Burnout Toolkit

Learn more about burnout, its contributors and key strategies to address it for leaders, faculty, staff, and learners.

Learning Objectives:

  1. Challenge the problem

  2. Understand burnout and why it's a problem

  3. Engage burnout with toolkit strategies

CHALLENGE THE PROBLEM

Burnout is Common

Burnout can occur in any occupational setting. It is a particularly common experience for faculty, staff, and learners in a medical, research, and academic community like Michigan Medicine. It can be characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment.1 We must recognize that burnout, and its effects, can manifest in any occupation across our organization.

While current research has focused heavily on burnout among clinicians in the academic medical setting, it is important to acknowledge that everyone is susceptible over the course of their career regardless of their role. Burnout is a serious issue that may cause an individual to reduce work hours, or to leave their profession entirely.6,8

National Rates of Burnout

  • 54% of physicians 2

    • Female physicians and physicians at the front line of service are at a greater risk of burnout

  • 43% of Physician Assistants and Nurses 4

  • 69% Residents 4

  • 53% of Pharmacists 5

  • 40% of Researchers 7

Michigan Medicine Rates of Burnout

Why Should You Care About Burnout?

Workplace burnout is not just a small thing that people need to figure out how to get over. It is a difficult and impactful reality that can lead to many negative consequences, including:

  • Organizational-level: at an institutional level, burnout can negatively impact culture and lead to loss of productivity and increased turnover.

  • Work-level: burnout can be detrimental to patient care, including patient satisfaction. It can also lead to interpersonal conflicts within a unit/department/team.

  • Individual-level: burnout can greatly impact ones physical health, and emotional and mental well-being as well as career.

UNDERSTAND MORE ABOUT BURNOUT

What does burnout look like?

Burnout can look like many different things. Individuals may be at different levels of burnout, which can range from neglecting personal care and needs, withdrawing, behavioral changes, to mental or physical exhaustion or collapse.

The three classical domains of burnout mentioned above can manifest in many different ways.

Examples of what burnout may look like, include but are not limited to:

  • Strained relationships

  • Isolation

  • Irritability

  • Neglecting personal needs

  • Detachment from patients

  • Loss of joy in work


Image adapted from Executive Leadership and Physician Well-Being: Nine Organizational Strategies to Promote
Engagement and Reduce Burnout
12.

What can contribute to burnout?

  • Organizational-level: leadership behaviors and decision-making, work expectations, culture.

  • Work-level: workload overload, inefficiencies, long hours, administrative burden, lack of autonomy or support.

  • Individual-level: self-criticism, over-commitment, coping strategies, work-home imbalance, no sleep or support.

Often these are referred to as the 'terrible too's': too much work, stress, paperwork, and too little sleep or compensation.

What does Wellness look like?

  • Having energy for work, or feeling energized by it

  • Feeling connected to people and purpose

  • Having flexibility between work and home

  • Feeling psychologically safe, where you can speak up with your ideas, questions and concerns, or even mistakes, without fear.


Listen to Dr. Brower discuss burnout on The Wrap podcast, here!

ENGAGE WITH TOOLKIT STRATEGIES

Individual interventions are necessary, but not sufficient, to address burnout. Interventions must also be focused at the organization and work levels in order to enact lasting change.9

Organizational Level (senior leaders and managers):

      1. Identify burnout and engage in positive change

      2. Consider well-being in decision making

      3. Support policies and procedures that include well-being as part of daily practice

      4. Create psychological safety, by making it safe to speak up. Find activities HERE.

      5. Questions to ask as leaders:

  • What can we do (or stop doing) to facilitate the well-being of our staff, faculty and learners?

  • What effect will our decisions and actions today have on our well-being?

  • How can we take care of each other and ourselves each day?

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Learn More

When you identify burnout in yourself

When you identify burnout in others
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Work Level (your teams):

  1. Encourage work-home flexibility, encourage use of PTO, minimize working while sick

  2. Utilize peer support programs available for faculty, staff, and learners

  3. Track and monitor well-being in your area. Measuring well-being has been shown to improve burnout and other wellness outcomes. 10

The Wellness Office has created a comprehensive assessment in Qualtrics examining key domains of workplace well-being using a variety of evidence-based, actionable questions. This tool differentiates from high-level engagement surveys by probing deeper, enabling leaders to make more informed decisions by targeting specific root causes impacting well-being. The survey contains a simple demographics section and 30 questions; the estimated time for completion is less than 10 minutes. Please contact wellness-office@med.umich.edu for more information on using this electronic survey.

This short Qualtrics survey is created for anyone employed at the University of Michigan Health system. It features a simple demographics section and six key questions for a brief, actionable report on workplace well-being. The estimated time for completion is less than 3 minutes. Please contact wellness-office@med.umich.edu for more information on using this electronic survey.

  1. Practice High Reliability Organization (HRO) skills to improve team culture, foster a collaborative environment, and reduce burnout:

  • Humble Inquiry (i.e. asking open-ended questions to reduce power distance among team members and open doors for workplace improvements)

  • Idea Generation (i.e. exploring new ideas and encouraging creativity among team members)

  • Problem Solving (i.e. framing problems as opportunities, not failures, while engaging the team to reduce burnout)

  • Chain of Command (i.e. providing a clear channel for team members to speak up for safety and escalate issues to appropriate leaders)

For more information on High Reliability at Michigan Medicine, visit the Quality Department's Internal Website here

  1. Learn about and use the 'Pause' Tools developed by Dean Runge's Stress + Burnout Task Team, available here.

  2. Utilize performance (e)valuations as an opportunity to identify how you can help your employees further their goals. Access HR's FY21 Valuation resources here.

Individual Level (you):

There are many coping and resilience strategies11 as well as mental health support services to help you at an individual-level. For more information, visit:

References

1. The Maslach Burnout Inventory.3rd ed. Palo Alto, CA: Consulting Psychologists Pr; 1996

2. Shanafelt T, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377. doi:10.1001/archinternmed.2012.3199

3. Rabatin J, Williams E, Baier Manwell L, Schwartz M, Brown R, Linzer M. Predictors and Outcomes of Burnout in Primary Care Physicians. J Prim Care Community Health. 2015;7(1):41-43. doi:10.1177/2150131915607799

4. Reith TP. Burnout in United States Healthcare Professionals: A Narrative Review. Cureus. 2018;10(12):e3681. Published 2018 Dec 4. doi:10.7759/cureus.3681

5. Durham M, Bush P, Ball A. Evidence of burnout in health-system pharmacists. American Journal of Health-System Pharmacy. 2018;75(23_Supplement_4):S93-S100. doi:10.2146/ajhp170818

6. Shanafelt T, Mungo M, Schmitgen J, et al. Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort. Mayo Clin Proc. 2016;91(4):422-431. doi:10.1016/j.mayocp.2016.02.001

7. Enders F, West CP, Dyrbye L, Shanafelt TD, Satele D, Sloan J. Burnout and Quality of Life Among Healthcare Research Faculty. Research Management Review. 2015; 20 (2).

8. Tugend A. (2020). On the Verge of Burnout. The Chronicle of Higher Education. Research Brief.

9. Awa, W, Plaumann, M, & Walter, U (2010). Burnout prevention: A review of intervention programs. Patient Education And Counseling, 78(2), 184-190. doi: 10.1016/j.pec.2009.04.008

10. Dunn, P, Arnetz, B, Christiansen, J and Homer, L, 2007. Meeting the imperative to improve physician well-being: Assessment of an innovative program. J Gen Intern Med, 22(11):1544–1552. doi: 10.1007/s11606-007-0363-5

11. Meldrum H. Exemplary Physicians' Strategies for Avoiding Burnout. Health Care Manag (Frederick). 2010;29(4):324- 331. doi:10.1097/hcm.0b013e3181fa037a

12. Shanafelt T, Noseworthy J. Executive Leadership and Physician Well-being. Mayo Clin Proc. 2017;92(1):129-146. doi:10.1016/j.mayocp.2016.10.004