Your feelings are IMPORTANT.

There is evidence that supports that people can be motivated by rewards, to bind this principle many health care organizations have linked burnout to financial compensation to productivity.

 Strategies for sustaining innovation

The fact that mental health care staff burnout is a national epidemic and leads many organizations to believe that there is nothing they can do to address the problem. Those centers that do recognize that they control many of the factors that drive burnout are often unsure how an organizational-level intervention can combat such a complex problem. Even the dauntless institutions who recognize that they must try are frequently unsure where to begin and do not believe that the resources they have to invest are sufficient to do anything meaningful. The available evidence contradicts all of these notions. Burnout is primarily a system-level problem driven by excess job demands and inadequate resources and support not an individual problem triggered by personal limitations(Weintraub & McKee, 2019).

To be able to sustain organizations innovative intervention to target burnout, it is important for a strategic plan customized to the local environment along with prioritization, commitment, and follow through at the highest level of the organization. Organizations should also aspire to realize the potentially even greater benefits of taking on the challenge of improving the efficiency of their work environment, reducing clerical burden, addressing problems with workload, and having the courage to address problems with values alignment and organizational culture. Commitment from executive leadership is the prerequisite, assessment the first step, and frontline leadership a force multiplier.

Return on investment (ROI) can also be applied to determine the economic cost of burnout and guide the appropriate initial and ongoing investment to address the problem. The business case to address burnout is multifaceted and includes costs associated with turnover and lost revenue associated with decreased productivity, as well as financial risk and threats to the organization’s long-term viability due to the relationship between burnout and lower quality of care, decreased patient satisfaction, and problems with patient safety (Weintraub & McKee, 2019).

It is crucial for the organization to understand the business case to reduce burnout and promote engagement as well as overcoming the misperception that there is nothing that can be done to promote improvement in staff’s burnout.  Organizations should also comprehensively examine the structure of their paid time off benefits, coverage for life events (eg, birth of a child, illness/death in family), and a strategy for coverage of nights and weekends. Compensation practices that disincentives using paid time off are shortsighted and should be eliminated.

Reference:

Weintraub, P., & McKee, M. (2019). Leadership for Innovation in Healthcare: An Exploration. International journal of health policy and management, 8(3), 138–144. https://doi.org/10.15171/ijhpm.2018.122

https://www.mayoclinicproceedings.org/article/S0025-6196(16)30625-5/pdf

As technology continues to evolve and influence the everyday work life, during the last three decades we have seen an enormous shift in the way technology affects the daily life. Technology influences the way we communicate, learn, interact and work.

If you have been following my blog, you know that job burnout is a negative occupational outcome that develops due to prolonged chronic stressors during the job.

Implications for data and privacy

The use of technology has literature supporting both positive and negative aspects in direct relation to burnout and stress. The best way to prevent technostress is to secure the workplace organizational culture and provide support when implementing new technology. Negative attitudes should be avoided and support from management and colleagues is important, as well as the possibility of further qualifications. Specific awareness of the middle-aged group should be made to better support their work–life balance (Berg-Beckhoff et al., 2017).

Historically, healthcare professionals have faced unique barriers to seeking mental health treatment, including a competitive culture and concerns related to privacy and career repercussion. There is data that supports that physicians are less likely than non-physicians to seek medical treatment or therapy from mental health professionals, often due to fear of consequences to their careers. Physicians also have a higher rate of depression, burnout and suicide compared with the general public, and the problem is not limited to physicians—nurses also have an increased suicide rate (Boydell et al., 2014).

Lack of action to address the mental health needs of medical professionals has, in some cases, been exacerbated by medical settings. Specifically, with providers sometimes associate significant feelings of distress with their professional identities, preferring to hide feelings of worry, anxiety and shame to avoid drawing attention to self-perceived weakness. These feelings, combined with more access to lethal means, have the potential to increase the suicide rate among medical professionals and those professionals that are also providing behavioral health services (Boydell et al., 2014).

