How do you fix burnout in healthcare?

This question is to simplistic and cannot be answered with a simple one-size-fits-all solution. Burnout has emerged as a central topic for booming businesses. Almost everywhere I turn, I encounter people from various industries approaching this topic from all angles, offering coaching programs, mentorships, courses, lectures, etc.

After all, burnout is the reason why I created this brand in the first place. I have also taught various continuing education courses online and across the country on the topic. Heck- I’m even writing a book about it!

In the midst of all the self-care rage you see on social media, it’s important to discuss the bigger systems at play that act as the root cause for the development of burnout for many people. In this article, I discuss a huge culprit of burnout in healthcare: fraud.

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WHAT APPROACHES WORK TO FIX BURNOUT IN HEALTHCARE?

In order to ‘fix’ burnout, we first must understand what burnout is. I cover the definition of burnout here along with the six major factors at work that may be causing you to experience burnout. The three main outcomes of burnout include:

  • Emotional exhaustion
  • Cynicism
  • Decreased self-efficacy

Burnout leaves a worker drained, disengaged from work, and lacking a sense of accomplishment. One study found that work-directed approaches and combined approach (work-directed and person-directed) yielded longer-lasting beneficial effects than person-directed approaches alone to address burnout (Westernann, Kozak, Harling, & Nienhaus, 2014).

In that study, person-direct approaches included teaching people skills/techniques reduce effects of stressors. Work-directed approaches included changing the work environment, work tasks, and/or working methods.

#WorkWellSeries

Our collection of articles on how to create the optimal work environment.

Learn about the six major work factors that are burnout you out.

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PRODUCTIVITY, FRAUD, AND BURNOUT IN HEALTHCARE

Researchers found that high productivity demands are associated with increased observed unethical behavior in rehab professionals. Unethical behaviors were defined as those that were explicitly illegal or fraudulent based on governmental regulations.

In fact, high productivity standards creates an environment that accelerates the rate of burnout. (Tammany, O’Connell, Allen, & Brismee, 2019). Traditional productivity standards do not assess for quality of care. Such unrealistic demands can regularly put providers in tough positions where they have to make unethical decisions.

This is important because so many tasks in the workplace for an occupational and physical therapist or assistant involves ‘non-productive’ time, which includes:

  • Documentation
  • Reviewing charts
  • Ordering equipment
  • Conferring with physicians and other medical professionals

To add to this, there is NO standard approach and it varies by setting and employer.

      NIPPING PRODUCTIVITY PRESSURES IN THE BUTT

      Employers and stakeholders can work towards reducing unrealistic productivity pressures.

      • Emphasize ethical and evidence-based practices
      • Survey employees about the ethical climate and organizational behavior
      • Avoid the use of productivity standards based on billable unit
      • Involve clinicians in developing productivity goals
      • Look for other metrics of measurement, like leadership, clinic growth, patient outcomes, attitude, continuing education

      BURNOUT IN HEALTHCARE: REPORTING FRAUD

      One of my favorite articles from The Mayo Clinic outlines solutions to address physician burnout regarding multiple levels, including individual, work unit,organizational, and national factors.

      In an interview I had with Dr. Robert Pearl on the Burnt Out to Lit Up Podcast, he so eloquently summarized the major problems we see in today’s healthcare landscape that have built the foundation for burnout to occur, and offers solutions to address our fragmented healthcare system.

      First thing’s first- if you have been observing unethical and fraudulent behavior at your workplace, you can take the appropriate action. If you belong to another profession that is not listed here, refer to your profession’s national association.

      AOTA/APTA/ASHA GUIDELINES FOR REPORTING NON-COMPLIANCE

      The American Occupational Therapy Association along with the Physical Therapy Association and the American Speech-Language-Hearing Association created a consensus document on Medicare compliance that can be found here.

      What is compliance? AOTA defines it as:

      Compliance is an organization’s adherence to laws, regulations, and policies applicable to its operations. Violations may result in punitive action, including the imposition of fines and/or criminal charges. Clinicians have a responsibility to adhere not only to their profession’s clinical and ethical standards, but all applicable laws, regulations and policies.

      American Occupational Therapy Association Tweet

      RECOMMENDED STEPS FOR REPORTING FRAUD

      AOTA recommends to immediately stop engaging in any activity that you believe to be a compliance violation, and discuss concerns and questions with your immediate supervisor.

      They also note that although concerns are best addressed directly, remember that only compliance officers are legally bound to ensure confidentiality and whistleblower protections.

      Read more on that here.

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      MEDICARE WASTE, FRAUD, AND ABUSE IN MEDICINE

      The American Medical Association has their recommendations and information about Medicare Recovery Audit Contractors. If you observe a colleague acting unethically, AMA also provides guidelines here.

      NURSING RECOMMENDATIONS  FOR FRAUD

      As per the American Nurses Association, if you have information about fraud and abuse against Federal health care programs, you may report that information through the OIG Fraud Hotline at 1-800-HHS0TIPS (1-800-447-8477)or HHSTIPS@oig.hhs.gov.

      MEDICARE FRAUD INFORMATION

      You can report suspected Medicare fraud by:

      • Call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
      • If you’re in a Medicare Advantage Plan, call the Medicare Drug Integrity Contractor (MEDIC) at 1-877-7SAFERX (1-877-772-3379).

        YOU ARE NOT ALONE

        If you have observed unethical behavior or have engaged in such behaviors for fear of losing your job, you are not alone. Please take the appropriate actions. At the end of the day, no job is worth more than your license, physical health, or mental health.

        References:

        Westernann, C., Kozak, A., Harling, M., Nienhaus, A. (2014). Burnout intervention studies for inpatient elderly care nursing staff: Systematic literature review. International Journal of Nursing Studies, 51: 63-71. http://dx.doi.org/10.1016/j.ijnurstu.2012.12.001 

        Shanafelt, T.D., Noseworthy, J.H. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings. 2(1):129 146. http://dx.doi.org/10.1016/j.mayocp.2016.10.004

        Tammany, J.E., O’Connell, J.K., Allen, B.S., & Brismee, J.M. (2019). Are productivity goals in rehabilitation practice associated with unethical behaviors? Archives of Rehabilitation Research and Clinical Translation, 1: 100002. https://doi.org/10.1016/j.arrct.2019.100002

        Categories: Healthcare

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