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Reducing Physician Burnout without Reducing the Bottom Line

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Reducing Physician Burnout without Reducing the Bottom Line

How can you reduce physician burnout in your workplace without hurting the bottom line?

When most people think about burnout they think about its primary manifestation – exhaustion.  Burnout also manifests as cynicism, which damaging to the person and those around him/her, and as inefficacy, the sense that what you do doesn’t make a difference.

When people think about how to reduce burnout, they think about one of two approaches:

  • Reduce the workload
  • Provide wellness programs that include counseling meditation, and exercise.

Both of these approaches help.  And both come at a cost that can be a challenge for healthcare organizations that already run on thin financial margins.  The thought of a reduction in revenue from a reduced work schedule can lead a CFO to recommend against such action and a CEO to take the CFO’s advice.  Wellness programs do have a cost, but the benefits are worth the investment.

There is a viable alternative to reducing simply productiivty that will not hurt the bottom line – Leading with Lean.

The Drivers of Burnout

As identified by Maslach and Leiter in The Truth about Burnout, the drivers of burnout include:

  • Work Overload
  • Lack of Control
  • Insufficient Rewards
  • Breakdown of Community
  • Absence of Fairness
  • Conflicting Values

It makes sense to think first about reducing the amount of work to reduce work overload.  But if we recognize the five other drivers of burnout, and take action to reduce the impact of each of those, we can achieve a significant reduction in burnout without reducing productivity.

The Lean Management System

How does Lean help in this approach?  A Lean Management System has four key components:

  • Strategy Deployment, which identifies the values of the organization and its long term goals, creates role clarity and alignment for everyone from the C-suite to the front lines, and does this with a catchball process that gives everyone a voice in determining their responsibilities.
    • This addresses Lack of Control, Absence of Fairness, and Conflicting Values.
  • Value Stream Improvement, which engages the people who do the work in redesigning their work to remove the waste, barriers, and frustrations that they deal with every day. This work is done in teams, with trained coaches, and guidance from leadership.
    • This addresses Work Overload, Lack of Control, and Breakdown of Community. In most organizations the Report Out at the end of a weeklong improvement event includes recognition and celebration, addressing Insufficient Rewards as well.
  • Daily Improvement, which is driven through tiered huddles that empower the front line workers to identify and solve problhuddle-boardems, and provide the mechanism to escalate problems that can’t be solved on front lines to the level needed for resolution within a day, even to the level of the CEO if needed. The huddles include team members recognizing each other for the good work they do.This addresses Lack of Control, Insufficient Rewards, Breakdown of Community, Absence of Fairness, and Conflicting Values.
  • Lean Infrastructure, which is the team of coaches and mentors who support leaders and front line workers through the Lean transformation.
    • This addresses Lack of Control and Absence of Fairness.

When fully deployed, the Lean Management System creates a workplace where people are treated fairly, in control of their jobs, working together as a community, sharing aligned values, and being recognized for their efforts.

Such organizations achieve higher productivity without work overload, significantly reducing physician burnout.

What’s keeping you from getting Lean to reduce burnout?  Please share your thoughts.