Beating Burnout: How Doctors Can Regain Control

Leigh Page

Disclosures

October 12, 2016

In This Article

How to Start Re-engineering

"Before you can fix a problem, you need to know what it is," Dr Linzer says. To measure the extent of burnout, his office developed the mini Z test (so-called because it's a short test for Zero Burnout), which has 10 questions and can be accessed[7] on the STEPS Forward website. The test asks questions such as whether you're burnt out, the extent of your burnout, whether the workplace is chaotic, and how your EHR is affecting you.

The mini Z can point out areas that need to be changed. In addition, you can ask clinicians for a "wish list"—things that they would do differently within the practice. Your team can then discuss these findings in staff brainstorming sessions.

Start small, the module advises. Try out just one or two proposed changes, eliminating proposals that aren't realistic, such as hiring a new employee or requiring your EHR to function in a way it's not set up to do.

The next step is to test the changes. Start changes by using a pilot involving just one or two physicians. "As institutional knowledge grows and bugs are worked out, the process can be spread to more physicians," it states. "Many practices report a 3- to 6-month learning curve."

"Small changes make a difference," Dr Linzer says. "For example, introducing a scribe is transformative. This one change can measurably improve doctors' satisfaction with their work."

"As you introduce interventions, you have to keep measuring the amount of stress," he adds. This can be done by readministering the mini Z. The test is so simple that in small practices, it's possible to process the results by hand, Poplau says. This is harder to do in a large organization with hundreds of results. If your computer can't process the results, you can get a free trial of Survey Monkey to do the data entry and processing, Poplau adds.

If your intervention isn’t resolving the problem, the next step is to figure out why and develop a new approach, Dr Linzer says. It could be that some doctors will balk at a particular improvement, such as being paired with an MA. "Then you have to look for another approach," he says.

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