"A system level problem requiring a system level response"
– Jane Lemaire & Jean Wallace. BMJ 2017;358:j3360
It provided for an excellent opportunity for like-minded people, passionate advocates of health professions' health and wellbeing, to come together and kick-start a dialogue in developing a unified approach to addressing the epidemic of health professions burnout.
Attached below is a video I have made summarizing my key learnings from the conference.
Health Professionals Burnout: A Profession in Crisis.
The quality of health care systems and patient safety depend heavily on high-functioning health care professionals.
Recent data, however, have revealed an alarmingly high prevalence of burnout, emotional exhaustion, interpersonal disengagement, and a low sense of personal accomplishment amongst the health care professions.
Many recent publications have warned about the rising levels of burnout rates— having reached an “epidemic” level.
With compelling evidence now available, there is a real sense of urgency for the health care system to realize that burnout can have devastating consequences for those affected, their colleagues, patients, and the healthcare system as a whole.
Stanford Model for Professional Fulfillment.
#ACPH17 used the Stanford Model as a contextual framework for the conference (see below).
Many would likely agree in that the two domains in red — 'Efficiency of Practice' and 'Culture of Wellness' — both pertain to a combined individual and system's responsibility in ensuring health professions wellbeing.
However, I respectfully disagree with the authors on the title of the third domain in blue — 'Personal Resilience' — which I think takes the emphasis away from the overall impression created by the first two domains — "implying" that resilience is a "personal" responsibility only.
"Personal Resilience" — A Misnomer.
While traditionally the focus has been on individual health care practitioners and their resilience as solutions, a more balanced approach is necessary in recognizing the more important role of systems’ resilience — workplace culture, toxic work environments, unnecessary and inappropriate resistance to change, desire for greater control over front-line practitioners, resisting calls for greater accountability, for e.g.
Resilience within the health system must support and protect all team members, for e.g., in pointing out problems, rather than fearing retaliation or other negative reactions from colleagues or superiors.
It is imperative for health systems to build a stable platform that will drive sustained improvements in health professions wellbeing and the performance of health care systems.
Health care organizations must embrace their responsibility in building an efficient, supportive, open workplace environment — to foster a culture of wellness, while also supporting health professions’ efforts to improve their own health & wellbeing.
Personalization of Health & Care.
Perhaps a more appropriate title for the third domain would be 'Personalized Health & Care' — instead of "Personal Resilience".
As Drs. Lemaire & Wallace (BMJ 2017;358:j3360) have noted in their recent BMJ Editorial that "...although individual targeted interventions such as mindfulness, stress reduction techniques, and education around communication skills, exercise, and self confidence resulted in small reductions in burnout, they worked better in combination with organizational interventions such as rescheduling shifts, reducing workload, and enhancing teamwork and leadership."
This would bring the necessary balance in referring to an individual's health and care as a joint personal and system's responsibility.
Attached below is an infographic that shows a modified version of the Stanford Model that I have designed, assimilating the concepts I have discussed above.
Appropriateness in Health: Inappropriate Without Including Health Professions Wellbeing.
I define appropriateness in health as "right care, more patient safety".
In times when efforts to employ concepts of ‘appropriateness’ towards health care systems sustainability are a priority for health care leaders — workable solutions must include health care professions wellbeing as an essential quality and patient safety indicator.
A recent Canadian study has estimated that early retirement and reduced clinical hours from burnout will cost the health system CAD213million in lost future service.
That is staggering! — and again brings home the point about addressing health professions burnout as an utmost priority.
Role of Behavioural Insights & Design-Thinking in Co-developing Workable Solutions.
There is increasing realization of the role of:
• Behavioural Insights — in using behavioural sciences theories to study and gain insights into how and why people behave the way they do; and
• Design-Thinking — an approach to solving complex problems, and finding desirable solutions
— in guiding the development of appropriate policies and decision-making processes that foster health care professions wellness and wellbeing.
Personalization of Initiatives.
Personalization of health professions lifelong learning / professional development initiatives — including leadership development — can help foster ownership within the health care professions, thereby increasing value and joy in personal lives, as well as practice.
However, care must be taken to ensure that any personalized initiatives launched are not just "token" programs. Fundamental concept of all such initiatives must be to move the paradigm in health care system: From "what's the matter with you" — To "what matters to you".
Take Home Points.
1. There is an urgent need for health care organizations and systems to appreciate the more important and critical nature of their role and responsibility in co-developing programs, initiatives, policies and decision-making processes — together with the health professions themselves - in order to meaningfully address the growing crisis of health care professions burnout.
2. Comprehensive, systems-based, sustained efforts are urgently required in order to improve health care professions’ wellness & well-being.
3. All stakeholders in a health care ecosystem, including allied health care professions, owe it to ourselves, our families, our patients, and to our generations after — in collaborating to advocate and advance the need for co-creating system level changes — in order to improve our practices, workplace culture, and ourselves.
4. We must realize the importance of a ‘connected’ profession in achieving the goal of health care practitioners professional fulfillment — developing networks, sharing experiences, as well as co-creating strategies.
5. When co-developing workable solutions, it must be ensured that health care professions wellbeing is included as an essential quality indicator.
6. There is a desperate need to co-create common understanding of the notion of 'value' in a health care system.
7. All stakeholders in a health care ecosystem must also work to co-develop common understanding of:
Here is a short 3-min video summarizing how we at Health District can help you / your organization in effectively tackling some of the core issues related to improving Health Practitioners' Professional Fulfillment.
Do you have any constructive feedback or perhaps some additional comments you'd like to make?
You can contact me via email: CEO@Health-District.com