MSMS Michigan Medicine November December 2022

Nov / Dec 2022 | michigan MEDICINE® 25 Contributed by The Doctors Company (CONTINUED ON PAGE 26) Leaders in healthcare recognize that clinician burnout is not a new problem—and that it grew in severity during the crucible of the COVID-19 pandemic. But burnout in healthcare is too complex for a single leader or resource to solve. Driving burnout are work overload, loss of control, insufficient reward, erosion of community, absence of fairness, and misalignment of values.1 Addressing these drivers in highly complex sociotechnical systems requires comprehensive organizational commitment, multiple strategies and tools, and support for high-functioning teams. Solving these issues also requires respectful, humble leaders who have the tenacity to change systems and can deliver the solutions that healthcare workers need to thrive. These types of people-first leaders (some use the term “servant leaders”) put the needs of others first by sharing knowledge and power and by helping individuals perform to their highest capacity. People-first leaders whose actions have a positive impact on clinician burnout and well-being share common traits. Leaders recognize burnout as a problem unique to the workplace(s) in their charge that profoundly affects the multidimensional well-being of the people they lead and the patients they serve. They understand a hard truth about burnout, as described by experts Christina Maslach and Michael Leiter: “Burnout is shown to be a sign of a major dysfunction within an organization, and [it] says more about the workplace than it does about the employees.”2 With this realization, people-first leaders react by saying, “This is unsustainable. We have to do something!” Commit People-first leaders elevate their organizational commitment by making workforce well-being a measurable strategic imperative—prominently displayed on the organization’s performance dashboard—with dedicated resources, the same as other major strategic organizational priorities. Depending on the size of the organization, actions may include creating a chief wellness officer or champion position that has authority and resources. Measure Impact People-first leaders assess their workplace with validated instruments that measure burnout, well-being, and the organizational costs of burnout in physicians, nurses, and other clinicians. Evidence-based tools support accountability and help establish a baseline for tracking and reporting measurements over time as commitments are put into action. Build Leadership Skills Leaders committed to healthcare worker well-being are needed at all levels. People-first leaders acknowledge this and take steps to strengthen and develop their own and others’ leadership skills and behaviors and invest in building high-functioning teams—expert teams instead of teams of experts. One of these behaviors is to shadow clinicians at work, using “humble inquiry” to ask frontline staff questions to which the leader does not already know the answer.3 Questions that will reveal opportunities to support include: “How has the pandemic affected your life? What do value and appreciation look and feel like at work? What gets in the way of doing a job you would feel proud of? What can be done to move forward and help you do a job you are proud of?”4 Answers to these questions from frontline staff point to the solutions that leaders with operational authority can deliver or enable staff to design and implement. People-first leaders de- emphasize “doing more with less” in favor of change that is done with, not to, people. Teamwork and inclusion are critical. Involving frontline workers in the improvement process empowers them to do the work well. A positive rounding frame used by people-first leaders in “Positive Leadership WalkRounds” is “associated with better healthcare worker well- being and safety culture.”5 Instead of asking, “What isn’t working?,” leaders ask, “What are three things that are going well and one thing that could