The American Pharmacists Association (APhA) applauds the National Academy of Medicine (NAM) on its new consensus report Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being that was publicly released on October 23, 2019.  The report outlines six goals that stakeholders should pursue to prevent and mitigate health care clinician burnout and foster professional well-being.

NAM describes clinician burnout as a workplace syndrome resulting from chronic job stress and is a major problem across the U.S. It is characterized by emotional exhaustion, detachment, and a low sense of personal accomplishment. It can jeopardize patient care and cause health care clinicians, including pharmacists, to leave the health care profession altogether.  It is specifically job-related and not an individual mental health diagnosis, says the report.  Mounting pressures in the health care system have contributed to burnout – including long hours, technologies and documentation requirements that detract from patient care, difficulties with work-home balance, and insufficient job resources, such as unsupportive organizational culture and ineffective team structures.

Personal stress management strategies are not sufficient to address the issue of clinician burnout, says the report. It is critical to address burnout not as an individual issue, but rather as a systems issue that emanates from workplace culture, health care policies and regulations, and societal expectations.  The NAM report committee member noted that “to provide the best patient care possible, health care organizations must create a work environment that fosters clinicians’ safety, health, and sense of fulfillment.”

“These findings and recommendations in the National Academy of Medicine report affirm the 50 recommendations that were developed at the national consensus conference Enhancing the Well-being and Resilience of the Pharmacists Workforce spearheaded by APhA last July, ” said Tom Menighan, APhA CEO.  “Pharmacy, both organizations and individuals, must come together to address the systems issues that are contributing to the burnout and moral distress experienced by our pharmacy workforce.  APhA looks forward to continued partnerships to address these issues.”

The NAM report outlines six goals the health care system should pursue:

• Create positive work environments. Health care executives should commit to, and be accountable for, creating a work environment that promotes high-quality care, job satisfaction, and social support, says the report. It recommends that health care organizations create and maintain an executive leadership role dedicated to clinician well-being. Health care organizations should also assess how business and management decisions — for example, whether to deploy new technologies — may affect clinicians’ job demands and levels of burnout, as well as patient care quality and safety. They should continuously monitor and evaluate the extent of burnout in their organization, using validated tools, and report on this at least annually to leaders, managers, and clinicians within the organization.

• Address burnout in training and at the early career stage. Clinicians often experience burnout early in professional training. The report recommends that schools of health professions alleviate major sources of stress by monitoring workload (including preparation for licensure examinations and required training activities), implementing pass-fail grading, improving access to scholarships and affordable loans, and building new loan repayment systems.

• Reduce tasks that do not improve patient care. Federal agencies, state legislatures, and other standard-setting entities should identify and address the sources of clinician burnout related to laws, regulations, and policies, eliminating those that contribute little or no value to patient care. They should specifically evaluate regulations and standards related to payment, health information technology, quality measurement and reporting, and professional and legal requirements for licensure.

• Improve usability and relevance of health IT. Health information technology (IT), including electronic health records, should be as user-friendly and easy to operate as possible to reduce burnout, the report says. Health IT vendors and health care organizations should deploy technologies to reduce documentation demands and automate non-essential tasks. In addition, federal policymakers and private sector health IT companies should collaborate to develop the infrastructure and processes that enable shared decision-making between clinicians and patients.

• Reduce stigma and improve burnout recovery services. Many clinicians do not report burnout because they fear the potential consequences, including loss of licensure or jobs. In order to eliminate the stigma of getting help and to promote recovery and well-being, the report recommends that state legislative bodies facilitate access to employee assistance programs, peer support programs, and mental health providers without the information being admissible in malpractice litigation.
• Create a national research agenda on clinician well-being. By the end of 2020, federal agencies — including the Agency for Healthcare Research and Quality, the National Institute for Occupational Safety and Health, the Health Resources and Services Administration, and the U.S. Department of Veterans Affairs — should develop a coordinated research agenda on clinician burnout, says the report. Research priorities should include identifying the drivers of burnout across career and life stages for different types of clinicians; burnout’s implications for the workforce as well as patient safety outcomes; and potential systems-level interventions to improve clinician and learner well-being.

APhA is a Network Organization Member of the National Academy of Medicine Action Collaborative on Clinical Well-being and Resilience, committed to reversing trends in clinician burnout and has made a visible commitment to improving the well-being of pharmacists.