It is important to understand why this was the case as a better understanding of the causes could well lead us to discover some potential solutions.
Burnout amongst health workers has been extensively studied and documented over the past few years and we are all very aware of the potential contribution of some of the ways we practice 21st century medicine to the increase in levels of depersonalisation amongst front line workers. From increased complexity of pathways, EMRs that are not configured to follow clinical flows, legal considerations, the changes in relationship between patients and their carers and indeed the shift that has taken place over the past few years where patients are assuming the role of consumers of care. Many of these trends and shifts are desirable. The shift from individual opinion to evidence-based care and better clinical governance, the shift from passive receptive patients to active assertive and activated consumers have both positively contributed to positive outcomes for example.
It is also increasingly understood that there are other extraneous factors contributing to burnout. Ageing populations are a significant contributor as inevitably the complexity of the interplay between multimorbidities and the way the individual guidelines intersect, interact and often collide significantly increases levels of anxiety amongst those trying to implement them. We also should never forget that the workforce is of course ageing at exactly the same rate as the population and this scarcity of workforce compounds an already crowded and time limited time for consultations.
Finally, the lack of properly designed clinical decision support (CDS) delivering the right information to the right person in the right format through the right channel and in the right workflow (as described by Robert Campbell as the “five rights”) just makes an already difficult job more challenging.
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Now add COVID-19 to this mix, and we potentially have a truly explosive and unstable situation. We are already seeing large numbers of health care workers having to self-isolate or otherwise withdraw from the front line through illness or sheer exhaustion and this is no doubt exacerbating the already critical workforce shortages. Furthermore, the fact that the COVID-19 workforce will now have to manage complex patients, some of whom will either have assisted ventilation through CPAP or ventilated in an ICU situation will no doubt pile on the complexity. The challenge of managing ventilation in older people who are also multimorbid is a very significant one and one that is the more common presentation amongst COVID-19 patients.
A digital first approach
Paradoxically, as we all know, health and care tends to be resistant to change in working practices. In Scandinavia for example, there were many discussions about telehealth and making this mainstream and although progress was being made, there remained a level of resistance to altering tried and tested ways of working despite the fact they were clearly already being overwhelmed by demand. The cathartic nature of COVID-19 swept all that aside. Already, and it is only a few weeks since the emergence of the epidemic, a digital first approach has become the default and to a degree, it feels like we have at last breached the threshold towards making digital transformation something you can feel and see happening everywhere and with ever increasing momentum.
Burnout however is likely to become even more of an issue unless we take remedial action and we need to do this with speed, as otherwise the diminished ranks of people in the front line will be denuded further which of course will lead to further exacerbation of an already critical situation.
Source: Healthcare IT News