Contributors: Linda Roszak Burton, ACC, BBC, BS and Betsy Chapin Taylor, FAHP
To learn more about Linda and Betsy, click here.
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"Clinician well-being is experiencing satisfaction and engagement with work, while also having a feeling of professional fulfillment and a sense of meaning in work." A joint statement from the American College of Cardiology, American Heart Association, European Society of Cardiology, and World Heart Federation.1
This definition of clinician well-being closely aligns with Accordant's ethos approach to creating a Virtuous Practice, one that embraces gratitude, kindness, compassion, and love of humankind while improving clinician well-being through research and evidence-based practices to increase job satisfaction and boost patient trust.
In the complex landscape of healthcare, the well-being of clinicians (physicians, nurses) stands as a cornerstone of sustainable and effective care delivery. Yet, historically, the focus on clinician well-being has often been overshadowed by other priorities within healthcare systems. Additionally, healthcare institutions are slow to conduct organizational well-being assessments among clinicians.
In a 2023 study by The Joint Commission, only one-third (33.7%) of study participants had conducted at least one in three years.2 While surveys show organizations have increased well-being budgets with access to offerings, without assessing the state of well-being of clinicians, wellness programs are a huge waste of resources and limit clinician participation in programs that are irrelevant or offer too little of the desired support.
As the understanding of the interconnectedness between clinician well-being and patient outcomes deepens, integrating clinician well-being into strategic planning has emerged not just as a compassionate endeavor but as a strategic imperative.
Having clinicians involved in the strategic planning process can help overcome some of the reasons why clinicians are less engaged in organizational wellness programs. Lack of leadership support, organizational cultures that unceasingly live by “do more with less,” and strategic metrics that don’t align with organizational challenges of staffing shortages and burdensome administrative tasks leave little time and energy to participate in programs.
Forward-thinking healthcare leaders are beginning to recognize the critical importance of integrating clinician well-being into the strategic planning process. Here are a few critical reasons clinician well-being as a key performance indicator is a fundamental component of any healthcare organization's strategic plan:
Enhanced Patient Care Quality and Safety
A clinician's well-being is inextricably linked to the quality and safety of patient care. As reviewed in our October 2023 issue of the WHQ, with high levels of stress, fatigue, and burnout, the ability to provide optimal care diminishes. Research consistently demonstrates that stressed or burned-out clinicians are more prone to medical errors, show decreased empathy, lower patient satisfaction, and reduced adherence to clinical guidelines.
Studies show statistically significant negative relationships between clinician burnout, poorer quality of care, and reduced patient safety.3 Conversely, when supported and healthy, clinicians are better equipped to deliver compassionate, high-quality and effective care to their patients.
Improved Employee Retention and Recruitment
Clinician burnout has reached alarming levels in recent years, leading to increased turnover rates within healthcare organizations. Recruiting and retaining talented clinicians are crucial for maintaining continuity of care and sustaining organizational success. By integrating clinician well-being initiatives into strategic plans, healthcare leaders can engage and retain top talent.
Moreover, in an era where clinician shortages are prevalent, attracting new talent is equally crucial. Because clinician turnover and staff shortages can disrupt patient care continuity, affect staff morale, and negatively impact the bottom line, fostering a culture of well-being leads to greater stability and the opportunity to improve the patient experience and resultant satisfaction levels.
The costs associated with recruiting and training new clinicians are substantial. In the U.S., burnout is estimated to be responsible for about $4.6 billion in annual costs related to physician turnover and reduced clinical hours. Total costs associated with nurse turnover for an average hospital were estimated to range from $4.4 million to $6.9 million in 2018.4
Further, imbedding clinician health and well-being initiatives into strategic plans makes the organization more appealing to prospective clinicians, if genuine efforts are made with the necessary investments to support them. It also becomes a magnet for healthcare professionals seeking fulfilling and sustainable careers.
The Business Case
While it stands to argue that there are strong moral and ethical reasons to support clinician well-being, there is also a strong business case. Consider an organization that employed 450 physicians, with an annual turnover rate of 7.5%, and typical replacement costs of $500,000 per physician. The annual organizational cost of physician turnover would be approximately $16.9 million/yr.5 A more accurate ROI in investing in an organizational well-being intervention can be calculated if healthcare institutions were frequently conducting organizational well-being assessments of their clinicians.
The economic impact of clinician burnout extends beyond the individual practitioner to healthcare systems as a whole, as a significant financial burden. Investing proactively in clinician wellness programs, burnout prevention measures, and supportive work environments can yield substantial returns on investment by mitigating medical malpractice liabilities, reducing turnover rates, enhancing productivity, and minimizing the need for locum tenens temporary staffing.
