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Highest among primary care providers, symptoms of physician burnout include emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment.
Clinician burnout syndrome is epidemic within the U.S. healthcare system and has become so pervasive that it has been labeled a “public health crisis.” In a survey conducted in 2018 (prior to the pandemic), 78% of physicians said they experienced some symptoms of professional burnout. Further, those experiencing burnout are more likely to reduce their work hours or leave their profession.1 Exacerbated by the COVID-19 pandemic, addressing burnout among healthcare workers is critical because the US Department of Health and Human Services (HHS) predicts that there will be a nationwide shortage of nearly 90,000 physicians by 2025. This dire forecast led to $103,000 million in awards from the Biden-Harris Administration’s American Rescue Plan to improve the retention of healthcare workers by reducing burnout and promoting mental health and wellness among the healthcare workforce.
A Patient Aligned Care Team (PACT) is a team-based approach that involves Veterans working with healthcare professionals to plan for their whole-person care and life-long health and wellness.
The VA healthcare system also is affected by clinician burnout. For example, VA’s All Employee Survey (AES) demonstrated that more than 50% of physicians working within the VA Healthcare System exhibit at least one symptom of burnout. The literature suggests that this syndrome can be improved by increasing the resilience of those providing healthcare. HSR&D and QUERI investigators are working with VA’s Office of Patient Centered Care and Cultural Transformation (OPCC&CT) and VISN 22 (Desert Pacific Healthcare Network) to evaluate Dr. Greg Serpa’s Hospital Employee Awareness and Resiliency Training (HEART) for PACT (Patient Aligned Care Team) Wellbeing. Susan Stockdale, PhD, part of HSR&D’s Center for Healthcare Innovation, Implementation and Policy (CSHIIP), and Stephanie Taylor, PhD, who directs QUERI’s Complementary and Integrative Health Evaluation Center (CIHEC) and is a CSHIIP investigator, lead this evaluation with Project Director Briana Lott, MPH.
Hospital Employee Awareness and Resiliency Training (HEART)
HEART is a seven-week program for providers and staff intended to bolster resiliency and reduce burnout. The program teaches Whole Health, mindfulness, self-compassion, and practical skills. The HEART program offers six weekly one-hour staff resilience and self-care trainings, one three-hour wellness retreat, in addition to handouts with audio links to encourage home practice and weekly wellness newsletters.
VA Whole Health is an approach to healthcare that supports a patient’s health and wellbeing through a personalized health plan based on individual values, needs, and goals.
The HEART program was first piloted in 2017 as an in-person program among members of HPACT (Homeless PACT). With the onset of the COVID-19 pandemic, Dr. Serpa began delivering a virtual version for clinicians to four primary care practices from two VA healthcare systems (Los Angeles and Long Beach, CA) in 2021-2022. The evaluation will be complete in Fall 2022 but feedback, so far, has been very positive. Feedback from VA clinicians involved in the HEART Program includes:
Participating in this program has given me tools that I can use in work and my personal life. It's been most beneficial when I'm having a hard or stressful day. Learning techniques for relaxation and self-care will allow me to live a more healthy life.
Each time has been insightful & helpful. Many times I feel like my struggles are my own, but through this am able to realize that many have similar feelings & experiences.
This program makes me feel that I have a family to fall back on here at the VA, when I feel like overwhelmed by workloads, patients, and administration. I feel rejuvenated that I feel excited to share this newly-found energy with my colleague and patients.
Very rewarding and illuminating. Made me eager to return to work… and life.
VHA’s Reduce Employee Burnout and Optimize Organizational Thriving (REBOOT) Task Force was created to address employee burnout and to enhance staff retention through multiple initiatives.
Workplace cultural and organizational factors are the primary drivers of healthcare burnout.3,4 Interventions delivered to individual providers, however, remains a key opportunity to address this crisis. While the VA National REBOOT Task Force explores the structural factors of burnout, the HEART program hopes to address the needs of front-line providers.
For more information about the HEART program, please contact: J. Greg Serpa, PhD at the VA Greater Los Angeles Health Care at John.Serpa@va.gov. To learn more about the HEART Program evaluation, contact Susan Stockdale, PhD at Susan.Stockdale@va.gov or Stephanie Taylor, PhD, at Stephanie.Taylor8@va.gov .
- Jha A, Iliff A, Chaoui A, et al. A crisis in health care: A call to action on physician burnout. Partnership with the Massachusetts Medical Society, Massachusetts Public Health and Hospital Association, Harvard T.H. Chan School of Public Health, and Harvard Global Health Institute.
- Recupero, EA. Resilience training for VA primary care providers. 2018. Instructional Design Capstones Collection. 39.
- Helfrich C, Simonetti J, Clinton W, et al. The association of team-specific workload and staffing with odds of burnout among VA primary care team members. Journal of General Internal Medicine. July 2017;32(7):760-766.
- Shanafelt T and Swensen S. Leadership and physician burnout: Using the annual review to reduce burnout and promote engagement. American Journal of Medical Quality. Sept/Oct 2017;32(5):563-565.