Clinicians of all kinds, across all specialties and care settings, are experiencing alarming rates of burnout. New case studies from the National Academy of Medicine’s (NAM) Action Collaborative on Clinician Well-Being and Resilience provide an overview of initiatives that reduce clinician burnout and support clinician well-being at organizations across the country.
The Educational Commission for Foreign Medical Graduates (ECFMG®) is a member of the NAM Action Collaborative. Every year, ECFMG sponsors more than 11,000 foreign national physicians in J-1 visa status to participate in U.S. clinical training programs. These residents and fellows face the stresses of living and working in a foreign country in addition to the significant demands of their training programs. ECFMG and its Exchange Visitor Sponsorship Program (EVSP) are refining several initiatives to support these physicians and meet their unique needs.
“Our mission at ECFMG/FAIMER is to advance medical education and help improve health care worldwide,” said Dr. William W. Pinsky, President and CEO of ECFMG and Board Chair of FAIMER. “These case studies are important examples of how we can attend to the needs of clinicians, so they can attend to the needs of their patients.”
The NAM hopes that each case study serves as an idea-generating resource for leaders to implement programs and policies at their own organizations that address systemic factors that contribute to clinician burnout. Each case study is designed to help readers more fully understand the successes that organizations have had in implementing well-being programs.
Ohio State University Case Study
At Ohio State University, initiatives to address burnout and promote the well-being of medical, nursing, and health sciences students, trainees, and practicing clinicians are supported by the highest levels of leadership, including the university president. This case study explores the central coordination and alignment of well-being initiatives that span the university, as well as focused examples of programs and policies within the College of Nursing, College of Medicine, Department of Emergency Medicine Residency Program, and the Wexner Medical Center. The Ohio State University case study also explores the role of the University Chief Wellness Officer in advancing the professional fulfillment and well-being of the entire university community. Ohio State calculates a cumulative productivity net savings of over $15 million from wellness programming as well as a $3.65 return-on-investment for every dollar invested in wellness. Additional impact includes decreased anxiety, depression, stress, and suicidal intent among students, faculty, and staff as well as increased academic performance and levels of healthy lifestyle behaviors. University Chief Wellness Officer Dr. Bernadette Melnyk notes, “Leaders, faculty, and managers must ‘walk the talk’ and provide needed wellness resources as well as support for ‘grassroots’ initiatives. The return on and value of investment—including faculty, staff, and students who are happy, healthy, and engaged—will be well worth it.”
Virginia Mason Kirkland Medical Center Case Study
The Virginia Mason Kirkland Medical Center, an outpatient clinic located outside of Seattle in Kirkland, WA, utilizes an innovative, system-wide management method to improve patient care and safety by eliminating waste and inefficiencies. This management method is used to streamline repetitive aspects of care delivery, standardize clinical roles, and engage in continuous learning activities. Two pillars play a central role in improving wellbeing at the medical center: (1) Workflow optimization and (2) Promoting a culture of collegiality, respect, and innovation. Kirkland Medical Center relies heavily on the integration of clinical pharmacists into the care team to free up time for physicians, physician assistants, and advanced registered nurse practitioners to see patients with more complex conditions. Medical assistants help reduce clinician workload and manage administrative tasks, such as confirming patient medications, processing orders, and replying to patient portal messages. Mandatory “pauses” after every 3-5 patient visits allow clinicians to address documentation needs throughout the day, ensuring that all clinicians can leave for home within one hour of seeing their last patient. Surveys from the medical center show that 90% of Kirkland Medical Center’s non-clinician staff and 93% of clinicians are “content” or “engaged.”
The development of each case study was informed by expert interviews with professionals from each organization. The NAM conducted preliminary interviews, in-person site visits, extensive follow-up interviews, and document review for each case study. Additional case studies are forthcoming.
Read the full case studies: nam.edu/clinicianwellbeing/case-studies.
For questions, please contact the National Academy of Medicine at ClinicianWellBeing@nas.edu.