The use of technology–

Often, burnout can be the result of having too much to do without enough time in which to do it. If you’re a provider, you don’t want to spend your time pulling charts or performing other similar clerical tasks. One way to prevent burnout is to redesign the workflow and allow professionals to do the work no one else can do.

Figuring out how to adapt workflow so everyone is making the best use of their time requires complex thought, especially when the organization in question has many employees. However, the work you put into a redesign will pay off in the long run as each employee can focus more on the core duties of their job.

Utilizing an electronic health records (EHR) system goes a long way in reducing the incidence of burnout for mental healthcare professionals. Using the wrong EHR can contribute to stress for clinicians, so it’s important to choose one that is specially designed for behavioral health professionals.

EHRs can remove the stress and time drain associated with creating documentation the traditional way, and often can help with administrative tasks like scheduling and sending out appointment reminders. Some EHR systems feature patient portals that make for easy communications safeguarded by HIPAA protections. An EHR helps clinicians use their time efficiently and for the most impact, thereby reducing the emotional exhaustion that drives burnout.

References:

Boydell, K. M., Hodgins, M., Pignatiello, A., Teshima, J., Edwards, H., & Willis, D. (2014). Using technology to deliver mental health services to children and youth: a scoping review. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent, 23(2), 87–99.

Berg-Beckhoff, G., Nielsen, G., & Ladekjær Larsen, E. (2017). Use of information communication technology and stress, burnout, and mental health in older, middle-aged, and younger workers – results from a systematic review. International journal of occupational and environmental health, 23(2), 160–171. https://doi.org/10.1080/10773525.2018.1436015

Mental health care staff that are employed in public sectors have limited to none interventions for burnout seen in their staff. However, private sectors are known to have more robust incentives and commitment to building a culture that supports health living. Private sectors promote benefit plans and programs that enhance the quality of life and allows for staff to have work life balance. Many of the benefits provided are tailored to promote healthy living.

• Variety of plans to choose from for medical insurance
• Dental
• Vision
• Wellness Incentives
• Assistance Program
• Generous Paid Time
• Paid Leave Benefits
• Parental Leave
• Smoking Cessation Program

In addition to the benefits listed about that many private sector organizations offer their employees, it was found that another big push and focus for staff in to have financial fitness.

 Financial fitness is an additional support that allows the employee to have a concrete plan for their finances and their future. It is important to understand that financial stress leads to additional stressors and can affect the overall wellness of an individual. Many benefits that private sectors offer employees can be:

• 401(k) Retirement Savings Plan
• Short- and Long-Term Disability
• Life Insurance
• Flexible Spending Accounts
• Health Savings Accounts
• Competitive Compensation
• On-site Financial Planning Assistance

How can innovation play a role in improving burnout in Mental Health care staff?

The use of artificial intelligence (AI) and machine learning could create more personalized engagement for mental healthcare staff and patients, which in the future could lead to staff having additional time to spend if need be with patients, chart and do other duties without feeling rushed and overworked. Technology has been proven to be effective in healthcare and in a recent survey, it was found that consumers are becoming receptive of their personal information including medical records being on an online platform.  However, mental health is still lacking full implementation of what technology has to offer and how it can enhance the overall care provided to patients (Collins et al., 2019). Having the evidence that supports that technology can enhance and improve the overall workflow, this should help organizations and policy makers in promoting policy driven changes to reduce and improve burnout reported in mental health care staff.

So, why is it important for organizations to see burnout as an ongoing detrimental concern for their organization, staff and patients?

In 2018, when the American Psychological Association analyzed multiple studies that looked at burnout in mental health services provided, its researchers found that “anywhere between 21% and 61% of mental health practitioners experience signs of burnout”.  Also, a 2018 research review paper published in the Journal of Clinical Psychology 30 years of research on this topic, involving 9,000 psychotherapists. Over  half of the therapist that were sampled reported “moderate-high levels of stress and burnout” (Collins et al., 2019).

