How physician leaders can help
Burnout is a system-level problem that requires institutional changes where physician leaders can play a role in addressing burnout
Multiple studies show that interventions at the organizational level are far more effective than interventions directed at individual physicians.
Feeling safe at work
Psychological safety is the need to feel safe, validated, recognized and accountable at work. A positive work culture and feeling safe at work helps prevent burnout and is a moral and ethical imperative.
Staff want to be heard, protected, prepared, supported, and cared for.
Leaders can create psychological safety at work by:
- having open and candid dialogue between leadership and staff
- naming the issue and being willing to listen
- measuring physician well-being as a routine institutional performance metric, which could include assessing several dimensions such as burnout, engagement, professional fulfillment/satisfaction, fatigue, and emotional health/stress
- evaluating the relationship of physician well-being dimensions with other key organizational performance measures such as safety/quality and patient satisfaction
Principles for creating psychological safety
Studies show that psychological safety allows for moderate risk-taking, speaking your mind and creativity. Creating a sense of psychological safety on your team results in higher levels of engagement, increased motivation to tackle difficult problems, more learning and development opportunities, and better performance.
Here are eight steps you can take to create psychological safety at work.
1. Recognize your role.
There is an ethical obligation to foster psychological safety in the workplace.
2. Prioritize psychological safety.
Integrate well-being into your organization’s new normal at all levels of the workplace.
3. Express commitment through your words and actions.
Practice psychological safety by finding ways to say yes, acknowledging that you do not have all the answers, inviting and valuing all voices, expressing appreciation for divergent views and ensuring that time and attention are equitably divided in conversations.
4. Prioritize staff connections.
Help your team to get — and stay — connected. During the COVID-19 pandemic, find creative ways to maintain presence and connection with team members while physical distancing. You can also provide both formal and informal sources of peer support as well as encourage team members to check in emotionally with their colleagues, reflect on their experiences and distill learnings. Acknowledge and reinforce the positive actions of others (for example, include a “spreading good” feature in regular email or team meetings as a way of publicly acknowledging positive efforts) and invite team members to share something personal, such as an uplift of joy during team meetings.
5. Remind staff of the value of their work.
Staff who feel valued have and increased sense of self-worth and self-esteem, which drives morale in the workplace.
6. Help burned out staff reconnect.
Help team members to reconnect with their prior sense of value, competence and purpose by integrating projects that are personally meaningful to them into their work.
7. Model attention to self-care.
Respond to vulnerability with care and compassion. Be available to your team and directly acknowledge their shared human vulnerability, create space for, and serve as witness to, team members’ pain. Be transparent about sharing both the known and unknown, hopes and fears, and opportunities and realities, and engage front-line staff to identify practical opportunities for self-care.
8. Provide psychological first aid training.
Advocate for accessible support resources, including psychological first aid, ongoing professional counselling, formal peer support, and reflective group activities for all staff. Invest in relational skills training for leaders at all levels to promote emotional intelligence, humility, and a strengths-based approach to leadership.
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Costs of burnout
Preventing burnout is cheaper and safer than managing burnout after it has already occurred. Here are ways that burnout can impact physician health, patient care and the health-care system.
- marital or relationship conflicts
- motor vehicle crashes
- substance abuse
- decreased quality of care, patient safety and patient satisfaction
- increased medical errors
- longer recovery times
- increased turnover with physicians choosing to retire early or change jobs (costs of replacing a physician are estimated to be 2-3 times the physician’s annual salary)
- reduced physician productivity; decreased physician work effort
- less patient access
- increased costs