Prevention and Management of Burnout for Healthcare Professionals

Burnout is an improperly managed state of chronic workplace stress, with feelings of emotional exhaustion, detachment or cynicism, and lack of fulfillment. This chart answers questions about managing and preventing burnout. Find more in our chart, Dealing With Stress: Healthy Habits and Resources.

Question

Answer/Pertinent Information

What factors contribute to burnout?

Examples of individual or personal factors that may contribute to burnout include:1,2,5,16

  • age and sex (more common in younger females)
  • lack of social support
  • lack of work/life balance or time for selfcare (e.g., sleep, healthy eating, exercise)
  • personality traits (e.g., perfectionism)
  • personal struggles or life changes (e.g., family, financial, death)
  • pre-existing mental health conditions

Examples of work environment factors that may contribute to burnout include:1,2,5,16

  • lack of autonomy and/or flexibility
  • long hours/heavy workload (e.g., working 12 days straight due to weekend staffing)
  • inadequate staffing
  • inadequate training
  • pressure to work quickly/fear of errors

What are consequences of burnout?

Examples of possible consequences to the individual experiencing burnout include:1,12

  • on-the-job injuries (e.g., needle sticks)
  • substance use
  • depression/anxiety/suicide
  • chronic health conditions (e.g., musculoskeletal pain, diabetes, high cholesterol, heart disease)
  • job dissatisfaction

Examples of possible consequences to leadership, employers, or healthcare organizations include:1,10,11

  • increased employee turnover
  • increased healthcare costs
  • reduced productivity

Examples of possible consequences to patients include:1,9

  • increased errors
  • lower patient satisfaction
  • reduced quality of care
  • threatens patient safety (e.g., healthcare-associated infections, mortality)

How can you identify burnout?

Watch for signs and symptoms. Signs and symptoms of burnout include:2,4,8

  • reduced quality of work
  • lack of engagement
  • patient safety issues
  • the three subdomains of burnout:
    • emotional exhaustion (e.g., emotionally drained, overwhelmed, fatigued, feeling powerless)
    • depersonalization or detachment (e.g., cynicism, loss of altruism)
    • loss of work fulfillment

Use a tool.1 Examples of objective measurement tools that can be used to identify burnout are:

What are general recommendations to reduce the risk of burnout?

General suggestions to reduce the risk of burnout that anyone can do include:3,13

  • Make self-care a priority (e.g., healthy eating, exercise, getting plenty of sleep)
    • Pharmacy staff, see our CE, Self-Care and Well-Being for Pharmacy Staff.
  • Take time to do something fun.
  • Stay engaged with your support system, by connecting with family and friends.
  • Work on self-awareness to identify possible triggers. Then, take steps to stop or prevent future burnout.
  • Remember that no one is perfect. Everyone makes mistakes. But, be sure to learn from your mistakes to reduce the likelihood the same mistake happens again.
  • Regularly practice mindfulness and relaxation. There are lots of apps to help, example apps include:

What can pharmacy technicians or trainees (e.g., residents, students) do to reduce the risk of burnout?

Things an individual can do to reduce the risk of or manage burnout include:

  • Limit the number of extra work hours.2,3 Simple examples can include:
    • not checking email during nonwork hours.
    • scheduling one day per week that is completely work-free.
  • Work smarter, not harder. You don’t have to reinvent the wheel. Examples include:14
    • Ask for help when you need it.
    • Use available resources (e.g., “peripheral brains,” electronic databases)
    • Use available technology. Is there a way to automate routine tasks (e.g., running labs reports, pick lists)?

What can prescribers or pharmacists do to reduce the risk of burnout?

Specific things prescribers or pharmacists can to do reduce the risk of or manage burnout include:

  • Limit the number of extra work hours.2,3 Simple examples can include:
    • not checking email during nonwork hours.
    • scheduling one day per week that is completely work-free.
  • Work smarter, not harder. You don’t have to do everything yourself.14
    • Ask for help when you need it.
    • Delegate appropriately. Involve others to help with some duties (e.g., office staff, nurses, pharmacy technicians, students)
  • Be proactive to prevent unnecessary work.14 For example, when writing or filling Rxs:
    • Make sure to authorize an appropriate number of refills to last until a patient’s next appointment (or other appropriate time frame) in order to prevent an unnecessary request.
    • When possible, put the indication in the directions of each Rx, so patients know what each med is for without having to make a phone call.

What can leadership (e.g., managers, supervisors, preceptors) do to reduce the risk of burnout among subordinates and trainees (e.g., students, residents)?

Examples of ways leadership can reduce the risk of burnout for individuals include:3

  • Evaluate your own leadership style.
    • Do your individuals have autonomy or any flexibility in work assignments?
      • Find ways to create scheduling flexibility or offer protected time to work on projects.13,16
      • Preceptors: See our CE, Precepting: Incorporating Learners into Your Practice, for tips to accomplish these specifically with trainees.
      • Hospital subscribers: Access our Pharmacy Resident Precepting Toolbox for guidance on how to set up your rotations efficiently to reduce the risk of burnout for you and the trainee.
    • Are work assignments realistic? Are you aware of how your subordinates perceive workload?
      • Use employee satisfaction survey results to identify areas of dissatisfaction.17
      • Implement quality improvement projects to address needed changes.17
    • Encourage two-way communication.16
      • Check in with subordinates to see how they are doing.
      • Share your burnout triggers with your subordinates and explain what strategies help you.
    • Foster an environment, and ensure coverage, to encourage everyone to take earned time off.13
  • Incorporate mentor/mentee opportunities to build relationships.
    • These relationships can help to identify burnout and improve well-being.2
  • Teach subordinates how to break big projects into smaller chunks or to set intermediate deadlines.15
  • When you suspect someone is experiencing burnout, address it with empathy:16
    • inquire about their support systems
    • work with them to find a solution

What can organizations (e.g., employers, healthcare organizations, residency programs) do to reduce the risk of burnout?

