Creating a resilient workforce has become a focus for many healthcare organizations. The pandemic underlined the presence and damaging effects of healthcare worker burnout at all levels. A simple definition of burnout is provided by Thom A. Mayer, MD, FACHE, founder, BestPractices, medical director, NFL Players Association and executive vice president, Leadership, LogixHealth, Bedford, Mass.: Burnout occurs when job stressors exceed the individual’s adaptive capacity or resiliency to deal with those stressors.
Burnout is characterized by three symptoms: high emotional exhaustion, high depersonalization or cynicism, and a low sense of efficacy or personal accomplishment. There is general agreement in the literature that the causes of burnout include:
- Mismatch of job stressors and adaptive capacity or unsustainable workload.
- Perceived lack of control or autonomy.
- Insufficient rewards for effort.
- Lack of a supportive community.
- Lack of fairness.
- Mismatched values and skills.
There have been numerous studies of burnout among physicians, nurses and other front-line healthcare workers. In June 2021, ACHE collaborated with Mayer and Stanford University researchers Tait Shanafelt, MD, and Mickey Trockel, MD, PhD, to examine burnout and other stress-related symptoms among healthcare leaders. A survey was sent to 5,670 ACHE members holding positions of department head/director and above in healthcare provider organizations. Of those, 1,269 responded, resulting in a 22% response rate among eligible respondents who received the survey.
The survey results indicated that one-third of healthcare leaders in the study had burnout scores in the high range. Because leaders set the directions, standards and tone for their teams, and are responsible for maintaining their morale, this figure is of concern. The proportion of those with burnout scores in the high range by position are shown in the table below.
The percentage of leaders with burnout scores in the high range increases markedly for positions of vice president and below, although when controlling for other factors, managers stood out as more at risk of burnout than those in any positions above them. The survey did not collect reasons why this might be so, although several hypotheses can be proposed. Those in less senior positions have less autonomy, lower rewards and may be in more direct contact with front-line workers experiencing burnout than those in more senior positions. It may also be that those who achieve the most senior positions in their organizations are more likely to have developed effective strategies for dealing with job stress.
ACHE wishes to thank the healthcare leaders who responded to this survey for their time, consideration, and service to their profession and to healthcare leadership research.
Percent With Burnout Scores in the High Range by Position
