You can’t open a business magazine or scroll through LinkedIn these days without running across an article about burnout.  It’s a topic on a lot of people’s minds.  A quick Google search of the word “burnout” brought up over 104 million results in 0.53 seconds.  Wow!  Narrowing that down to “burnout in healthcare leadership” dropped it to slightly less than 3 million.
 
In 2019, the World Health Organization classified burnout as an “occupational phenomenon.” Specifically, they said, “burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

• feelings of energy depletion or exhaustion;
• increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
• reduced professional efficacy.”

 
There has been a lot of attention given to physician burnout in recent years and rightly so.  The suicide rate among physicians is alarming and burnout is often pointed to as a contributing factor.  Health systems are making efforts to address burnout by pursuing initiatives that focus on physician wellness and engagement, reduce “pajama” time, and addressing the bureaucratic challenges that electronic medical records have placed on physicians by doing such things as adding scribes.  All of these are important to help combat the burnout that our physician partners are experiencing and they should continue.

However, burnout in the healthcare industry isn’t exclusively experienced by physicians.  It’s happening in many positions – nursing and others.  According to a 2017 white paper published by the Institute for Healthcare Improvement titled IHI Framework for Improving Joy in Work, “If burnout in health care were described in clinical or public health terms, it might well be called an epidemic.” 

What most health systems are neglecting to address is the burnout that the rest of their employees are experiencing.   I see it in the most extreme and with the least attention given in the area of leadership.  Burned out leaders responsible for units that are operational 24/7, such as nursing leaders, are being hit particularly hard, but even leadership over areas such as Information Systems and Human Resources are reporting burnout. 

In a 2017 study by Witt Kieffer called The Impact of Burnout on Healthcare Executives, 79% of study participants indicated that burnout was negatively impacting their organization and 79% of participants didn’t feel that their organization was doing enough to reduce or prevent executive burnout.  The report indicates that “respondents at all levels report experiencing feelings of burnout during the previous six months with directors, CIOs and CFOs reporting the highest rates.”  100% of directors participating in the study indicated experiencing some level of burnout.  That is staggering.

The study also indicated, “An alarming 71% of survey respondents indicate they are concerned that burnout will affect their own careers in healthcare management.”  Most disturbingly, “three-quarters of healthcare executives know a colleague who left the industry altogether due to career burnout.”

This is a crisis in the healthcare industry that we must start talking about more openly and addressing.  If we don't, the talent shortages that already exist in an industry that is already experiencing pressures is only going to get worse.  Talent is leaving the industry at a time when we need their expertise.  

​One year ago, this month I left my corporate job.  With the exception of a 9-month period of time in my 30s when I was laid off when the company I worked for closed, 2019 was the first year since I was 15 years old that I hadn’t been steadily employed. 

I turned 50 this past year.  As that birthday was approaching, I was utterly exhausted and, for the better part of a year, went home at the end of every work day feeling like I was failing.  It was time to reassess my priorities.  And I’m so glad I did.  This past year has given me a new perspective and a new sense of happiness that I don’t think I could have gained any other way.

What led up to the decision to leave my job was that I was losing myself.  Somewhere along the way I had burned out.  And with that, I lost my passion for my work.  I had been struggling with the overwhelming workload for quite some time.  And I was failing to achieve the things that gave me satisfaction in my work.

​That was coupled with the need to reduce even more staff, the challenges of finding good people to fill the critical vacancies we did have, the need to make some major system redesign changes and the continued increasing expectations that came with being an executive in a high performing health care organization - the pressures just continued to increase. 

Our nation’s economy is thriving and unemployment rates are at some of the lowest since 1969.  For employers, this creates a challenge in finding and keeping workers.  Creating a great workplace culture that will attract talent, make them want to stay and keep them engaged is an important strategy in meeting this challenge.
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To do this effectively, you must recognize your employees have choices, just as your customers do.  Yes, you pay them to do a job, but you need to approach it understanding there is a war for talent going on.  The key is in creating an exceptional experience for your employees that will attract and retain them to YOUR organization as their employer of choice.  They in turn will create an exceptional experience for your customers.   Your outcome will be an engaged workforce and better business results.

According to the Gallup Organization, the differences between engaged and actively disengaged businesses/work units is significant in the following way:

• 41% lower absenteeism
• 24% less turnover (in high turnover organizations)
• 59% less turnover (in low turnover organizations)
• 70% fewer safety incidents
• 40% fewer defects (quality)
• 10% higher customer ratings
• 17% higher productivity
• 21% higher profitability

And according to a recent SHRM (Society for Human Resources Management) article titled, The High Cost of a Toxic Workplace Culture: How Culture Impacts the Workforce – And the Bottom Line, “Great workplace cultures are associated with low employee turnover and high engagement, making these organizations more innovative, productive, and profitable.  Bad cultures, on the other hand, leave employees dissatisfied and unproductive – and eager to move on.  In fact, the high employee turnover (and low engagement) that stems from a bad workplace culture costs U.S. employers billions of dollars a year.”
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Your efforts to create an exceptional experience for your employees will pay off in business results that directly impact your organization’s bottom line.  It’s best to take a business approach to this work by creating a formal People Strategy. Formalize your strategy with specific goals and tactics that are refreshed annually.  

There have been numerous occasions over the course of my career where I’ve found myself in difficult situations professionally and I’ve had to make a decision that’s not been easy.  Sometimes it’s been to speak up about something that wasn’t popular or to push back on the thinking of someone in a more senior position.

Other times it’s been to make an exception to a policy when I knew it was the right thing to do in that circumstance or to dig into an investigation about something that I knew was going to be messy for the organization.  That has been especially tricky when the investigation involved a member of senior leadership.  There are times when those situations have occurred and I’ve been faced with having to make a decision – a fork in the road so to speak.  Choose the easy road or choose the right road?

This past weekend I attended a memorial service for one of the greatest leaders I’ve ever had the privilege of working with.  He was one of my first bosses.  John hired me one year out of college for my first Director-level position for a hospital in Southern Oregon.  I had exactly one year of hospital experience and three years of HR experience at the time.  He saw potential in me.  He hired me with knowledge that we would be merging with another hospital in the same town and I knew I would be reporting to the other HR person when that happened and would no longer be the director. 

John got the CEO job over the merged hospitals and he was no longer my direct boss.  Not much time went by before he quickly saw that the other person was not right for that job.  Shortly thereafter, she was gone and he promoted me.  Again, another vote of confidence in me that far outweighed any level of confidence I had in my own capabilities at that time. 

Here I was, a mere two years out of college, 26 years old and now the Director of Human Resources for a 600+ employee hospital organization that was going through a merger of two competing hospitals in a small town in Southern Oregon. Who gets opportunities like that?  He gave me a shot that few people get and I sure worked my tail off showing him I could do the job that he already knew I could do.  I will be forever grateful to him for giving me that chance. Together, with the rest of leadership team, we went through four of the toughest years one can go through professionally, but we did it together as a team…and he led us through it with grace.
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Leading through a merger is stressful and character building, to say the least. I learned so much from John through those years about effective leadership. He handled it with such strength, positivity and a sense of calm.  We had to reduce staff and costs, address significant wage and benefit inequities, physical campus disparities, and a name change.  He approached all of these things in the most humane way possible.  Perhaps the greatest stressor of all was the decision to buy property on the other side of town across the river for the future site of a new hospital, which was met with a huge community and physician partner uproar.  John met every one of those challenges with patience, kindness and compassion.  He kept us focused and he acknowledged the difficulties and sense of loss that many were feeling as they adjusted to the many, many changes that they were facing.