Physician burnout surveys are often helpful in understanding the size and nature of the problem within the workplace. However, for Beth Israel Deaconess Medical Center, many of the available surveys did not provide customized strategies on how to intervene. To identify appropriate steps in establishing how to address burnout, Beth Israel worked in collaboration with the AMA to administer the Mini Z burnout survey.
Before deploying the Mini Z to identify and evaluate physician burnout, the leadership team at Beth Israel identified 20 changes that could improve doctors’ work life and that they knew they could implement. The team then asked physicians to rate each of these options.
“We used our survey to assess our baseline status, but simultaneously as an opportunity to ask the physicians to prioritize interventions that were most important to them,” said Alexa Kimball, MD, president and CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center Inc. “We gave them a list of things we felt confident we could achieve and that we thought could have an impact.”
“The results allowed us to prioritize our efforts and also set us up for a positive and consistent communication back to our physicians that say, ‘We asked, we listened and here’s what we have done,’” said Dr. Kimball, who is also professor of dermatology at Harvard Medical School.
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face. By focusing on factors causing burnout at the system-level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction.
Here is how the Mini Z helped Beth Israel improve their approach to identifying and evaluating physician burnout.
Preparing the team
“Even before the results of the survey were available, we expected that there would be things we could do to help improve the physicians’ experience,” said Dr. Kimball. “We searched the literature for interventions that had been tried, we brainstormed amongst ourselves and we asked the departments to share their best practices.”
After brainstorming, it was important to ensure each task was achievable.
“This approach allowed us to have buy-in from the groups that would have to implement the change even before we knew what the physicians wanted,” she said. “This approach also allowed us to intervene right out of the gate once we had the data back—we didn’t have to wait to design an intervention. We knew exactly what we wanted to do.”
Compiling a list
The list included many ideas from the IT department, but also from across multiple other domains. After completion of the Mini Z, the team at Beth Israel incorporated a list from their academic physicians, which resulted in these 12 priorities:
- Simplify or provide more support for Harvard promotion process (CV assistance).
- Cut the number of clicks in their EHR.
- Provide additional training for administrative team members to enhance the patient experience.
- Add a split screen to keep notes open while reviewing other sections of their EHR.
- Streamline and simplify credentialing paperwork.
- Shorten and simplify mandatory training, and provide CME credit when possible.
- Automatically populate ICD-10 billing codes into orders, notes and problem lists.
- Provide medical assistants with additional training so they can assist more during ambulatory visits.
- Provide more help with processing prior authorizations for medications or procedures.
- Develop tools to help address underutilization or cancellations (operating room time, ambulatory clinic space, patient visits).
- Provide more consolidated benefits information online.
- Expand child care and family resources.
“We are pleased to report that we have completed 11 of the top 12, and the 12th is in progress,” said Dr. Kimball. “We have also consistently reported back to our faculty those results throughout the year. Having a priority list also gave us tremendous influence in speaking to other groups who needed to help us because we could say, ‘This is what the physicians told us they needed.’”
The AMA Ed Hub™—your center for personalized learning from sources you trust—offers education and CME on a broad range of topics, including professional well-being from the AMA’s STEPS Forward™ open-access modules offering innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine, create a strong team culture and improve practice efficiency.
The AMA also offers practice transformation strategies and resources designed to increase professional satisfaction and physician well-being.