Examples of things to do to prevent or manage burnout at an organizational level include:

  • Providing burnout education during orientation to increase awareness about common triggers and available well-being/resilience programs.3 Examples of well-being and resilience resources include:
  • Implement a burnout monitoring program that includes regular use of a burnout assessment tool.1,3
  • Promote work engagement by fostering communication and team work (e.g., interdisciplinary cooperation, collaboration, team building exercises, resident retreats).1,13,14
  • Offer on-site or remote access for employees to learn about or participate in:1,14,15
    • exercise classes
    • mindfulness techniques (e.g., yoga classes, group mindfulness training).
    • time management skills
    • stress management training
    • professional development
  • Provide confidential and accessible support when needed (e.g., Employee Assistance Programs).18

References

  1. National Academy of Medicine. Clinician well-being knowledge hub. https://nam.edu/clinicianwellbeing/. (Accessed March 26, 2021).
  2. Potter JM, Cadiz ML. Addressing burnout with well-being in pharmacy residency training programs. Am J Pharm Educ 2021;85:8287. doi: 10.5688/ajpe8287.
  3. Arendt DD, Boyle JA. When resiliency is not enough: addressing the structure of a residency program and its contribution to pharmacy resident burnout. Am J Health Syst Pharm 2021 Feb 21;zsab067. doi: 10.1093/ajhp/zxab067.
  4. Durham ME, Bush PW, Ball AM. Evidence of burnout in health-system pharmacists. Am J Health Syst Pharm 2018;75(Suppl 4):S93-100.
  5. Zinurova E, DeHart R. Perceived stress, stressors, and coping mechanisms among PGY1 pharmacy residents. Am J Pharm Educ 2018;82:6574.
  6. Mind Garden. Maslach burnout inventory. https://www.mindgarden.com/117-maslach-burnout-inventory-mbi. (Accessed March 26, 2021).
  7. Oldenburg Burnout Inventory Scoring. https://www.papsych.org/uploads/1/0/3/6/103628808/oldenburg_burnout_inventory.pdf. (Accessed March 26, 2021).
  8. StatPearls. Provider burnout. November 15, 2020. https://www.ncbi.nlm.nih.gov/books/NBK538330/. (Accessed March 26, 2021).
  9. Vahey DC, Aiken LH, Sloane DM, et al. Nurse burnout and patient satisfaction. Med Care 2004;42(Suppl 2):II57-66.
  10. Berg S. At Stanford, physician burnout costs at least $7.75 million a year. November 17, 2017. https://www.ama-assn.org/practice-management/physician-health/stanford-physician-burnout-costs-least-775-million-year. (Accessed March 26, 2021).
  11. Buchbinder SB, Wilson M, Melic CF, Powe NR. Estimates of costs of primary care physician turnover. Am J Manag Care 1999;5:1431-8.
  12. Salvagioni DA, Melanda FC, Mesas AE, et al. Physical, psychological and occupational consequences of job burnout: a systematic review of prospective studies. PLoS One 2017;12:e0185781.
  13. Padgett EH, Grantner GR. Pharmacist burnout and stress. May 15, 2020. https://www.uspharmacist.com/article/pharmacist-burnout-and-stress. (Accessed March 26, 2021).
  14. Kantree. How to avoid burnout (and work smarter, not harder). January 8, 2019. https://kantree.io/blog/leadership/2019/08/how-to-avoid-burnout-and-work-smarter-not-harder. (Accessed March 26, 2021).
  15. Peakslead. How to avoid project burnout. https://peakslead.com/how-to-avoid-project-burnout/. (Accessed March 26, 2021).
  16. Gabriel KP, Aguinis H. How to prevent and combat employee burnout and create healthier workplaces during crises and beyond. February 4, 2021. https://www.sciencedirect.com/science/article/pii/S0007681321000392. (Accessed March 26, 2021).
  17. Kleinpell R. Using quality improvement strategies to address burnout and promote a healthy work culture. https://www.sccm.org/Communications/Critical-Connections/Archives/2019/Using-Quality-Improvement-Strategies-to-Address-Bu. (Accessed March 26, 2021).
  18. American Psychiatric Association Foundation. Employee assistance programs. http://workplacementalhealth.org/Mental-Health-Topics/Employee-Assistance-Programs. (Accessed March 26, 2021).
  19. American Society of Health-System Pharmacists. Guidance document for the ASHP accreditation standard for postgraduate year one (PGY1) pharmacy residency programs. August 2020. https://www.ashp.org/-/media/assets/professional-development/residencies/docs/guidance-document-PGY1-standards.ashx. (Accessed March 26, 2021).

Cite this document as follows: Clinical Resource, Prevention and Management of Burnout for Healthcare Professionals. Pharmacist’s Letter/Prescriber’s Letter. April 2021. [370419]

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