Breaking the Nurse Burnout Cycle with a Proactive Approach to Well Being
Healthcare worker wellbeing is a national priority and burnout levels are at an all-time high. According to the WSJ (Nov 22, 2021), Nurse turnover rates have increased to 22% this year, compared with an annual rate of 18% in 2019. Turnover is extremely costly for hospitals with the average cost of turnover of a nurse ranging from $37,700 to $58,400 (University of NM, The High Cost of Nurse Turnover). Institutions spend millions of dollars every year in recruitment, training, and retention of nurses and other medical professionals, and as more healthcare employees experience distress and burnout, the costs will continue to rise.
A recent study by the International Council of Nurses found that burnout rates in Nursing were 40 percent before the pandemic – and now the figure has grown to 70%. Nursing burnout is a major contributor to the national nursing shortage, with 47.9% of nurses reporting that they are actively looking for a less stressful nursing position, to leave the nursing profession all together, or have done so within the last three years due to burnout. This problem is accelerating and negatively impacting clinical quality, patient experience and employee engagement.
The prospect of a shrinking labor pool in the face of a pandemic is a frightening thought. Jacqueline Camp, a leader in healthcare with over 25 years’ experience notes “I have never seen the risk of burnout this high with our medical teams. We are seeing nurses tell us they are burned out by year three of their careers. Healthcare workers are looking to exit the healthcare workforce with no plan for what's next because they cannot keep showing up due to burnout”. Given the size and scope of the issue, new solutions must be designed to work rapidly and sustainably at scale. Some of our recent work highlights two new approaches for hospital leaders to consider in combatting nurse burnout while taking cost out of the system.
See Nurse Burnout Sooner
With insights into nurse well-being provided at a quarterly or annual cadence, how can a health care organization plan to effectively mitigate signs of nurse burnout and distress as it begins to appear? The simple answer is it can’t — at least not by relying on traditional feedback mechanisms alone. Organizations must be willing to innovate beyond traditional methods to perform meaningful surveillance of nurse well-being at a systems level. And while data collected from nurses through surveys, interviews, and focus groups are valuable, they are not sufficient in providing continuous, proactive signal detection and timely attention from leaders.
In healthcare, prevention is often more effective and much less costly than later-stage treatment. The same holds for nurse burnout. Preventing nurse burnout is better than waiting to treat it after it becomes a full-fledged problem. Unfortunately, few resources are focused on early detection and prevention. If hospital leaders can spot signs of nurse burnout earlier, they will be more effective in interventions resulting in greater levels of employee retention and wellbeing.
Our firm, Adaptive Strategic, is launching a series of pilot programs and is partnering with a select group of Hospital Systems on an innovation journey to scan for the high impact signals of nurse burnout. These pilot programs apply novel technologies in combination with advanced decision making under uncertainty methods to enable healthcare leaders to proactively fight burnout in its earliest stages. We use technology to efficiently connect directly with nurses to measure burnout. The goal is to enable CNOs and CHROs to quantify and manage burnout drivers using real-time intelligence in combination with existing employee engagement data.
The pilot program has Three critical elements:
1. Baseline observations of the organization’s current state of burnout-leading indicators. Findings are cut by shift, floor, and specialty. This enables identification of ‘burnout hot spots’.
2. Executive Dashboard summarizing semi-monthly directional changes to leading burnout indicators (Stress, Fatigue, Empathy, etc.).
3. Recommendations for reallocation of existing interventions quickly is important. It demonstrates to staff that the organization is serious and responding to issues at pace.
In order to get results you've never had, we believe you need to do things you've not done before. The Burnout Anticipation Technology (BAT) platform identifies patterns that precede burnout and retention risk and alerts leaders when retention risk increases. BAT represents a significant change in how most health systems and consulting firms approach nurse burnout identification and remediation.
Engagement and Rapid Response
As part of our rapid response intervention, we recommend leaders facing nursing burnout hotspots participate in our 90-Day Nurse Engagement Program. The program is designed to be a scalable coaching program that fosters productive nurse managers, builds employee engagement and team morale, and communicates a message that CNOs and hospital leadership care about the development and well-being of their nurses.
The 90-Day Engagement Program for nursing and health professional faculty and staff was developed by Cecond Opinion and successfully pilot-tested with 24 members of Drexel’s College of Nursing and Health Professions. Participants (nursing and health professional faculty and professional staff) who were in or entering leadership positions gained leadership, communication, and conflict resolution skills working with a professional coach, peer coach, and then monitored their progress through periodic co-worker feedback. This program is flexible and capable of serving dozens or hundreds of health professionals simultaneously. Program costs are a fraction of the cost of standard executive coaching programs and could be integrated into the operating budgets of colleges as a standing practice.
Most importantly, the program made an impact in only 90-days. Based on co-worker feedback and coachee self-assessment data, participants felt they developed better leadership and communication skills compared to other approaches used previously. Participants also said they were enjoying their work more and liked getting to know and working more closely with their peer coaches.
Unprecedented levels of nurse stress and burnout risk means the demand for effective training and development is greater now than ever. Since burnout risk is a large-scale problem affecting a high percentage of nurses, interventions to combat this risk must also be large-scale. Coaching nurses to build engagement and team cohesion is an effective way to combat individual and team-wide burnout. A large-scale coaching program capable of serving dozens or hundreds of nurses means the intervention matches the size of burnout that hospitals are now facing.
Conclusion
Organizations that spot employee burnout signs before they go too far will be far more effective in interventions resulting in greater levels of employee retention and wellbeing. Hospital leaders that check-in with, and value, their employees are better prepared to handle cases of employee burnout. Paul Yakulis retired chief human resources officer of Main Line Health indicates, “caring for caregivers as early as possible has many benefits. Early intervention demonstrates interest in employees’ wellbeing, improves their perception of the relationship with their leaders, sustains a high level of clinical focus for patient safety and reduces costs. And, most importantly this is the right thing to do for people who are suffering.” The personal and organizational costs of burnout can be considerable in terms of physical health, psychological well-being and work performance, so taking steps to minimize the risk of burnout before it happens is a more effective and prudent strategy than waiting until it grows.
About the Authors
Toomas H. Truumees – CEO, founded Adaptive Strategic to combine his expertise with decision making under uncertainty with novel sensing technologies to enable healthcare leaders see sooner and act faster to fight the burnout crisis. Toomas is a trusted advisor to boards and senior management teams in the development of strategies designed to thrive in complex and uncertain environments. He found his passion for helping others at a young age in the competitive world of athletics. The great Arthur Ashe once said, “You’ve got to get to the stage in life where going for it is more important than winning or losing” and it is a philosophy that he strives to live by and share in his personal and professional relationships.
Frank Rowe - Managing Partner of Cecond Opinion. Frank is an executive leader and consultant with over twenty-five years of experience in the healthcare, professional services, telecommunications, higher education, and nonprofit sectors. As an entrepreneur and teambuilder, he is adept at improving organizational performance through a combination of assessment, consulting, team building, and executive coaching. His work with dozens of clients during his career, including Glaxo Smith Kline, AstraZeneca, Merck Millipore, UnitedHealthcare, MindBody Inc, and The Bill and Melinda Gates Foundation, gives Frank a unique and valuable perspective on corporate initiatives tied to culture, organizational performance, executive leadership, team building, and employee engagement. Frank is also an Adjunct Professor at Drexel University, where he teaches undergraduate and graduate courses on leadership, strategic planning, team dynamics and organizational performance.