What is the role of the board of directors in addressing clinician burnout?
This is the focus of my discussion with my good friend and colleague, Byron Scott, MD, MBA, who has served on various healthcare boards over the past twenty years, and currently serves on three healthcare boards:
Rady Children's Hospital-San Diego (Board Quality, Patient Safety, and Medical Affairs Committee)
The challenges of the past year highlight the growing importance of the board's role in challenging the CEO to maintain focus on key issues while ensuring the business is running effectively.
Byron highlights the need for a focus on people as a key factor in a number of areas:
The impact of COVID on your people - which ranges from safety concerns, and overwhelm for frontline clinicians and support staff, to stresses for outpatient clinicians in various ambulatory settings and often overlooked Federally Qualified Health Centers (FQHC) suddenly desperate for PPE, or delivering care virtually for the first time, while others were losing jobs and health insurance.
The increasing importance of diversity, equity, and inclusion as the pandemic has highlighted health disparities including unequal support sometimes for clinicians serving diverse and vulnerable populations.
Board member onboarding and continuing education is necessary to ensure an effective board. Ideally, this should be designed as a formal process that includes:
Education about the organization and key aspects of the strategic plan,
Education in disaster preparedness and crisis management
Experiential learning by immersion in clinical operations - walking around with a senior leader, and shadowing clinicians without senior leaders present. Non-clinical business leaders are often impressed by both the intensity of clinical care and the challenging workflows that hinder clinicians and lead to burnout.
Having personally experienced the challenge of EHRs being implemented without taking in to account the impact clinicians, Byron recommends boards also develop an awareness, not only of technology innovations that will be changing care delivery, but also a deep understanding of potential impacts on clinicians and care processes.
We wrapped up our discussion with Byron sharing his hopes for healthcare changes in 2021. He stressed that we need to do a better job on inequity, with health systems finding innovative ways to provide care for people and improve access, particularly as people continue losing jobs and insurance during the pandemic. He would also like to see health systems increase focus on community and population health, asking community leaders what else they can do to better serve the under-served.
I would like to thank Byron for sharing his experience and thoughts on the role of board members. If you'd like to learn more, you can reach me at paul@pauldechantmd.com