University of Michigan program looks to reduce clinician burnout

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University of Michigan Health has identified that many members of its healthcare workforce are experiencing high levels of burnout, mirroring trends that are occurring among clinicians and healthcare staff around the country. This, said U-M Health, threatens workforce stability and the clinical mission.

One way that U-M Health is tackling this issue involves implementing a "Choosing Wisely" effort, intended to identify, design, and rigorously and rapidly evaluate specific projects focused on improving the value of clinical care.

The goal is to allow clinicians to provide the clinical care they are trained to do and eliminate or scale back unnecessary administrative work, thereby improving both professional and patient satisfaction.

For example, Hawaii Pacific Health eliminated an unnecessary requirement for hourly rounding documentation and saved approximately 1,700 nursing hours per month across four hospitals, U-M said.

WHAT'S THE IMPACT

The first step in this effort involves gathering feedback from clinicians. A workgroup, co-led by Dr. Eve Kerr of the Department of Internal Medicine, and Dr. Christopher Friese of the School of Nursing, is asking for suggestions on clinical administrative work that U-M Health should stop or scale back.

The team is also seeking clinicians who have at least a 50% appointment focused on clinical care delivery to join its workgroup. The workgroup will examine responses on low-value administrative practices that contribute to clinician burnout to launch a pilot effort to eliminate or scale back one aspect of low-value clinical administrative work and address other identified areas over time.

To identify low-value administrative practices performed by clinicians that should be eliminated or scaled back, respondents are asked to consider items that create unnecessary burdens for the clinician workforce; do not have sufficient evidence base to improve clinical quality, access, equity, or other organizational outcomes such as financial performance; do not address outcomes patients care about; and/or are duplicative or a waste of time.

These may include what U-M considers unnecessary, redundant or unwieldy practices that could be stopped without harming patient care, such as time-consuming MiChart features; documentation processes and signature requirements; mandatory compliance and risk-management trainings; medication renewal and reconciliation management; prior authorization processes; coding requirements and processes; referral, care coordination and scheduling barriers; and administrative work that could be directed to non-clinician team members.

THE LARGER TREND

With a projected shortage of nearly 140,000 physicians by 2033, and a shortage of 3 million lower-wage healthcare workers in the next five years, U.S. Surgeon General Dr. Vivek Murthy sounded the alarm on the country's ongoing healthcare burnout crisis in May.

Health workers – including physicians, nurses, community and public health workers, and nurse aides – have long faced systemic challenges in the healthcare system, even before the COVID-19 pandemic. That, according to Murthy, is leading to crisis levels of burnout.

The pandemic, of course, only made things worse, prompting Murthy to issue an advisory for addressing health worker burnout that includes recommendations, such as reducing administrative burdens, being more responsible to workers' needs and eliminating punitive policies for seeking mental health and substance use disorder care.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com