Summary and Conclusion
No single actor is responsible for making the significant investments needed to ensure sustainable, system-wide changes and to achieve the vision set out in this National Plan. Investment in health worker well-being must come from multiple levels. These actions must include individual health systems and training programs—both large and small—committing to a baseline understanding of burnout and distress in their workforce. Then, interventions must be implemented with frontline health workers that include public and private payers streamlining processes and requirements, providing reimbursements for mental health care, and supporting efforts to enhance well-being; developers of health IT improving EHRs and innovating to be more human-centered; and federal and state governments investing in wide scale research, as well as tracking and removing barriers to allow funding to flow to work and learning environments.
The goals, actions, and actors identified in this National Plan are interconnected and aim to support health worker well-being and a thriving U.S. health system. Improving health worker well-being is a shared responsibility that requires collective action by all actors in the U.S. health system and those who influence the systems that support health. Health leaders play an important role in their institutions and must work together with frontline health workers to address barriers to well-being. Community members, from patients to the public, private and non-profit institutions to media organizations, are also called upon to join this burgeoning social movement for health worker well-being and start spreading change on a massive scale.
Leaders of health, public health, and educational institutions must understand the extent and drivers of workplace stress and burnout at the organizational level. Frontline health workers and
learners are vital partners for implementing context-specific interventions that will create safe and supportive work and learning environments. Our health workers and learners cannot be expected to work in violent, threatening, and unsafe conditions, or be made to feel unwelcome in environments that are not diverse, equitable, inclusive, and accessible. As a nation, we must understand the effects of COVID-19 and public health crises on the well-being of the health workforce, protect their mental health, and reduce the stigma associated with speaking about these issues now and in the future.
At the national level, policies, payment structures, and other key systems governing care and disease prevention must align to focus on human connection and trust in health care. We must review and revise our technology, rules, regulations, and policies to streamline care and reduce the burden in service of the critical health worker-patient relationship. We must institutionalize well-being as a value to ensure the health and longevity of those who care for us and train, hire, and retain a health workforce that reflects the diversity of the U.S. population.
Much like how the national movement to improve the safety and quality of care delivery has gained ground over the last 20 years, improving health worker well-being will be a long journey. While there is no finish line, every step makes a difference in improving the environment for our health workforce and brings us closer to experiencing a health system where both health workers and patients thrive.
How will the nation know we are on the right path? Key indicators of progress are more health systems using validated surveys to track health worker well-being and burnout, and training programs that integrate health worker well-being into their strategic plans and educational curricula. Other signs of positive change at the national level include increased funding streams and evidence-based policy making that support health workforce well-being, and the design, deployment, and accessibility of human-centered technologies that increase the efficiency and safety of the health workforce and simultaneously enhance patient care.
Where do we go from here? An ecosystem of actors that work collectively to coordinate, facilitate, report, and enable accountability
will be necessary for long-term change. A coalition should catalyze action across professions, settings, and regions; fairly represent all health professions; and unequivocally embrace the principles of diversity, equity, inclusion, and accessibility. With this National Plan, the key elements to create a social movement for health workforce well-being in the United States are identified, and we must seize this COVID-19 crisis as a window of opportunity (see Chapter 1). Next will be a focus on the voices of newly committed and re-committed actors to spark widespread change, advocacy of the actions outlined in this National Plan, and mass communication efforts to amplify the messages of this National Plan.
This moment demands urgency. Challenges to health worker well-being were documented prior to the pandemic, and COVID-19 has only deepened these issues and led to a health workforce that is too small and has high levels of burnout and distress. We cannot witness and not act, as our health workers continuing to sound the alarm for reprieve from the multitude of stressors that have strained and drained our health workforce. Immediate and sustained action to address health worker burnout and improve wellbeing is imperative to ensure that the United States has a health workforce that can support our population now and in the future. While we have made progress, more commitment and investment are necessary for sustainable change. Improving health worker well-being is a societal issue—it is our ethical obligation to take action to protect those who care for all of us.
