Editor’s Note: This content has been excerpted from the book The Human Margin: Building the Foundations of Trust, a science-backed leadership book that integrates the latest workplace research with tactics proven to create high-performance environments. The content has been edited for length.
One of the most surprising findings of our research was that of all the different stressors at work and at home during the COVID-19 pandemic, the ones predicting overall distress were almost all work related. Similarly, burnout is specifically defined as an occupational phenomenon.
The following six factors drive burnout:
- Workload: An overwhelming amount of work to be done in a limited amount of time.
- Control: A lack of control over the work that is being done, including decision-making authority and autonomy.
- Reward: A lack of recognition and reward for hard work and achievements.
- Community: A lack of supportive social connections in the workplace, including feelings of isolation and exclusion.
- Fairness: A perception of unfair treatment, favoritism and bias in the workplace.
- Values: A conflict between personal values and the values and mission of the organization.
Any improvement in these areas is going to make a big difference in terms of supporting the well-being of our workforce.
The Job Demands-Resources theory suggests that well-being occurs at the balance of the demands of the job and the resources to meet those demands. This means that you can attempt to get to that state of well-being in two ways: increasing resources and decreasing demands. Our research continues to show that both sides of the equation are important in mitigating distress. Resources such as autonomy, meaning, training and appropriate supplies are important. It is also important to reduce demands such as heavy workloads, long hours, inefficiency, inequity and conditions that create moral distress. This data also tells us that just providing resources will never get us there. This is why many organizations provide employee assistance program services, counseling, gyms, vacation time, and well-being training but do not see the movement they need in employee well-being.
We can’t always ease workloads and hours by hiring more people. However, we can work to address redundant and inefficient processes and non-value-added tasks. An intervention called Getting Rid of Stupid Stuff involved employees in identifying inefficiencies and systematically eliminating them. In doing this, the organization saved 1,700 nursing hours per month, which will reap benefits for hundreds of months to come. Below are three ways to address these ineffective processes.
Just ask
Employees probably already have many ideas about how to improve the processes they see daily. However, they need to be empowered to raise those solutions and ideas. Leaders can develop a structure for listening to and getting feedback from employees on how to improve the efficiency of the work by eliminating unnecessary tasks, using new technologies and streamlining processes.
Widen the net
Sometimes suggestions for improvement and efficiency will come from unlikely places. Make sure to give all employees, not just those with more powerful or visible positions, an opportunity to voice their ideas. Physicians, environmental services, food services, nurses, managers and students are all observers of the system and may have valuable insights. You can also seek patient input. Patients often spend many hours in waiting rooms or hospitals beds watching our processes. They likely have some suggestions about efficiency too.
Be careful of how you spend efficiency gains
When we improve a process and see gains in our efficiency, the tendency is to “spend” these gains by adding more patients or activities to improve the financial margin. This happens often in process improvement projects. We reorganize the clinic flow to reduce unnecessary walking and use the saved time to add a couple more patients. We need to be sure that we are spending some of those gains on making workload and pace more sustainable. If we improve efficiency but our clinicians still don’t have time to eat or go to the bathroom during their shifts, it doesn’t help us make progress on the human margin.
Shaping employees’ work lives is not easy. That’s why leadership is a skill set, one that’s important to master. No one is born knowing how to lead. And few are able to pick it up when they become interim leaders, as people in healthcare so often do.
Great leadership takes investment, and plenty of it. Creating the conditions that create a culture of wellness is an integral part of that training. Every leader behavior, every tactic, every process and every procedure that goes into creating a well-run organization either supports that wellness or detracts from it.
We owe it to our clinicians and staff—and, of course, our patients—to create high-performance organizations where people can be healthy and supported at work.
Katherine A. Meese, PhD, assistant professor, health services administration/director of research, UAB Medicine Office of Wellness, University of Alabama at Birmingham. Quint D. Studer is cofounder/partner, Healthcare Plus Solutions Group.