Taking Action Against Clinician Burnout A Systems Approach to Professional Well-Being (2019) / Chapter Skim
Currently Skimming:
2 A Framework for a Systems Approach to Clinician Burnout and Professional Well-Being
2 A Framework for a Systems Approach to Clinician Burnout and Professional Well-Being
Pages 37-62
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 37... ...
1 To consider approaches for improving patient care by supporting the professional well-being of clinicians, the committee developed a conceptual framework that clarifies the structure and dynamics of the system in which clinicians work and reveals potential levers for change. The committee's framework for a systems approach to clinician burnout and professional well-being is based on theories and principles from the fields of human factors and systems engineering, job and organizational design, and occupational safety and health.
|
From page 38... ...
The committee acknowledges that there are significant differences in how vulnerable individual clinicians are to burnout because personal resilience and other individual and contextual factors influence each individual's capacity and approaches to dealing with work-related stress (discussed further in Chapter 4)
|
From page 39... ...
, leading ultimately to the definition that burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment (Maslach et al.,
|
From page 40... ...
code of QD85. It should be noted that WHO defines burnout as a problem associated with employment rather than as an individual mental health diagnosis and that it is considered to be distinct from mood disorders (WHO, 2019)
|
From page 41... ...
. Philosophically, since the d rivers of burnout originate in the work environment, the committee favors the occu ational framework that views and addresses burnout as a system p issue rather than as a personal mental health diagnosis.
|
From page 42... ...
. Professional well-being is further conceptualized as job-related and is a function of being satisfied with one's job, finding meaning in one's work, feeling engaged while at work, having a high-quality working life, and finding professional fulfillment in one's work (Danna and Griffin, 1999; Doble and Santha, 2008)
|
From page 43... ...
. The literature offered many opportunities to better understand work organization, job stress, and professional well-being and provided the committee with a number of health work design approaches to consider.
|
From page 44... ...
. In the organizational context, complex adaptive systems are a type of socio technical systems that adapt to changes (e.g., changes in the external environment or technologies, disruptions, or unexpected events)
|
From page 45... ...
. In a similar manner, a solution enacted at a higher level (e.g., the health care organization or the regulation level)
|
From page 46... ...
See Chapter 4 for a further description of the various factors that contribute to burnout. See Chapter 3 for a description of the consequences that burnout and professional well-being have for patients, clinicians, health care organizations, and society.
|
From page 47... ...
aders | P | Le h es ys al s iti ic En ti v v i ro Ac n m ent | | Frontline Care Delivery | Health Care Organization | External Environment * Note: Care team members include clinicians, staff, learners, patients, and families.
|
From page 48... ...
. Frontline care delivery takes place in the context of a care team, including clinicians, learners (including trainees and students)
|
From page 49... ...
See Chapter 6 for a discussion of these elements of the external environment. Frontline care delivery, the health care organization, and the external environment all influence each other.
|
From page 50... ...
is in line with this com B mittee's proposed approach to expand the concept of learning health care systems to include improving clinician professional well-being. The 2012 IOM report on learning health care highlights the need to improve health care work systems so as to better support clinicians' work as well as the need to allow clinicians to continually learn and improve in their work (IOM, 2012a)
|
From page 51... ...
Patient–Clinician Relationships • Engaged, empowered patients -- is anchored on patient needs and per spectives and promotes the inclusion of patients, families, and other caregivers as vital members of the continuously learning care team. Incentives • Incentives aligned for value -- actively aligns incentives to encourage continuous improvement, identify and reduce waste, and reward high value care.
|
From page 52... ...
. HCD should be implemented at multiple system levels, in particular by health care organizations in their effort of reducing clinician burnout and implementing well-being systems (see Chapter 5)
|
From page 53... ...
. As discussed below, the sources of these threats to professionalism originate from all levels of the system: frontline care delivery, the health care organization, and the external environment (see Figure 2-2)
|
From page 54... ...
Threats to Professionalism and the External Environment Clinicians' first duty is to provide care for individuals who need health care services. The ability to do so, however, is influenced by multiple factors outside the sphere of direct influence for most clinicians and even of the health care organizations in which they work.
|
From page 55... ...
Resilience generally reflects the ability of a person, community, or system to withstand, adapt, recover, rebound, or even grow from adversity, stress, or trauma. The identification of interventions aimed at tackling the critical factors contributing to burnout is a way of fostering an improved state of professional well-being while improving patient care.
|
From page 56... ...
In the committee's model, there are three system levels -- frontline care delivery, health care organization, and external environment -- that together influence the factors contributing to burnout and professional well-being. Decisions made at the three levels of the system have an impact on the work factors -- job demands and resources -- that clinicians experience.
|
From page 57... ...
2016. The learning healthcare system: Where are we now?
|
From page 58... ...
2017. The Charter on Professionalism for Health Care Organizations.
|
From page 59... ...
2017. Shared decision making and improving health care: The answer is not in shared decision making and improving health care.
|
From page 60... ...
2016. Nurse moral distress: A survey identifying pre dictors and potential interventions.
|
From page 61... ...
2010. A new sociotechnical model for studying health information technology in complex adaptive healthcare systems.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.