Managing Pandemic Related Clinician Burnout

Clinician burnout was prevalent before the COVID-19 pandemic, and it continues as even more workplace hardships and moral dilemmas have arisen. 临床医生对感染COVID-19病毒并将其带回家以及工作时间延长和工作量增加感到担忧, staffing shortages, technology issues, regulatory compliance difficulties, and so much more.

Sixty-one percent of physicians now report experiencing feelings of burnout, which shows a significant increase since 2018. To combat this burnout, healthcare organizations should prioritize their clinicians’ health and well-being. 领导者应该识别并修改医疗机构中导致临床医生职业倦怠的流程和系统. Positive work and learning environments should be in place for clinicians. 它也可能有利于医疗保健组织创建一个领导角色和职能，负责所有临床医生的专业福利.

以下风险提示包括减轻临床医生职业倦怠和促进职业健康的更具体细节.

• Monitor the number of hours that clinicians are required to work, try to distribute workweeks effectively, and adjust staffing procedures and schedules where possible. Make sure clinicians receive adequate breaks.
• Pay attention to clinicians’ time constraints. Assess total workload and the complexity of clinicians’ duties, including continuing professional medical education, maintenance of certification, required institutional learning modules, and work performed outside of scheduled hours. 
• 提供充足的资源，包括充足和有效的个人防护装备.
• 对临床医生的健康和福祉进行持续评估，以满足他们的需求，识别风险或新出现的问题. 这种监视可以使用数据和经过验证的测量工具来指导面向系统的工作，以最大限度地减少负担, protect privacy, 并解决临床医生可能认为与测量或报告相关的任何耻辱或压力.
• 减少耻辱感，消除与获得管理职业倦怠所需的支持和服务相关的障碍. 确定心理健康专业人员和咨询方案，以支持临床医生, 并消除阻碍个体临床医生获得专业和个人支持项目的障碍.
• Provide appropriate measures for clinicians’ personal safety, 承认并解决对他们及其家人安全的担忧.
• 提供资源，如教练和充足的时间，为专业和个人发展. If possible, obtain clinicians to coach other clinicians. 
• 促进一种工作文化，在这种文化中，临床医生感到得到支持，能够畅所欲言，而不会受到影响. 给他们一个心理上安全的环境，让他们公开谈论影响他们健康的障碍, including stress and burnout. Incorporate items about stress into general care practices.
• Identify any part of the organization’s environment, culture, and infrastructure that can contribute to clinician burnout. 密切监测已实施技术的负面影响，并制定缓解计划以解决任何问题.
• Encourage clinicians to report safety incidents, such as encounters with violent people or exposure to blood or bodily fluids; adopt policies and procedures for immediate follow-up.
• 是否不要求临床医生在可能对其生命构成持续或严重危险的危急情况下重返工作岗位，直到采取措施改善这种情况. If clinicians contract COVID-19 following exposure in their workplaces, be certain to provide them compensation, rehabilitation, and curative services as necessary and provide any other resources needed.
• 促进同伴支持计划，并创造专业联系的机会. Allow time for reflection and processing. 鼓励临床医生与他们的队友一起检查，并定期与意义联系. 鼓励他们与专业人士保持联系，分清轻重缓急.
• Keep clinicians educated, informed, 尽可能通过中央接入点获取有关COVID-19的最新信息和技术更新. Make sure they’re familiar with technical updates.
• Give clinicians access to the appropriate tools for them to assess, triage, test, and treat patients as well as educate them on infection prevention and control.
• Evaluate how business and management decisions may affect work demands and resources, patient care quality and safety, and levels of burnout, and adjust decision-making as necessary.
• Create mechanisms for cooperation and collaboration between clinicians, management, and clinical teams.
• Support the implementation of new ideas, approaches, 技术可以提高临床医生的健康水平，提高医疗质量. 实施循证方法，以减少职业倦怠的风险，同时确保能力的适当发展, skills, professionalism, and ethical standards.
• Consider designating funding for research on clinician professional well-being.

Resources

Agency for Healthcare Research and Quality: Physician Burnout

American College of Physicians: Individual Physician Wellness and Burnout Tools

美国医学协会:没有人应该独自照顾:在“社会距离”时代为有意的专业联系创造过程... and Beyond...

American Medical Association: Physician Health

American Psychiatric Association: Well-Being Resources

Institute for Healthcare Improvement: Joy in Work

MedPro小组:医疗机构应对职业倦怠和建立健康和弹性文化的五种方法

MedPro Group: Risk Resources: Burnout in Healthcare

医生基金会:2021年美国医生调查COVID-19影响版:一年后

Endnotes

The Physician’s Foundation. (2021). 2021 survey of America’s physicians COVID-19 impact edition: A year later.

Retrieved from http://physiciansfoundation.o...

American Medical Association. (2021, March 29). Managing mental health during COVID-19. Retrieved from www.amaassn.org/delivering-care/public-health/managing-mental-health-during-covid-19; National Academies of Sciences, Engineering, and Medicine. (2019). 采取行动对抗临床医生的职业倦怠:一个系统的方法，以专业福祉. Washington, DC: The National Academies Press. http://doi.org/10.17226/25521; Berg, S. (2020, March 12). 6 big things that must change to beat physician burnout. American Medical Association. Retrieved from www.amaassn.org/practice-management/physician-health/6-big-things-must-change-beat-physician-burnout; National Academies of Sciences, Engineering, and Medicine. (n.d.). Checklist for health care leadership to take action against clinician burnout. Retrieved from http://nam.edu/systems-approa...

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