In a 2017 article in the AHA Trustees Services, a best practice included engaging physicians directly in the strategic planning leadership through broad representation on a steering committee.6
Positive Organizational Culture
A culture of well-being starts at the top. Executive leadership demonstrates a commitment to clinician well-being by making it a strategic priority. It signifies the importance of having a culture where clinicians feel valued, safe, respected, and empowered. Such environments attract top talent, enhance employee morale, and contribute to a positive reputation within the healthcare community. Prioritizing clinician well-being results in the type of performance metrics and reputation enhancers that attract patients seeking not only expert but compassionate care and fosters partnerships and collaborations with other healthcare entities.
A commitment to building a positive organizational culture builds staff and patient trust and encourages greater engagement with healthcare services. Integrating clinician well-being into the strategic plan sends a powerful message about the organization's commitment to nurturing a positive work environment. Supporting clinician well-being also enhances community trust and strengthens the institution's brand.
There are numerous other reasons why clinician well-being should be a fundamental component of any healthcare organization's strategic plan, including:
- Regulatory Compliance and Accreditation Regulatory bodies and accrediting agencies are increasingly emphasizing the importance of addressing clinician well-being as part of organizational governance and quality improvement initiatives. Healthcare organizations that integrate clinician well-being into their strategic plans demonstrate a proactive approach to compliance and accreditation requirements. The Magnet Recognition Program was developed by the American Nurses Credentialing Center (ANCC). It now includes well-being as part of its application requirements to guarantee healthcare organizations and nurse leaders include structures and processes to support nurses’ well-being.
- Mitigation of Public Health Crises During times of crisis, such as pandemics or natural disasters, the resilience and effectiveness of healthcare systems are put to the test. Clinician well-being becomes even more critical in such circumstances, as healthcare professionals face heightened stress, long hours, and emotional exhaustion. By embedding clinician well-being into the strategic plan, healthcare organizations will be better prepared for and more nimble in the response to future public health crises.
- Innovation and Continuous Improvement Well-supported clinicians are more likely to engage in lifelong learning, innovation, and quality improvement initiatives. By nurturing a culture that encourages creativity and professional growth, healthcare organizations can drive innovation in patient care, processes, and technologies, ultimately leading to better clinical and financial outcomes and increased efficiency.
- Community Trust and Patient Engagement Healthcare consumers place a premium on trust when selecting providers. Organizations that prioritize clinician well-being signal to the community their dedication to ethical practices and patient-centered care. This commitment builds patient trust and encourages greater engagement with healthcare services, ultimately leading to better health outcomes and stronger community relationships. So it’s important if an organization is actually supporting clinician well-being that its efforts are associated with its brand.
Integrating clinician well-being into strategic plans is essential for the long-term sustainability of healthcare organizations. In an era of unprecedented challenges, including an aging population, rising healthcare costs, and evolving regulatory landscapes, resilient and adaptive healthcare systems are needed. Investing in clinician well-being is an investment in the organization's ability to weather these storms and thrive in the face of uncertainty.
Ignoring clinician well-being in favor of immediate financial or operational goals can lead to systemic issues that undermine the organization's sustainability in the long run. As healthcare continues to evolve, embracing clinician well-being as a strategic imperative is essential for building sustainable, high-performing healthcare systems that prioritize both the health of patients and those who care for them.
Contact Linda at: [email protected]
Contact Betsy at: [email protected]
References
- Mehta LS, Elkind MSV, Achenbach S, Pinto FJ, and Poppas A. Clinician Well-Being: Addressing Global Needs for Improvements in the Health Care Field: A Joint Statement from the American College of Cardiology, American Heart Association, European Society of Cardiology, and World Heart Federation. Glob Heart. 2021;16(1):48. Published 2021 Jul 13. doi:10.5334/gh.1067
- Longo BA, Schmaltz SP, Williams SC, Shanafelt TD, Sinsky CA, and Baker DW. (2023). Clinician Well-Being Assessment and Interventions in Joint Commission–Accredited Hospitals and Federally Qualified Health Centers. The Joint Commission Journal on Quality and Patient Safety, 49(10), 511-520. https://doi.org/10.1016/j.jcjq.2023.04.007
- Salyers MP, Bonfils KA, Luther L. et. al.The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis. J GEN INTERN MED 32, 475–482 (2017). https://doi.org/10.1007/s11606-016-3886-9
- A call to action: Improving clinician wellbeing and patient care and safety https://www.healthpolicyohio.org/our-work/publications/improving-clinician-wellbeing-and-patient-care-and-safety
- Shanafelt T, Goh J, and Sinsky C. The Business Case for Investing in Physician Well-being. JAMA Intern Med.2017;177(12):1826–1832. doi:10.1001/jamainternmed.2017.4340
- Strategic planning: Physicians needed https://trustees.aha.org/articles/1287-include-physicians-in-strategic-planning