Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON SYSTEMS APPROACHES TO IMPROVE PATIENT CARE BY SUPPORTING CLINICIAN WELL-BEING
• Reviewers
• Acknowledgments
• Preface
• Acronyms and Abbreviations
• Summary
  • CONCEPTUAL FRAMEWORK
  • RECOMMENDATIONS
• 1. Introduction
  • ORIGIN OF THE TASK AND COMMITTEE CHARGE
  • METHODS OF THE STUDY
  • CONCEPTUAL FRAMEWORK
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. A Framework for a Systems Approach to Clinician Burnout and Professional Well-Being
  • DEFINITIONS OF BURNOUT, PROFESSIONAL WELL-BEING, AND RESILIENCE
  • A SYSTEMS MODEL OF CLINICIAN BURNOUT AND PROFESSIONAL WELL-BEING
  • SYSTEM LEVELS AND INTERACTIONS
  • IMPORTANT CONSIDERATIONS RELATED TO THE SYSTEMS MODEL
  • KEY FINDINGS
  • REFERENCES
• 3. Extent and Consequences of Clinician Burnout
  • MEASURING BURNOUT
  • PREVALENCE OF CLINICIAN BURNOUT
  • PERSONAL CONSEQUENCES OF BURNOUT
  • EFFECTS OF BURNOUT ON TURNOVER AND CLINICAL WORK EFFORT
  • EFFECTS OF BURNOUT ON JOB PERFORMANCE AND QUALITY OF CARE
  • KEY FINDINGS
  • REFERENCES
• 4. Factors Contributing to Clinician Burnout and Professional Well-Being
  • RELATIONSHIP TO THE COMMITTEE'S SYSTEMS MODEL OF BURNOUT AND PROFESSIONAL WELL-BEING
  • JOB DEMANDS
  • JOB RESOURCES
  • INDIVIDUAL FACTORS MEDIATING BURNOUT AND PROFESSIONAL WELL-BEING
  • KEY FINDINGS
  • REFERENCES
• 5. Healthy and Safe Health Care Organizations
  • EVIDENCE ON HEALTH CARE ORGANIZATION INTERVENTIONS
  • DESIGNING WELL-BEING SYSTEMS IN HEALTH CARE ORGANIZATIONS
  • KEY FINDINGS
  • REFERENCES
• 6. The Influence of the External Environment on Clinician Burnout and Professional Well-Being
  • HEALTH CARE INDUSTRY
  • LAWS, REGULATIONS, AND STANDARDS
  • KEY FINDINGS
  • REFERENCES
• 7. Health Information Technology
  • ELECTRONIC HEALTH RECORDS
  • THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN FOSTERING PATIENT-CENTERED CARE
  • SHARED RESPONSIBILITY FOR IMPROVING HEALTH INFORMATION TECHNOLOGY
  • FUTURE OPPORTUNITIES: NEW AND EVOLVING TECHNOLOGIES
  • KEY FINDINGS
  • REFERENCES
• 8. Student and Trainee Burnout and Professional Well-Being
  • EXTENT OF BURNOUT
  • CONSEQUENCES OF LEARNER BURNOUT
  • SYSTEM FACTORS CONTRIBUTING TO BURNOUT AND WELL-BEING IN THE LEARNING ENVIRONMENT
  • INDIVIDUAL MEDIATING FACTORS
  • ORGANIZATIONAL AND PROGRAM STRATEGY
  • KEY FINDINGS
  • REFERENCES
• 9. A Research Agenda to Advance Clinician Professional Well-Being
  • LIMITATIONS OF THE EXISTING LITERATURE
  • NEEDED RESEARCH
  • KEY FINDINGS
  • REFERENCES
• 10. Conclusions and Recommendations
  • REFERENCE
• Appendixes
  • Appendix A. Committee and Staff Biographies
  • Appendix B. Medicare Program, The Joint Commission, and International Classification of Diseases, Tenth Revision, Clinical Documentation and Coding Requirements

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2019. Taking action against clinician burnout: A systems approach to professional well-being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25521.

Digital Object Identifier: https://doi.org/10.17226/25521

Library of Congress Control Number: to come

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