Details on the campaign

The campaign's central focus is on what healthcare leaders can do to improve the work environments of their organizations. CDC provides various tools, including a worker well-being questionnaire, a guide that encourages leaders to share their personal struggles with mental health in an effort to encourage staff to do the same, and online workshops on a number of topics like how to support work-life balance, veterans, and sleep.

According to Casey Chosewood, director of the Office for Total Worker Health, which is part of NIOSH, the campaign will provide long-term solutions to health systems to address burnout and suggest changes to policies, workflows, and mental health support systems.

"Many of the current approaches [to burnout] have been directed at individual health workers, asking them to become more resilient, as opposed to changing the environment where these stressors are actually occurring," Chosewood said.

The campaign also includes a push to remove questions related to mental health history and status from healthcare credentialing and licensing applications. Organizations like the American Medical Association (AMA) have called for the removal of these questions as they could deter physicians from seeking treatment.

"A lot of people say, 'I can't do that. I can't avail myself of that because otherwise, I'm going to lose my job,'" said John Howard, director of NIOSH.

J. Corey Feist, president of the Dr. Lorna Breen Heroes Foundation, which worked on the campaign with NIOSH and CDC, said questions about whether someone has "ever" been treated for a mental health concern furthers stigma and creates fear among providers that they could face consequences for seeking help.

"What we have found in these questions is they go way back: Have you 'ever' gone to therapy?" Feist said. "It's these 'have you evers' which really create and reinforce that you should never."

According to Feist, other potential solutions for health systems are also fairly simple.

Feist pointed to a tool called a "signal report," which is available on electronic health records and can help managers determine how much time a provider is working outside of their scheduled shift and address that problem.

"There's been this incredible influx of capital expenses borne by hospital systems over the last 10 or 15 years, yet there has been very little investment in optimizing that tool for the workforce itself," Feist said.

Reaction

Experts say CDC's campaign is a good first step, but there are a number of systemic things that also need to be addressed to effectively tackle healthcare provider burnout.

"Let's definitely support the workers," said Laura Linnan, director of the Carolina Center for Healthy Work Design and Worker Well-being. "But let's not fool ourselves into thinking that if we have healthy workers, that'll be enough. Because if healthy workers go into an unhealthy work environment, they become unhealthy."

Linnan pointed to the campaign's online sleep workshop as an example of how important it is to recognize both individual and systemic factors in burnout.

"We can't ignore that there's some things individual workers can do today, like, 'Here's some strategies for better sleep quality,'" Linnan said. "But we have to look at, 'What are the schedules that we're putting these workers under? What are the number of hours that we’re requiring them from a policy perspective to be on-call as residents?'"

Christine Sinsky, VP of professional satisfaction at AMA, urged people to remember that burnout isn't a mental illness.

"Occupational distress, which is known as burnout, is distinct from a mental health condition. And I think they become conflated in people's minds," she said. "It's important to recognize occupational stress and burnout is related to the work environment in which people work, and so there are many things that can be done to improve that work environment."

Howard said CDC and NIOSH hope bringing more focused attention on how organizations play a role in improving anxiety, burnout, and depression could also encourage regulatory changes in the future.

"The maximum we can do is get folks like [the media] to help us in getting the message out so that those entities, state and federal, that have actual levers … can have a basis for saying, 'We need to change the way we're doing things,'" he said. (Reed, Axios, 10/31; Trang, STAT, 10/31; Devereaux, Modern Healthcare, 10/31)

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 the report to find out what steps you can take to invest in the wellbeing of your healthcare workforce.