Defined as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed,” burnout can have a number of causes. When left unchecked, it can lead to distress, reduced performance at work, and poor patient outcomes.
Although an issue in any workplace, burnout can be exacerbated in a number of ways by the strains of the healthcare field. Let’s delve into those causes.
What is healthcare burnout?
Burnout is a state of emotional, physical, and mental exhaustion. It can be brought on by long-lasting and severe stress, and it can lead to decreased quality of patient care and also physical and mental disorders in people who experience it.
Burnout is characterized by three dimensions, as defined by the ICD-11. These include:
- Feelings of energy depletion or exhaustion
- Increasing mental distance from work, or cynicism surrounding one’s job
- Lowered efficacy at work
Healthcare burnout stems from a number of factors, as defined by the US Surgeon General. These include societal and cultural factors, difficulties within the healthcare system, organizational stress, and workplace environment. Healthcare comes with various occupational aspects that can exacerbate burnout as well, which are expanded below.
What makes burnout so prevalent in healthcare?
Burnout can occur across industries, but there are a number of factors that specifically contribute to its incidence in healthcare. Here are some of those factors:
Clinical documentation burden
Clinical documentation is one factor that leads to burnout in healthcare workers. Electronic Health Record (EHR) use has increased in prevalence over the last decade, and while the reasons for this increase include benevolent motivations—like improved patient safety, adherence to regulatory requirements, and reduction of costs—the impact of increased regulation, documentation, and EHR use may inadvertently lead to clinician burnout.
One aspect of clinical documentation that leads to increased risk of burnout include time pressure for documentation. In a PubMed literature review, surveyed clinicians reported that they spend more than half their day documenting patient care, and that when clinicians spend more time on clerical tasks, they experience decreased job satisfaction and increased symptoms of burnout.
In order to combat this issue, some proposed solutions include the use of clerical support and/or scribes, optimization of EHR to enhance workflows, and team-wide training to improve documentation efficiency and quality. Recognizing the causes and potential impacts of documentation burden can help to identify this cause of burnout.
Compassion fatigue
Compassion fatigue is often described as “the cost of caring.” While often confused with burnout, it refers to the mental and emotional distress that can be a result of patient care. It occurs when healthcare professionals connect and empathize with patients, and experience emotional effects as a result. However, it can be a contributing factor to feelings of burnout.
Physician shortage
The Association of American Medical Colleges projects that there will be a shortage of up to 124,000 physicians by 2034. Increased caseloads, compassion fatigue, and attrition from the industry all lead to a reduction in workforce, which further perpetuates burnout among remaining healthcare workers.
Work-life balance
The healthcare industry is notorious for long hours and demanding, often unpredictable schedules. However, these factors can contribute to burnout. It is possible for healthcare workers to maintain work-life balance through self-care, prioritizing social time, and adopting new schedules and routines. Encouraging employees to advocate for themselves and providing resources can help lessen issues exacerbated by low work-life balance.
Healthcare burnout can arise due to a number of factors. Burnout is something that can affect any industry, but healthcare professionals may be particularly susceptible. Why can this be dangerous for the industry?
Why is healthcare burnout dangerous?
Healthcare burnout has a negative impact on those affected by it, including both healthcare workers and patients alike. While these effects aren’t intentional, it’s important to be able to recognize and mitigate it to prevent further burnout, malpractice, and other effects of exhaustion and human error.
How burnout affects patient outcomes and safety
One unfortunate outcome of burnout is that it can negatively impact patient outcomes. Large systematic reviews have identified a correlation between physician burnout and medical error. High workloads, a lack of support, and symptoms of burnout can all lead physicians to make mistakes they wouldn’t otherwise make.
Increasing emotional support and mental health resources in the workplace, as well as identifying pain points and implementing a culture of safety for workers and patients alike, can all help to reduce clinical error and improve patient outcomes.
How burnout affects healthcare professionals
Healthcare burnout can not only lead to negative patient outcomes, but it can also put those who suffer from it directly in harm’s way. Burnout can lead to exhaustion, feelings of depersonalization, and even higher risk of suicide. Suicidal ideation has been associated with high workload volume and medical errors, both of which go hand in hand with burnout.
Understanding risk factors, recognizing signs of burnout, and mitigating contributing factors can all lead to better patient care and physician outcomes.
How the pandemic has increased healthcare burnout
It’s hard to discuss burnout among healthcare workers without acknowledging the impacts of the COVID-19 pandemic. As found in a 2021 study by the Mayo Clinic, more than 3 in 5 physicians (62.8%) reported at least one manifestation of burnout in 2021. This is up from just 45% in 2011.
It was also found that physicians and other healthcare professionals had higher levels of anxiety and depression, somatization, and insomnia during the pandemic. These factors can lead to feelings of being overworked, being unable to engage in coping behaviors, and ultimately make these individuals more prone to burnout.
How to prevent healthcare burnout
There are a variety of factors that can help to reduce healthcare burnout and improve retention among physicians and other healthcare professionals. Acknowledging the causes and signs of burnout are major steps, but here are some ways that employers and healthcare organizations can advocate for employees and ultimately prevent burnout.
- Create a culture of appreciation
- Encourage asking for help
- Implement effective time management techniques
- Offer training and opportunities for professional development
- Provide access to counseling services and mental health resources
- Prioritize work-life balance and self-care
- Promote teamwork and collaboration
- Educate team members about the signs and causes of burnout
The prevalence of burnout in healthcare settings elucidates how important it is to get ahead of the issue and recognize the underlying causes. Healthcare worker well-being and patient care are heavily connected, and addressing the issues will help to prevent negative outcomes across all facets of the industry.
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