References:

Collins, T., Mikkelsen, B., & Axelrod, S. (2019). Interact, engage or partner? Working with the private sector for the prevention and control of noncommunicable diseases. Cardiovascular diagnosis and therapy, 9(2), 158–164. https://doi.org/10.21037/cdt.2018.08.04

https://www.bbc.com/worklife/article/20200108-is-minimum-leave-a-better-alternative-to-unlimited-time-of

Did you know that burnout and mental health problems are on the rise amongst public sector employees? Stress and burnout are a common factor seen in employees in the public sector, surprisingly the risk of stress-related illnesses in the public sector surpasses that of the private sector. The working environment of public sector differs from private sector as the management objectives, job types and organizational structures are different. Public sectors are directed to serve society and their citizens and staff have a higher liability to conflict positions among different stakeholders. Also, public sector organizations function in a more bureaucratic style, versus private sectors that are profit-oriented and are competitive in changing market environment.

 However, there is enough evidence that states there are many public sectors who have not implemented a well-developed prevention strategy for their employees to reduce and prevent burnout among their employees. It is important to see that on an organization level; the effects of burnout can be shocking. It is of high importance to understand and implement stress management and burnout prevention (Vella, & McIver, 2019).

What can public sector institutions find in burnout employees?

-Increase requests for time-off

-Back and neck pain

-Poor performance

-Disability claims

-Alcohol and drug use

-Acute medical conditions such as strokes and heart attacks

Burnout cost public sector entities all over the work billion in health claims, loss of productivity and absenteeism.

How can organizations help and target burnout?

-Stress management and burnout prevention strategies

-Promote a positive work culture

-Effectively manage the return-to-work process and reintegrate employees who have taken a long absence

It is important to target the burnout, the goal for organizations should be to have healthier employees and reduce levels of sickness absence. Also, it will improve the overall performance and motivate employees.

 (Vella, & McIver, 2019).

Policies associated with burnout in Mental Healthcare staff

The AzNA supports and is promoting the bill HB2538 that would increase protection for nurses assaulted in the work place. Assault on nurse is a high priority and is taking a stand in this legislative session. The HB2538 if passed, would require employers to implement policies related to assaults on healthcare workers, including nurses. It also focuses on increasing the minimum penalty for assaults on healthcare works resulting in injury from class 6 to class 5 felony. This is an important bill that needs YOUR attention as assault leads to burnout and it has a negative impact on the psychological and physical well-being of the healthcare staff. It also affects job motivation and in turn it compromises the quality of care provide for the patients and it puts health-care provision at a high risk. It is also a tremendous financial loss in the health sector.

How can YOU help? The AzNA has provided instructions, please read below:

Email your two (2) House representatives and ask them to vote YES on HB2538. Click this link for the list and e-mails of your representatives. Don’t know your Arizona legislative district? Find it here.

Subject Line:

Your Nurse Constituent Urges a YES vote on HB2538

Write the e-mail in your own words:

It doesn’t need to be long. Write from your experience and your heart. Make sure to include that you are a registered nurse and a constituent in their legislative district

This bill needs vocal support from Arizona’s nurses to move forward. Without the necessary 31 votes in the Arizona House of Representatives, this bill will not pass! Please take action and help pass this bill!

References:

https://azna.informz.net/informzdataservice/onlineversion/ind/bWFpbGluZ2luc3RhbmNlaWQ9Mjg4MjI3MiZzdWJzY3JpYmVyaWQ9Mzk3NzUzNjM2

Vella, E., & McIver, S. (2019). Reducing stress and burnout in the public‐sector work environment: A mindfulness meditation pilot study. Health Promotion Journal of Australia, 30(2), 219-227.

