The state of the healthcare workforce

From 2020 to 2022, Press Ganey surveyed 1.6 million U.S. healthcare workers to assess the workforce burnout and retention crisis. According to their analysis, burnout has been worsening for all healthcare workers, but three metrics provide a clear picture of what is happening in the industry:

• Engagement: In 2022, the downward trend in worker engagement observed during the pandemic slowed.
• Alignment: Press Ganey also observed a slower rate of decline in worker alignment, which was evaluated through measures that show how providers perceive their relationship with their organization's leadership. If providers "do not feel respected or that their voices are heard in decisions that impact their practice, they are not likely to feel aligned with the organization even if they are proud of it," the authors write.
• Resilience: According to the authors, worker resilience, which they define as "the ability to find meaning in work (activation) and recharge when away from work (decompression)," improved in 2022.

While these trends are encouraging, the authors note that they don't apply to all organizations. "Our data shows a widening gap between the top 10% of organizations in workforce engagement and the bottom 10%," they write. "In short, employee engagement at many organizations is improving, while at others it is getting worse."

3 steps to move from a 'vicious cycle to a virtuous one'

Some organizations are stuck in a "vicious cycle in which stress is leading to burnout leading to worse performance leading to more stress," the authors note. To "get from a vicious cycle to a virtuous one," the authors suggest implementing the following measures:

1. Listen to your workers

First, organizations should take steps to actively "listen and understand the challenges facing their individual employees and their leaders," the authors write.

"What it means to authentically listen changed during the pandemic. It no longer means just getting out for 'leadership walk rounds,' surveys every one or two years, or occasional town halls for the shift that happens to be on duty at midday," they note. "It involves not only amassing more information but also simultaneously showing employees that you are doing so."

2. Prioritize engagement and well-being

Top-performing organizations — specifically their senior leadership — all prioritize staff engagement and well-being. "They recognize that an engaged and healthy workforce is critical for them to provide excellent patient care and reduce patient suffering," the authors note.

"These top performers hold themselves accountable for improving every year and are making the investments to support this improvement," they note. "While they rely on their HR leaders heavily, they engage leadership across the organization, including nursing, physician, and quality and safety leaders to collectively address these issues."

3. Focus on 3 key areas of improvement

According to the authors, almost all top-performing organizations focus on three things:

• Promote self-care: Strategies to support workers should underscore the importance of self-care — something the authors say is "done poorly in health care." To encourage self-care, "[o]rganizations should share positive feedback from colleagues, leaders, and patients (and the vast majority of patient feedback is positive) to demonstrate organizational gratitude and respect."
• Provide support: Developing effective leaders and teams is a critical strategy for maintaining virtuous cycles. "This requires investments in coaching and more structured training," the authors write. "Focusing on the skills that leaders require to engender trust and confidence should be taught so that new leaders have the skills to support and build their teams."
• Address dysfunction: The top-performing organizations are committed to addressing dysfunction in their existing systems and processes. "They fix broken processes, leverage technology, and build teams so that they can all work smarter," the authors write. "And they know that to solve these problems, they must include the voices of their front lines."

"Organizational leadership that embraces a coordinated strategy of authentically listening to its employees and patients, developing their leaders, and continuously improving workflows will drive the flywheel of pride and engagement necessary to sustain the virtuous cycle," they add. (Dudley et al., Harvard Business Review, 5/30)

Workforce burnout has been a long-standing challenge for hospitals and health systems, even before the COVID-19 pandemic. The impact of burnout is far reaching, impacting turnover, absenteeism, engagement, and quality. Access this resource to find out what steps you can take to invest in the wellbeing of your healthcare workforce.