Collaborative Aim

I entitled this post “Collaborative Aim” after reading Dike Drummond’s post, Physician Burnout and Healthcare’s New Quadruple Aim. The essence of the article is that the authors felt that the triple aim of cutting costs, improving the patient experience, and improving population health was inadequate because it neglected optimizing the workforce environment for caregivers as well as patients:

In visiting primary care practices around the country, (we) have repeatedly heard statements such as, We have adopted the Triple Aim as our framework, but the stressful work life of our clinicians and staff impacts our ability to achieve the 3 aims.”

These sentiments made us wonder, might there be a fourth aim—improving the work life of health care clinicians and staff—that, like the patient experience and cost reduction aims, must be achieved in order to succeed in improving population health?

Paolini et al. echoed a similar sentiment in Physician Burnout and The Patient Experience: Are We Overlooking a Crucial Element? when they wrote:

Is it possible for physicians to deliver personalized, relational, compassionate care while they are dissatisfied, burned out, and disengaged? Is it possible to achieve the results that are needed as they relate to the physician-patient
relationship by deploying a quick script or course on the “right words to say, eye contact, and sitting down with the patient,” regardless of the physician’s state of mind or health?
The results of cognitive attempts, quick fixes, and the teaching of new skills have so far not been encouraging. We believe that it is because we try to train a physician in technique when what we desire is a compassionate presence. For that, we need physicians who are experiencing their own wellness, who can access the language of caring, and who will find a way to be resilient in maintaining their health, wellness, and satisfaction in the midst of the overwhelming ever-changing business of medicine.

Collaborative Aim: A Systems Approach

I confess that most of the burnout literature that I have read, including my own, focuses on remedies that physicians can take rather than on the care systems that lead them to experience emotional exhaustion, decreased empathy, and lack of personal accomplishment (Cohn et al. Workplace Burnout, in Better Communication for Better Care. 2005. Chicago: Health Administration Press, 57-62.)

The best example of a systems approach to dealing with burnout is in  Managing Stress and Preventing Workplace Burnout by Dr. Jonathon Halbesleben. Dealing with stress and confronting workplace burnout allow leaders to have an engaged workforce, committed to their organization’s goals and mission as manifested by the:

  • vigor that they bring to their jobs
  • dedication to advancing the organization’s mission
  • absorption in their work, the flow state

He concludes that by addressing the system causes of burnout:

You have nothing to lose. You have only to gain a productive, safe organization with engaged employees who stay with you for the long haul- a challenging goal, but one worth pursuing.

As always, I welcome your input to improve healthcare collaboration where you work.  Please send me your comments and suggestions for improvement.

 Kenneth H. Cohn
© 2014, all rights reserved
Disclosure: I have not received any compensation for writing this content.  I have no material connection to the brands, topics and/or products that are mentioned herein.

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