Redesigning Clinical Workflows to Return Joy to Patient Care

Absence of Fairness and Burnout

Absence of Fairness and Burnout

Have you ever felt that there is an absence of fairness where you work? Do you think, or have you heard others say, “This is not fair!” In this post, I’m continuing a review of each of the five drivers of burnout.

I’d never thought much about fairness as a driver of burnout before I did in-depth research on the issue. As you are likely aware, absence of fairness is the fifth driver of burnout as described by Maslach and Leiter in their classic and excellent book, The Truth About Burnout. Although first published in 1997, it remains one of the best resources for those interested in understanding burnout’s causes and what we can do to reduce it. It’s an easy and enlightening read.

Why do we care so much about Absence of Fairness?

Why does fairness matter? It has an impact of all of the other five drivers of burnout. For example:

  • Work overload – It’s hard not to feel things are unfair if you are constantly asked to do more than you have the capacity to do.
  • Lack of control – When you have little control over what you are expected to do, and when you are unable to do what you think is right, it’s hard to feel that you are being treated fairly.
  • Insufficient reward – It can feel rewarding when you give your all, going above and beyond expectations, to accomplish something important.  Yet, if you are not not acknowledged for doing so, especially if this happens time and again, it feels less than fair.
  • Breakdown of community – Fairness depends on trust, openness, and respect. It’s much harder to feel a part of a community at work if we do not trust our co-workers or leaders, if we are kept in the dark about key information, or if we are not treated with respect.
  • Conflicting values – If we do not share values with those we work with, it’s much more likely that management decisions and actions will seem unfair. In our rapidly changing world, even when we share values decisions made without adequate communication and a baseline level of trust.

How can Lean help?

A Lean Management System that includes Strategy Deployment and Daily Management provides the infrastructure and processes to overcome the feelings of absence of fairness. They do so by aligning and empowering everyone in the organization.

Strategy Deployment includes four key aspects that guide the work of leadership:

  • Selecting the most important strategic initiatives for the organization, and DESELECTING all others, to avoid setting unattainable goals.
  • Assigning key elements of implementing the strategy to specific individuals, teams, or departments, and clarifying who will do what by when.
  • Providing the resources needed for the team to succeed at the initiative.
  • Linking metrics to the initiatives, to objectively assess the success of the process.

Daily Management is the job of those on the front lines. Effective daily management includes:

  • Huddles of front line staff to acknowledge great work, plan for the day to ensure the team has the capacity to meet the demand, tracking metric performance compared to targets, and rapidly solving small problems so they do not escalate into larger problems.
  • Escalation of any concerns from the front line staff to managers, directors or top leaders as needed to understand and solve problems that are bigger than what the front lines can handle.
  • Communication of organizational changes to explain the impact to the individual worker and patient.

Strategy Deployment and Daily Management work best when everyone lives by the Lean principle of “Respect for People.” When we carefully consider the impact of our decisions, and care about those around us, these management processes work well to create a sense of fairness.

There are many other fairness challenges in the workplace that are tied to societal fairness issues, such as gender or race discrimination, that organizations equity programs are needed for. These will be more effective if Strategy Deployment and Daily Management are in place.

What Absence of Fairness issues have you experienced in your workplace?

What have you found that works to reduce the impact of these issues?

Feel free to share your thoughts in the comments below.

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