            Burnout among mental health staff is a real problem that affects all areas of the medical field. Such policies and procedures have been implemented to help reduce the effects of this phenomena. One AHRQ-funded project (HS18160), listed by Agency for Healthcare Research and Quality (2017), reported that the MEMO-Minimizing Error, Maximizing Outcome-Study, found that more than half of all the physicians reported experiencing time pressures when conducting exams. Work conditions such as time pressure, low control over work pace, chaotic environments and unfavorable organizational culture were among the top reasons of burnout. Providers dealing with these work conditions did not directly correlate to lower quality of care for the patients.

The AHRQ grant (HS18160) study then put in place a series of policies and procedures the help identify and treat providers burnout. Implemented was a “intervention” method. Monthly provider meetings focusing on work life issues, depression and diabetes screening, quality improvement projects to enhance and engage in team work, even something as simple as having medical assistants enter patient’s data into the electronic health records. Just introducing these simple steps, they decreased the rate of burnout report from 32.7 percent to 25.8 percent (Agency for Healthcare Research and Quality, 2017).

Additional interventions that may be able to lower the rate of burnout are as followed:

-Creating standing order sets

-Providing responsive information technology support

-Reducing required activities

-Providing time for the physician to enter patient data into the EHR (Electronic Health      Records)

-Hiring floating clinicians to cover unexpected leave

-Ensuring values between leaders and clinicians are parallel

(Agency for Healthcare Research and Quality, 2017).

As a future health care provider, part of my initiative is to promote healthily work life balance, as well as reduce burnout and to take a stand and be a voice. I will be conducting an interview with U.S. Rep John Katko (NY-24) in hopes of learning more about his new bipartisan bill (H.R. 2431) With only one third of those with mental illness receiving care, H.R. 2431 provides incentives to those providers who treat those in underserved areas. Providing an educational loan forgiveness for said providers, will also allow a chance for new grads to focus on why they became providers in the first place. Introducing this bill is critical for the 115.4 million Americans living in areas without adequate access to mental health care. The bill also focuses on providing additional federal support for behavioral health workforce training programs is in high demands in order to meet the growing needs for mental health care staff in the United States, which is expected to increase significantly by 2030 (U.S. Congressman, 2019).

(U.S. Congressman, 2019).

References:

Agency for Healthcare Research and Quality.  (2017).  Physician Burnout.  Retrieved from https://www.ahrq.gov/prevention/clinician/ahrq-works/burnout/index.html

U.S. Congressman. (2019). Kotko House. Retrieved from https://katko.house.gov/media-center/press-releases/reps-katko-napolitano-reintroduce-bipartisan-legislation-reduce-shortage

Burnout is often times referred as an “occupational phenomenon”. In May of 2019, the World Health Organization (WHO), included burnout in the 11th revision fo the international classifications of Diseases (ICD-11) as an occupational phenomenon.

The ICD-11 defines burnout as:

• feelings of energy depletion or exhaustion;
• increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and
• reduced professional efficacy.

World Health Organization, 2019.

Why is burnout important and how why should it relate to policy?

• The Centers for Disease Control and Prevention, 2019 reported that mental health disorders are amongst the most burdensome health concerns in US. 71% of adults reported at least one symptom of stress, such as feeling overwhelmed, anxious and having headaches.
• Promoting and encouraging policies that promote mental-well being in the workplace is crucial, there is about 63% of Americans that are part of the US labor force.
• Addressing burnout in the workplace can help reduce health care cost.

The Centers for Disease Control and Prevention. (2019)

The goal is to bring awareness and promote self-care, which is an importance factor of proactive stress reduction techniques to avoid burnout.

References:

The Centers for Disease Control and Prevention. (2019). Mental Health in the Workplace. Retrieved from https://www.cdc.gov/workplacehealthpromotion/tools-resources/workplace-health/mental-health/index.html

O’Connor, K., Muller Neff, D., & Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. European Psychiatry, 53, 74-99. doi:10.1016/j.eurpsy.2018.06.003

World Health Organization. (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases.Retrieved from https://www.who.int/mental_health/evidence/burn-out/en/