In many physician practices and health care organizations, people aren’t the ones causing problems. Instead, systems and behaviors are the culprit.

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An AMA STEPS Forward™ toolkit can help you identify and correct local opportunities for improvement (LOFIs) in your practice. The CME toolkit, “LISTEN-SORT-EMPOWER: Find and Act on Local Opportunities for Improvement to Create Your Ideal Practice,” also helps you recognize the benefits of increased professional fulfilment and reduced burnout when the team takes pride in improving the practice.

“Using a collaborative problem-solving technique like that found in LISTEN-SORT-EMPOWER results in a friendlier work environment for clinicians and a cohesive team that is able to meet the daily challenges that arise,” according to the toolkit.

The model—adapted from the Mayo Clinic’s listen-act-develop approach to physician engagement—is intended to:

  • Identify what drives burnout.
  • Foster healthy clinician-leadership relationships.
  • Engender teamwork and camaraderie.
  • Support developing clinician leaders.
  • Alleviate burnout by improving team dynamics, processes and systems of care.

The toolkit walks health care professionals through four key steps to effectively use the listen-sort-empower model to engage the frontline care team in identifying and solving sources of frustration and root causes of professional burnout in the practice.

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Listen to the team to uncover LOFIs unique to your practice. The majority of these opportunities for improvement are unique to local work units, so create a safe environment for clinicians and emphasize that responses will not lead to reprimand or backlash.

Convene focus groups of clinicians from the same work areas and discuss questions such as what makes for a good day and what can be done to improve work life. Record the discussion by taking notes. Don’t try to solve problems in this setting.

Sort the LOFIs to prioritize them for resolution. Once a list of opportunities for improvement is compiled, use a whiteboard or other collaborative approach for the team to sort the items to identify who has control over each LOFI. Does your team have the authority to address the problem or does it require partnerships with other leaders and work units to fix?

Or, is there no local control to remedy the problem and it needs to be escalated to the next leadership level? Prioritize each LOFI based on impact and feasibility and then rank them based on preferences, cultural readiness, difficulty and estimated time to complete.

Empower team members to make changes and resolve issues. Appoint a local clinician to lead the effort to start resolving issues who will work in partnership with local administrators or managers. Once the team develops an intervention or improvement, conduct a pilot or trial to the approach and evaluate the outcomes.

Assess whether the intervention achieved the goal or if it needs to be refined; communicate results to all staff members; establish new practices, protocols and systems as needed; communicate plans to the care team and senior leadership; and recognize the group’s accomplishments and celebrate.

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Repeat to revisit or replenish your list of LOFIs. In pursuit of the ideal work environment, there will always be issues that need to be addressed. Revisit or replenish your rank list to identify the next round of opportunities for improvement.

In addition to removing sources of inefficiency and frustration, using the listen-sort-empower approach allows you to:

  • Send an important message from leadership that says: We are listening. We trust and respect you.
  • Foster self-discovery among team members: We know what the problems are. We can develop solutions together.
  • Build camaraderie: We care about each other. We are not helpless.
  • Provide meaning and purpose in work: We are improving the practice environment to allow us to better serve our patients. We can make a difference.

The AMA STEPS Forward open-access toolkits are part of the AMA Ed Hub™️, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources, all in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.

Learn more about AMA CME accreditation.

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