New data suggests
integrating social determinants of health interventions into primary care can
combat clinician burnout issues.
By Sara Heath
November 18, 2019
- Creating a system by which primary care clinicians can address patient
social determinants of health may help combat the clinician burnout epidemic,
according to new data published in the Annals of Family
Medicine.
“Recent studies have
demonstrated direct or potential links between clinician burnout and the
ability to address patients’ social needs,” the researchers wrote. “Lower
satisfaction with resources for treating complex patients has been associated
with more symptoms of burnout; conversely, practice preparedness to address
social needs and ease of coordinating social services have been associated with
greater clinician satisfaction.”
This comes as the
healthcare industry zeros in on clinician burnout, an issue that afflicts 83 percent of hospitals.
Burnout can have
negative consequences on patient care, with physicians experiencing burnout
feeling disconnected from their work and less productive. Clinicians reporting
burnout symptoms might also encounter clinical care quality problems and
emotional exhaustion, especially when they have fewer resources for addressing
patient needs.
And while programs to
support physician mindfulness and to address technological
hurdles that often drive burnout have shown some promise, experts say more
efforts are needed to truly tackle the burnout problem.
Helping providers
address the social determinants of health may be one such strategy, the Annals
of Family Medicine study showed.
In a survey of 29
primary care clinicians, researchers identified a clear link between resources
for addressing patient social needs and burnout symptoms. Specifically,
physicians with fewer resources to address the social determinants of health
were more likely to feel symptoms of burnout.
But that logic holds
up in the inverse, as well. Physicians feeling intense burnout are more likely
to say their organization has insufficient resources for addressing patient
social needs, even if the organization does have adequate SDOH tools, the
survey showed.
The 17 clinician
respondents with low to moderate emotional exhaustion expressed confidence in
their ability to use clinic resources to address the social determinants of
health. Meanwhile, the three clinicians with high emotional exhaustion and
depersonalization said they had no confidence in their ability to use clinic
resources to address social needs.
All of the provider
respondents agreed that unaddressed social needs took away from the clinical
care encounter. While all clinicians agreed addressing the social determinants
of health is an essential part of primary care, they noted that doing so can
disrupt clinical workflows, especially when resources are limited.
Unmet social needs
can also impact care plans, with most clinicians expressing frustration when a
patient is unable to adhere to treatment protocol because she
experiences a certain social barrier.
“In the absence of
social needs resources, clinicians described a negative cycle whereby
inefficacy exacerbated emotional exhaustion and vice versa,” the researchers
reported. “Having to reconcile the responsibility they felt to their patients
with their limited capacity to facilitate access to social services was
emotionally taxing. In turn, being emotionally exhausted made clinicians feel
less capable of addressing social needs.”
Embedding social
resources and experts in addressing SDOH, including social workers or
behavioral health specialists, did help ease this burden, survey respondents
reported. Co-locating these services made it easier for clinicians to refer
patients to resources and ultimately helped ease clinician burnout.
Specifically,
respondents said seeing their patients’ social needs alleviated helps address
their own emotional wellbeing and morale.
Most provider
respondents agreed integrating these resources into the primary care clinic
would be a step forward in managing clinician burnout, but noted that more was
needed to truly address emotional exhaustion. Notably, three clinicians were
teetering on the edge of full emotional exhaustion during the study, despite
working in clinics with several SDOH resources.
These clinicians
reported challenges with EHR use, competing demands
with their work and personal lives, intense workloads, inadequate staffing
levels, and documenting requirements as key burnout drivers.
“Clinicians noted
that even if and when primary care clinics maximized the internal capacity to
address social needs, external, nonclinical social, governmental, and community
resources are required to really improve SDH and reduce patients’ social
needs,” the researchers reported. “External resources were often perceived as
difficult to access amid limited resources, restrictive eligibility
requirements, staff turnover, or unstable funding.”
More work is needed
to understand how SDOH programming can help address clinician burnout, the
researchers said. The limited evidence suggests that embedding SDOH resources
into the primary care clinic can be effective, but more work is needed to
understand how to be model these programs to truly help both patients and
providers.
“This exploratory
study may inform efforts to improve social needs capacity in primary
care and initiatives targeted to reduce primary care clinician burnout
symptoms,” the researchers concluded.
“Equipping clinicians
with social needs resources through team-based care may therefore improve the
sustainability and effectiveness of primary care work. Given that research on
burnout interventions has demonstrated only modest effects for those that do
not consider patients’ social needs, increasing clinics’ capacity to
address social needs may be a burnout prevention strategy worth testing.”
No comments:
Post a Comment