New data suggests integrating social determinants of health interventions into primary care can combat clinician burnout issues.
Creating a system by which primary care clinicians can address patient social determinants of health may help combat the clinician burnout epidemic, according to new data published in the Annals of Family Medicine.
“Recent studies have demonstrated direct or potential links between clinician burnout and the ability to address patients’ social needs,” the researchers wrote. “Lower satisfaction with resources for treating complex patients has been associated with more symptoms of burnout; conversely, practice preparedness to address social needs and ease of coordinating social services have been associated with greater clinician satisfaction.”
This comes as the healthcare industry zeros in on clinician burnout, an issue that afflicts 83 percent of hospitals.
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Burnout can have negative consequences on patient care, with physicians experiencing burnout feeling disconnected from their work and less productive. Clinicians reporting burnout symptoms might also encounter clinical care quality problems and emotional exhaustion, especially when they have fewer resources for addressing patient needs.
And while programs to support physician mindfulness and to address technological hurdles that often drive burnout have shown some promise, experts say more efforts are needed to truly tackle the burnout problem.
Helping providers address the social determinants of health may be one such strategy, the Annals of Family Medicine study showed.
In a survey of 29 primary care clinicians, researchers identified a clear link between resources for addressing patient social needs and burnout symptoms. Specifically, physicians with fewer resources to address the social determinants of health were more likely to feel symptoms of burnout.
But that logic holds up in the inverse, as well. Physicians feeling intense burnout are more likely to say their organization has insufficient resources for addressing patient social needs, even if the organization does have adequate SDOH tools, the survey showed.
The 17 clinician respondents with low to moderate emotional exhaustion expressed confidence in their ability to use clinic resources to address the social determinants of health. Meanwhile, the three clinicians with high emotional exhaustion and depersonalization said they had no confidence in their ability to use clinic resources to address social needs.
All of the provider respondents agreed that unaddressed social needs took away from the clinical care encounter. While all clinicians agreed addressing the social determinants of health is an essential part of primary care, they noted that doing so can disrupt clinical workflows, especially when resources are limited.
Unmet social needs can also impact care plans, with most clinicians expressing frustration when a patient is unable to adhere to treatment protocol because she experiences a certain social barrier.
“In the absence of social needs resources, clinicians described a negative cycle whereby inefficacy exacerbated emotional exhaustion and vice versa,” the researchers reported. “Having to reconcile the responsibility they felt to their patients with their limited capacity to facilitate access to social services was emotionally taxing. In turn, being emotionally exhausted made clinicians feel less capable of addressing social needs.”
Embedding social resources and experts in addressing SDOH, including social workers or behavioral health specialists, did help ease this burden, survey respondents reported. Co-locating these services made it easier for clinicians to refer patients to resources and ultimately helped ease clinician burnout.
Specifically, respondents said seeing their patients’ social needs alleviated helps address their own emotional wellbeing and morale.
Most provider respondents agreed integrating these resources into the primary care clinic would be a step forward in managing clinician burnout, but noted that more was needed to truly address emotional exhaustion. Notably, three clinicians were teetering on the edge of full emotional exhaustion during the study, despite working in clinics with several SDOH resources.
These clinicians reported challenges with EHR use, competing demands with their work and personal lives, intense workloads, inadequate staffing levels, and documenting requirements as key burnout drivers.
“Clinicians noted that even if and when primary care clinics maximized the internal capacity to address social needs, external, nonclinical social, governmental, and community resources are required to really improve SDH and reduce patients’ social needs,” the researchers reported. “External resources were often perceived as difficult to access amid limited resources, restrictive eligibility requirements, staff turnover, or unstable funding.”
More work is needed to understand how SDOH programming can help address clinician burnout, the researchers said. The limited evidence suggests that embedding SDOH resources into the primary care clinic can be effective, but more work is needed to understand how to be model these programs to truly help both patients and providers.
“This exploratory study may inform efforts to improve social needs capacity in primary care and initiatives targeted to reduce primary care clinician burnout symptoms,” the researchers concluded.
“Equipping clinicians with social needs resources through team-based care may therefore improve the sustainability and effectiveness of primary care work. Given that research on burnout interventions has demonstrated only modest effects for those that do not consider patients’ social needs, increasing clinics’ capacity to address social needs may be a burnout prevention strategy worth testing.”
Source: Patient Engagement Hit