Physicians take to “reset room” to battle burnout

Troy Parks
Staff Writer
AMA Wire
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After surveying physicians and medical providers to assess the presence of burnout, one hospital in Minneapolis implemented several changes to their facility and processes to make sure the identified burnout triggers were addressed as soon as possible. In addition to scheduling and environmental transformations, a unique solution stands out—the creation of a room where physicians and medical providers can go to “reset” following a challenging or traumatic situation.

An office for work-life balance and burnout prevention

Leaders at Hennepin County Medical Center developed the Office for Professional Worklife to address the needs of its physicians and other medical providers.

In order to make sure physicians and other providers are directly involved in burnout solutions, a wellness committee was created in 2013. It is made up of volunteers from each department who work with organizational leaders to periodically measure burnout through a survey called the “mini Z,” (document) which they administer annually. The committee meets for about an hour each month for brainstorming sessions to review current projects, plan new initiatives, discuss survey data and respond to new opportunities or stresses.

“We sit down with the chair of each department and review their data from this year compared to last year and try and gain some insights about where the stress or burnout might be coming from,” said Mark Linzer, MD, internal medicine specialist and director of the division of general medicine at Hennepin County Medical Center.

“Then we try and determine some next steps, which might require me to go to the executive leadership group to ask for flexibility or resources so they can put some plans into place,” Dr. Linzer said.

Here are three ways Hennepin County Medical Center has already addressed burnout:

Reset room

The reset room is a place physicians and other providers can go if they need a moment to reset during their day. If there is a traumatic event they wish to recover from, or they just want to get away for a moment, make a phone call or take a short nap, they can duck into the reset room.        

With LED lights, flameless candles, a sound machine, and comfortable chairs, several plants, and an “in-use” sign on the door, physicians and other providers can enter this quiet space for reflection or to disconnect for a moment.       

Few resources were required to create this welcoming space. The reset room was built inside what used to be an oddly shaped and poorly located office, which is perfect for this purpose because it is situated away from the regular action of the medical center.         

“I try not to monitor [the reset room] because I don’t want people to think I’m monitoring them,” said Sara Poplau, senior research project manager and assistant director of the Office for Professional Worklife. “That’s not what it’s about. But I know how I leave things, and I know how I find things, so I can tell that someone’s been in there—and that it’s benefitting our providers.”    

“Even if you don’t get to use it that often,” Poplau said, “at least you know that the institution values you in that sense.”

Schedule changes for work-life balance

One of the first changes made at Hennepin County Medical Center addressed work-life balance. Physician parents were often unable to leave on time because their last complex patient was scheduled at 4:30 p.m. In many instances, this patient would not be ready for the physician to see until 4:45, making it challenging for a physician to pick up a child from daycare by 5:30 p.m.        

As a solution, the end-of-day schedule was re-engineered so the last complex patient was scheduled at 4 p.m. The 4:40 p.m. slot was changed to routine care instead of complex care, and this simple change helped parents leave work on time.         
Recognizing the demands of the day also was an important component.        

“We have one division where the burnout rate was high for nurse practitioners and PAs,” Dr. Linzer said. “We introduced some slots during their days to slow the pace of work and give them a chance to catch up with the [electronic health record], and that was very successful.”

Environmental changes

One clinical department invested in new carpeting and asked staff to contribute ideas for locally sourced art.      

“A lot of the art ended up being from the staff,” Poplau said. “It was a fun team-building exercise in the sense that people might not have known that their co-worker was such a good photographer or painter.”        

The more welcoming environment and greater sense of community may have helped boost satisfaction among members of the department. Satisfaction in the department increased from 65 percent in the 2013 survey to 83 percent in 2014, while burnout decreased from 39 percent to 17 percent over the same time period.

Changes in the pipeline

Many other changes to help physicians and other hospital staff in their daily routines are underway at Hennepin County Medical Center.

“People come to us a lot,” Dr. Linzer said, “often with individual issues, and we really try to address those quickly so that they know that there’s an office that will take care of individual challenges to work life and wellness.”

“We’ve been fundraising for the transformation of our old dining room into a provider dining and wellness center with a workout space, a shower and changing area, some meditation areas, yoga mats and an area to sit on the floor and debrief challenging events,” Dr. Linzer said. The wellness center is set to open by July.

Also, one of the departments that reported a high stress as a result of electronic health records brought it to the attention of the wellness committee and together came up with a 10-point plan to reduce those stresses.

