes for at-risk patients.
Send your thoughts to Letters to the Editor. Learn moreJuly 9, 2019Share on FacebookShare on TwitterEmail to a friendPrint The Napa Institute, an organization that promotes traditionalist Catholicism with an annual gathering of largely affluent Catholics in Napa, California, as well as other conferences in major cities, will now offer legal and organizational resources for Catholic non-profits from healthcare to education. The new endeavor will be called the Napa Legal Institute.
Announced in late 2018 and officially launched May 2 at a Mass and event at the Catholic University of America's Busch School of Business, the Napa Institute offshoot will help connect non-profits "faithful to the Magisterium of the Catholic Church" with "Catholic lawyers who can provide legal counsel on corporate, tax and other non-litigation matters," Legal Institute executive director Josh Holdenried told NCR in an email.
Holdenried said the new entity will "not provide legal advice to organizations" per se, but its own spin-off, the Napa Legal League, will develop corporate education and non-litigation legal resources "that lay apostolates need."
In a July newsletter, the Legal Institute announced that its Healthcare Working Group would be headed by Louis Brown, executive director of Christ Medicus Foundation, a non-profit that "champions authentically Christ-centered health care at a moment when many are calling for a health care system that radically expands abortion, limits religious freedom, and dramatically undermines person-centered care," states its website.
c80f0f1006