Burnout and lab quality: Using utilization management to improve patient care


 
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by Jessica Sweeney, MHA

"Helping labs move the world forward by aiding the shift to value-based care."
 
 

What if you only had 11 seconds to explain yourself?

What if you were clarifying something you found important?

Or what if you were describing something that was life-threatening?


Well, according to a new report published in the Journal of General Internal Medicine, 11 seconds is all the time you have when speaking to a physician. As of now, it is unclear why doctors only allow patients an average of 11 seconds to speak; however, it is possibly associated to factors such as limited time, lack of communication training, and burnout.

Physicians are expected to see an average number of patients per day which limits their time spent seeing each patient. With high expectations, lack of communication training, and burnout has been a concern and a growing topic within healthcare. With electronic medical records (EMR) restricting eye contact and taking longer than expected to complete as well as the increase in physician shortage, it is no wonder why physicians are rushing conversations to meet their quota and see all their patients. By the end of the next decade the United States could see a shortage of up to 120,000 physicians.

 
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"By the end of the next decade the US could see a shortage of up to 120,000 physicians."

Burnout in the lab

Does burnout affect quality?


It is important to acknowledge that burnout among other physician specialists and nurses likely impacts all lab personnel. In many ways, it becomes a negative feedback loop: Burned-out clinicians and nurses may drive burnout in laboratory staff, and vice versa.
— James S. Hernandez, MD, MS

Numerous articles have been published about the cause and effects of errors related to burnout in the medical field; however, little has been published to address the issue of lab associated errors due to burnout among pathologists and laboratory professionals.

As medical professional burnouts and shortages increase, the risk of errors in patient care can also increase. With lack of time to accurately assess patients, the probability of physicians ordering inappropriate and unnecessary tests (normal or stat) may occur, resulting in an increased demand on lab and increased stress on lab staff. The lab has been facing a shortage of experienced Clinical Lab staff for years, and this decline will likely continue when combined with poor work experience. As the industry moves to a value-based care model, more responsibility and pressure will be placed on the laboratory for ensuring accurate testing is being ordered and completed. Even though multiple studies have contributed to laboratory medicine discovering and understanding the root-cause in operational (pre-analytical, analytical, or post-analytical) errors, little to no studies have been conducted on errors due to burnout in the lab.

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Deteriorated test utilization increases stress in the lab, which could lead to burnout.

- Jessica Sweeney on the impact of a stressed, constrained physician workforce.

What is burnout?

A silent manifestation.


Burnout - defined as exhaustion, cynicism, and reduced effectiveness is shown to impact the quality of patient care, safety, satisfaction, and physician turnover. In the article Executive Leadership and Physician Well-Being, Tait D. Shanafelt et al outline the drivers of burnout to include1) Workload and job demands, 2) Efficiency and resources, 3) Meaning in work, 4), Culture and values, 5) Control and flexibility, 6) Social support and community at work, and 7) Work-life integration.

 
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We - like battered children who feel that they have no control over their environment - are subject to the whims of whatever tyrannical circumstance we find ourselves in.
— Robert C. Babkowski MD

Physician burnout is more than just a “symptom.” Physicians Simon Talbot MD and Wendy Dean MD believe that burnout itself is caused by “our broken health care system.” With built up frustration, many physicians have considered a career other than healthcare; however, stay due to reasons preventing them from leaving.

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Having an intuitive utilization management tool will help achieve goals and expectations.

- Jessica Sweeney on solutions to reduce stress and improve quality in health care.


Now what?

A call on lab leaders to take charge.


Declining remuneration rates continue to pressure the bottom line for laboratories. Management typically responds by pushing for higher productivity and pressuring staff to do more with less. The end result for our clinicians and patients is unprecedented levels of laboratorian burnout and increasing latent errors. Our industry must adopt technological solutions to reverse this trend as the number of laboratory professionals decreases and financial pressure increases.
— Michael Harvey, M.D.

As awareness grows around these topics, healthcare systems should be willing to help address the issues. It is imperative that Lab leaders maintain open communication with organizational leaders to create an energized and welcoming culture. As the lab moves into a role that drives decisions in the patient care pathway, having an intuitive utilization management tool will help achieve goals and expectations to identify redundant tests for physician interventions. Creating an efficient laboratory workflow to function like a lean machine will decrease stress and unnecessary disruptions. Providing mid-level clinical lab scientists, the opportunities to advance their career into a more managerial role can reduce the lab staffing shortage. Instilling a laboratory culture that allows laboratories to be innovative through certainty can be powerful for morale.

At LTS Health, we can help reduce burnout by providing physicians with enlightening data insights delivered from the laboratory.


 

To discover the ways your lab can flourish, check out: LTS Health.

Get your 8 Principles of Laboratory Performance Poster.

To inquire about our Clinical Insights workshop that identifies opportunities and barriers in care, please email me: jsweeney@ltshealth.com

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Jessica Sweeney is a Senior Consultant at LTS Health USA.