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Dr. Christine Gall, Healthcare Expert
A three-year study¹ of U.S. healthcare workers from 2019 to 2022—spanning before the COVID-19 pandemic and nearing its end—found increased cases of emotional exhaustion amongst staff that contributed to their decision to change roles or leave the healthcare workforce altogether.
Although the "emotional exhaustion trajectories" varied by role, there was an overall increase in healthcare worker burnout across all disciplines.
Coupled with federal government reports2,3 indicating healthcare workers are five times more likely to experience workplace violence than staff in other industries, these trends signal that healthcare has a fundamental problem. A 2022 survey by National Nurses United, the largest union for registered nurses in the U.S., found 48% of more than 2,000 nurse respondents reported an increase in workplace violence, more than double the numbers from the previous year.
ROOTS OF BURNOUT
Causes.
The U.S. Surgeon General, Dr. Vivek Murthy, issued an advisory⁴ on healthcare worker burnout, writing "Health workers, across clinical and community settings, whether caring for patients or managing a public health crisis, have long-faced difficult, irregular hours in challenging, and extraordinarily stressful working environments."
But the COVID-19 pandemic further accelerated these challenges.
The advisory cites four major categories which likely contributed to the rise in healthcare worker burnout, including:
- Societal and cultural. Politicization of science and public health, structural racism and health inequities, health misinformation, mental health stigma, and unrealistic expectations of health workers.
- Healthcare system. Limitations in national and state regulations, misaligned reimbursement policies, burdensome administrative paperwork, poor care coordination, and lack of human-centered technology have contributed to increased rates of burnout.
- Organizational. A lack of leadership support, the disconnect between values and key decisions, excessive workload and work hours, biased and discriminatory structures and practices, and barriers to mental health and substance use care.
- Workplace and learning environment. Limited worker flexibility, autonomy, and voice, lack of a culture of collaboration and vulnerability, limited time with patients and colleagues, absence of focus on health worker well-being, and harassment, violence, and discrimination.
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REDUCING BURNOUT
Potential healthcare burnout solutions.
The Surgeon General's advisory recommends several possible healthcare technology solutions to various stakeholders for healthcare organizations, federal, state, local and tribal governments, and payers. Recommendations include "protect the health, safety, and well-being of all health workers" and "reduce administrative and other workplace burdens to help health workers make time for what matters."
A chapter of the report touches on what healthcare technology companies can do, noting, "Rapid advancements in technology, and health information technology, have enhanced our capability to deliver, process and access healthcare, yet more work remains to ensure these advances do not contribute to health worker burnout."
Recommendations for medtech include:
- "Design technology to serve the needs of health workers, care teams, and patients across the continuum of care." In particular, including health workers early on in the development and implementation of these healthcare technology solutions is important to "ensure inclusive, accessible design."
- "Design platforms with the goal of interoperability at the outset." The focus of technology integration must assure against increasing burdens on workers and ensure "patient-generated data is accessible in a meaningful way."
- "Strengthen integration of data across different platforms and health sectors." The advisory emphasizes the value of automated health data integration across systems that allow data from all members of the clinical care team, including the patient and caregivers to be integrated, analyzed, and transformed into actionable insights.
- "Improve seamless storage of and access to health data." A standard format for data storage and exchange would enable data to be accessed across systems and devices.
The report also notes nurses spend up to 41% of their time on electronic health records (EHRs) and documentation, and physicians spend two hours per day on EHRs and other administrative tasks.
A great deal of work must be done to ensure the safety and health of our healthcare workers.
As Dr. Murthy notes, "The stakes are high. If we fail to act, we will place our nation's health at increasing risk."
About the author:
Dr. Christine Gall, Healthcare Expert
Dr. Gall has been a healthcare leader for over 30 years. As a nurse, she has practiced in inpatient, outpatient, and homecare settings, allowing unique insights into the continuum of care. Dr. Gall has designed and implemented multiple clinical programs aimed at addressing gaps in services and care for underserved patients.
Prior to joining
Dr. Gall's academic credentials include a Bachelor of Science Degree from the University of Wisconsin-Milwaukee, a Master of Science Degree in Healthcare Management from the Lubar School of Business Administration at the University of Wisconsin-Milwaukee, and a Doctorate Degree in Public Health Leadership from the University of Illinois Chicago. Her Dissertation, funded by the State of Ohio, was on the topic of Mass Casualty Pandemics. Dr. Gall is a Six Sigma Green Belt and has a Certification in Business Analytics from the Wharton School of Business at the University of Pennsylvania.
Sources
1. Sexton JB et al. Emotional Exhaustion Among U.S. Health Care Workers Between and During the COVID-19 Pandemic, 2019-2021. JAMA Netw Open. 2022;5(9):32232748. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2796562
2. Boyle P. Threats against health care workers are rising. Here's how hospitals are protecting their staffs. Association of American Medical Colleges. August 18, 2022. https://www.aamc.org/news-insights/threats-against-health-care-workers-are-rising-heres-how-hospitals-are-protecting-their-staffs
3. Injuries, Illnesses, and Fatalities. U.S. Bureau of Labor Statistics. https://www.bls.gov/iif/home.htm
4. Addressing Health Worker Burnout. The U.S. Surgeon General's Advisory on Building a Thriving Health Workforce. https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf