Burnout Toolkit
Learn more about burnout, its contributors and key strategies to address it for leaders, faculty, staff, and learners.
Learning Objectives:
Challenge the problem
Understand burnout and why it's a problem
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. Workforce 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.
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 leave their profession entirely.6,8
Michigan Medicine Rates of Burnout
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 3
69% of Residents 3
53% of Pharmacists 4
40% of Researchers 6
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.
Listen to Dr. Brower discuss burnout on The Wrap podcast, here!
What does Well-Being 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, a climate in which people are comfortable expressing & being themselves without fear of shaming, humiliation, retribution, or retaliation12
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 to enact lasting change.9
Organizational Level (senior leaders and managers):
Identify burnout and engage in positive change
Consider well-being in decision-making with the Operational Decision Guide.
Support policies and procedures that include well-being as part of daily practice
Create psychological safety, by making it safe to speak up. Find activities HERE.
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?
Why should leaders care about burnout?
Burnout can negatively impact culture and lead to loss of productivity and increased turnover.
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What can contribute to burnout?
Leadership behaviors and decision-making, work expectations, culture.
Work Level (your teams):
Encourage work-home flexibility, encourage the use of PTO, and minimize working while sick.
Utilize peer support programs available for faculty, staff, and learners.
Track and monitor well-being in your area. Measuring well-being has been shown to improve burnout and other wellness outcomes. 10
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 workforce 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)
Visit the Quality Department's Internal Website for more information on High Reliability at Michigan Medicine.
Why should your teams care about burnout?
Burnout can be detrimental to patient care, including patient satisfaction. It can also lead to interpersonal conflicts within a unit/department/ team.
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What can contribute to burnout?
Workload overload, inefficiencies, long hours, administrative burden, lack of autonomy or support.
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:
Why should you care about burnout?
Burnout can greatly impact one's physical health, and emotional and mental well-being as well as career.
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What can contribute to burnout?
Self-criticism, over-commitment, coping strategies, work-home imbalance, no sleep or support.
References
The Maslach Burnout Inventory.3rd ed. Palo Alto, CA: Consulting Psychologists Pr; 1996
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
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
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
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.2016.02.00
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).
Tugend A. (2020). On the Verge of Burnout. The Chronicle of Higher Education. Research Brief.
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
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
Meldrum H. Exemplary Physicians' Strategies for Avoiding Burnout. Health Care Manag (Frederick). 2010;29(4):324-331. doi:10.1097/hcm.0b013e3181fa037a
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
Edmondson AC. The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons; 2018.