“That’s a great example where the data spoke clearly that that was a major source of stress,” Dr. Linzer said, “and the organization is going to be able to respond.”

Dr. Linzer, Poplau and Laura Guzman-Corrales, senior project coordinator at the Minneapolis Medical Research Foundation, authored a module on preventing physician burnout for the AMA’s STEPS Forward™ collection of practice improvement strategies to help physicians make transformative changes to their practices. Other available modules on burnout cover preventing resident and fellow burnout and improving physician resiliency.

Thirty-five modules now are available in the STEPS Forward collection, and several more will be added later this year, thanks to a grant from and collaboration with the Transforming Clinical Practices Initiative.

Physicians and experts from around the world will gather Sept. 18-20 in Boston for the International Conference on Physician Health™. This collaborative conference of the AMA, the Canadian Medical Association and the British Medical Association will showcases research and perspectives into physicians’ health and offer practical, evidence-based skills and strategies to promote a healthier medical culture for physicians. 

For more on how practices and organizations are preventing physician burnout

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Comments

Physician burnout will NEVER end until MOC does...
Great to hear of a success story in HCMC. Implemented in a vacuum, I don't think any number of reset rooms or unscheduled slots for EHR catchup would work. It's clear that HCMC leadership cares about its providers and communicates this care to the providers by coming up with meaningful and creative solutions to real challenges in the workplace. With regards to MOC and burnout, why don't we start by saying no to Step 2 CS at the medical school level? Not only is it a silly test that almost everyone passes, there's no feedback for those who pass and the test costs $1.2k to sit for and anothe $1k to travel to (only a few cities have Step 2 CS sites). Reduce burnout in training and address medical indebtedness, sounds like a win-win to me.
Aren't these essentially what we previously referred to as doctors' lounges? What seems somewhat humorous is that leaders in these big systems which employ docs probably previously disdained the notion that their docs deserved lounges to relax-- perhaps they found them elitist. But not that they're desperate to help their docs continue to be productive within the overly-complicated systems that have become the norm, they brainstorm about throwing their employees a bone-- "hey, let's throw 'em a bone" <br/> <br/> The bigger question is how we ended up in this situation in the first place: in which doctors-- many of the smartest and hardest working professionals around-- are routinely burnt-out and disheartened by the silly work we're being required to do....
Is this a joke or just another example of deceptive, diversionary nonsense coming from those who would enslave physicians and their willing accomplices? Burnout comes from overwork and under-respect. The only cure is to restore physicians to appropriate levels of respect and commensurate salaries. I routinely inspect IRS Form 990's for hospitals. They are readily available for free at Guidestar.org and show the annual payments to "key employees". See what your administrators are paid and compare it to salaries for most employed physicians and you will weep in despair or seethe with anger. In my hospital, an x-ray technician turned into a VP of Outpatient Services, earning roughly double what our hospitalist physicians earn.<br/> Blaming MOC, misguided and corrupt as it is, only diverts attention from the real problem. MOC is an episodic event; falling income and increasing workload result in a never-ending, downward, spiral for physicians. I am 39 years out of school and have pity for the fools coming out now. They are saddled with enormous debt and will never know what a true doctor-patient relationship is. They will likely be shift workers and regarded as "widgets" by those who truly profit from their labor.
Glad HCMC trying to help MD's do their best work. Regarding the scheduling thing, however, this seems like pretty basic blocking and tackling, unless someone other than the MD had final say over the schedule, in which case the problems might go deeper.
Your suggestions were meant to be a joke...right? LED lights, FLAMELESS candles, sound machine, plants, an 'IN USE' sign, new carpeting, art work? But it gets better: Workout space, MEDITATION area, YOGA mats and a special area to sit on the floor!! Who is making these suggestions. My guess that it is the person who is 'overlooking' the use of these 'burnout facilities'. Let me make it easy and simple for hospitals. You need a room with soft chairs and sofas and a T.V. and computer used only by the physicians (and CPA's). Whoever wrote this article has no concept what so ever as to what the pressures are upon physicians 'practicing' medicine. The information is changing every minute, peoples lives are in you hands, the legal community demands that you must be perfect and you want to be a good physician and this never was nor ever will be a situation that is easy. When you are practicing medicine think medicine in a room where no one is asking you questions. Yoga, meditation, exercise? Do at home when you are off call.
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