After surveying physicians and medical providers to assess the presence of burnout, one hospital in Minneapolis implemented several changes to their facility and processes to make sure the identified burnout triggers were addressed as soon as possible. In addition to scheduling and environmental transformations, a unique solution stands out—the creation of a room where physicians and medical providers can go to “reset” following a challenging or traumatic situation.
An office for work-life balance and burnout prevention
Leaders at Hennepin County Medical Center developed the Office for Professional Worklife to address the needs of its physicians and other medical providers.
In order to make sure physicians and other providers are directly involved in burnout solutions, a wellness committee was created in 2013. It is made up of volunteers from each department who work with organizational leaders to periodically measure burnout through a survey called the “mini Z,” (document) which they administer annually. The committee meets for about an hour each month for brainstorming sessions to review current projects, plan new initiatives, discuss survey data and respond to new opportunities or stresses.
“We sit down with the chair of each department and review their data from this year compared to last year and try and gain some insights about where the stress or burnout might be coming from,” said Mark Linzer, MD, internal medicine specialist and director of the division of general medicine at Hennepin County Medical Center.
“Then we try and determine some next steps, which might require me to go to the executive leadership group to ask for flexibility or resources so they can put some plans into place,” Dr. Linzer said.
Here are three ways Hennepin County Medical Center has already addressed burnout:
The reset room is a place physicians and other providers can go if they need a moment to reset during their day. If there is a traumatic event they wish to recover from, or they just want to get away for a moment, make a phone call or take a short nap, they can duck into the reset room.
With LED lights, flameless candles, a sound machine, and comfortable chairs, several plants, and an “in-use” sign on the door, physicians and other providers can enter this quiet space for reflection or to disconnect for a moment.
Few resources were required to create this welcoming space. The reset room was built inside what used to be an oddly shaped and poorly located office, which is perfect for this purpose because it is situated away from the regular action of the medical center.
“I try not to monitor [the reset room] because I don’t want people to think I’m monitoring them,” said Sara Poplau, senior research project manager and assistant director of the Office for Professional Worklife. “That’s not what it’s about. But I know how I leave things, and I know how I find things, so I can tell that someone’s been in there—and that it’s benefitting our providers.”
“Even if you don’t get to use it that often,” Poplau said, “at least you know that the institution values you in that sense.”
Schedule changes for work-life balance
One of the first changes made at Hennepin County Medical Center addressed work-life balance. Physician parents were often unable to leave on time because their last complex patient was scheduled at 4:30 p.m. In many instances, this patient would not be ready for the physician to see until 4:45, making it challenging for a physician to pick up a child from daycare by 5:30 p.m.
As a solution, the end-of-day schedule was re-engineered so the last complex patient was scheduled at 4 p.m. The 4:40 p.m. slot was changed to routine care instead of complex care, and this simple change helped parents leave work on time.
Recognizing the demands of the day also was an important component.
“We have one division where the burnout rate was high for nurse practitioners and PAs,” Dr. Linzer said. “We introduced some slots during their days to slow the pace of work and give them a chance to catch up with the [electronic health record], and that was very successful.”
One clinical department invested in new carpeting and asked staff to contribute ideas for locally sourced art.
“A lot of the art ended up being from the staff,” Poplau said. “It was a fun team-building exercise in the sense that people might not have known that their co-worker was such a good photographer or painter.”
The more welcoming environment and greater sense of community may have helped boost satisfaction among members of the department. Satisfaction in the department increased from 65 percent in the 2013 survey to 83 percent in 2014, while burnout decreased from 39 percent to 17 percent over the same time period.
Changes in the pipeline
Many other changes to help physicians and other hospital staff in their daily routines are underway at Hennepin County Medical Center.
“People come to us a lot,” Dr. Linzer said, “often with individual issues, and we really try to address those quickly so that they know that there’s an office that will take care of individual challenges to work life and wellness.”
“We’ve been fundraising for the transformation of our old dining room into a provider dining and wellness center with a workout space, a shower and changing area, some meditation areas, yoga mats and an area to sit on the floor and debrief challenging events,” Dr. Linzer said. The wellness center is set to open by July.
Also, one of the departments that reported a high stress as a result of electronic health records brought it to the attention of the wellness committee and together came up with a 10-point plan to reduce those stresses.
“That’s a great example where the data spoke clearly that that was a major source of stress,” Dr. Linzer said, “and the organization is going to be able to respond.”
Dr. Linzer, Poplau and Laura Guzman-Corrales, senior project coordinator at the Minneapolis Medical Research Foundation, authored a module on preventing physician burnout for the AMA’s STEPS Forward™ collection of practice improvement strategies to help physicians make transformative changes to their practices. Other available modules on burnout cover preventing resident and fellow burnout and improving physician resiliency.
Thirty-five modules now are available in the STEPS Forward collection, and several more will be added later this year, thanks to a grant from and collaboration with the Transforming Clinical Practices Initiative.
Physicians and experts from around the world will gather Sept. 18-20 in Boston for the International Conference on Physician Health™. This collaborative conference of the AMA, the Canadian Medical Association and the British Medical Association will showcases research and perspectives into physicians’ health and offer practical, evidence-based skills and strategies to promote a healthier medical culture for physicians.