Burnout, COVID-19, and Culture of Safety

While the COVID-19 pandemic is not over yet, the State of Oregon has started the process of reopening, with many people already returning to their pre-pandemic routines and habits. As this happens, it’s important to remember that the past year and a half will have lasting effects on Oregon’s healthcare professionals, like increased rates of burnout.¹ In a recent study published in Health Affairs,² OHSU professors Samuel T. Edwards and Miguel Marino identify the importance of organizational culture, strong leadership, and learning from mistakes in preventing burnout in primary care practices. Their study “reaffirms the importance of addressing burnout with organizational-level interventions, instead of tacitly shifting blame for burnout from the system to the individual.”² ⁽ᵖ⁹³²⁾ COVID-19 has highlighted the need for strong systems that cultivate a culture of safety and support learning and improvement, in times of stability as well as in times of increased stress on the healthcare system.

The Physicians Foundation found that 58% of the physicians they surveyed in 2020 had feelings of burnout, up from 40% in 2018.¹

As we assess the effect of the COVID-19 pandemic on the healthcare system, we find ourselves positioned between our old routines and habits and our new normal that’s taking shape. This is an opportunity to advance culture change and to make the healthcare delivery system more supportive for healthcare providers.

What You Can Do

Your healthcare organization can invest in programs that support the well-being and resilience of your healthcare professionals, inform them about what resources are available to them and ensure that they have protected time to use them. There are tools and resources to help your organization get started.

Resources That Can Help

Oregon Wellness Program
Currently open to physicians, advanced practice providers, and physician assistants, this program promotes the well-being of Oregon’s healthcare professionals through education, in-person counseling services, telemedicine services, and research.

Emerging Stronger After COVID-19: Priorities for Health System Transformation
A National Academy of Medicine series that describes the lessons learned for various sectors of the healthcare system. In the report on Clinicians and Professional Societies, the authors discuss how the pandemic has affected provider well-being and outlines priority areas for improvement.

Communication and Optimal Resolution (CANDOR) Toolkit
AHRQ’s CANDOR toolkit includes a section (Module 6: Care for the Caregiver) that can support your organization in building a peer support program.

Peer Support for Clinicians: A Programmatic Approach
In this 2016 Academic Medicine article, co-authors Jo Shapiro, MD, and Pamela Galowitz describe how they built the peer support program at Brigham and Women’s hospital and assert that it’s critical for organizations to invest in programs that support provider well-being and resilience.

References

¹ The Physicians Foundation. 2020 Survey of America’s Physicians COVID-19 Impact Edition. The Physicians Foundation; 2020:19 pages. Accessed July 2, 2021. https://physiciansfoundation.org/wp-content/uploads/2020/09/2020-Physicians-Foundation-Survey-Part2.pdf

² Edwards ST, Marino M, Solberg LI, et al. Cultural and Structural Features of Zero-Burnout Primary Care Practices. Health Affairs. 2021;40(6):928-936. doi:10.1377/hlthaff.2020.02391