Burnout is one of the most pressing issues facing ASCs, but leaders do not always know what steps they can take to help their clinicians and staff reduce burnout and its effects.
Marvella Thomas, a senior consultant of clinical operations for ASCs with Cardinal Health, took the time to speak with Becker's about burnout.
Editor's note: Responses have been lightly edited for length and clarity
Question: What are the top questions on burnout that you get from clients?
Marvella Thomas: Many times I don't get questions about burnout because folks don’t realize they have a problem. During discovery I start asking questions about staff turnover rates, loss of physicians, call offs, etc., and it starts to make them realize that there may be an issue that they’ve attributed to other causes.
I usually get questions on how to make the workplace and supply chain more efficient so that stress can be reduced for clinicians and physicians. We do talk about burnout and the cost associated with per diem staff vs regular staff. Burnout leads to more use of per diem staff who don’t share the strategies and don’t have the investment in the facility that full time staff would. Plus, we focus on clinicians and physicians,but think of the impact on your facility when you have turnover or vacancies in SPD or lose your business office manager.
Q: What are your clients' greatest misconceptions about burnout?
MT: Many clients think burnout is financially motivated. It's more of a work/life balance and making the work environment easier to work in. The financial impact that staff turnover has is not always recognized. The time, money, and resources required to replace clinical staff is significant. And after recruitment and hiring occurs, there is the time required and invested in orienting new staff.
Q: How does the issue of clinician burnout differ at ASCs than at hospitals?
MT: I think there is less burnout in the ambulatory space because working conditions are typically better than in the hospital space. The perception is that the ASC space offers less overtime, no call, no or fewer night/holiday/weekend shifts. They also believe patients are in good health, there are fewer exposure risks, and procedures are less complex. Some of this is changing with more procedures migrating to the ambulatory space. Segregation of specialties can also increase burnout if staff get tired of the same procedures.
Q: How does burnout differ between clinicians and staff? Should they be addressed with different methods?
MT: I think the causes may be closely related but physician burnout or loss due to burnout has a negative effect on your bottom line. It can be less time consuming or expensive to find a new clinician, compared to finding a new physician. I see more causation from inefficient working conditions and supply chains. Not having supplies needed, not being able to find things, clutter, disrepair, and lack of cleanliness also lead to dissatisfaction in the workplace. If your center is clean, organized, efficient, and schedules run smoothly there will be less burnout. Providing perks like profit sharing or meals are appreciated.
A great example is looking at the physical condition of the facility. Everyone is extremely careful to make sure that the public areas are clean, offer amenities such as coffee, snacks, Wi-Fi, and are always well lit and tastefully decorated. Signage makes it easy to find their way around and find the amenities. But cross the “red line” and you may find a totally different facility. We need to remember that our staff and physicians are our customers as well, and will appreciate the same amenities and concern for their comfort as patients and families do.
Q: Do you think burnout levels differ among clinicians of different ages?
MT: Absolutely, and for different reasons. Younger age groups put more emphasis on work/life balance. Their career and personal life goals are separate.
Q: Does native familiarity with technology help or hurt younger clinicians in terms of burnout?
MT: It’s a definite advantage to younger clinicians, some who have worked with advanced technology their entire lives. Not only are they more comfortable with EHR technology, they are also more comfortable with newer equipment including video equipment, robotics, RFID, and bar codes. Older clinicians also see these advances as threats to the status quo, may be resistant to change, and have more difficulty transitioning to the newer equipment and technologies.
Q: What is your top advice for leaders looking to address burnout within their organization?
MT: Strive to make your working environment as stress free as possible. Focus on cleanliness, organization, and efficiency. Provide perks when possible, such as space for personal time, snacks, meals, etc.
Salary vs hourly wage? Profit sharing. Give clinicians a voice and listen. And an efficient supply chain greatly enhances the satisfaction of your team. Having the supplies they need and being able to access them easily reduces waste in both time and money. Recognition and discussion of the causes of burnout, as well as more emphasis on retention, give me hope for the future of the issue.