For years now, pressure on the world’s healthcare professionals has been mounting—with aging populations, increased documentation requirements, and then a global pandemic.
In this new study, HIMSS and Nuance explored the impact on clinicians in several countries around the world. It found that—while causes and levels may differ—clinician burnout is an almost universal experience.
98% of those who participated in Nuance and HIMSS’ online survey said they had experienced feelings of burnout. When asked about the impact of COVID-19, 48% of clinicians based in Australia said it had exacerbated their feelings of burnout or overload, compared to 38% in the Nordics and 62% in France.
HIMSS also conducted telephone interviews with doctors and nurses in ten different countries, seeking to better understand their perspectives on burnout, its root causes, and its potential solutions.
We share some of the key findings below, but to explore the clinician’s responses in depth—and get HIMSS’ conclusions and action points—we would recommend you download the complete white paper.
What drives clinician burnout? What the clinicians said…
From a lack of control over their working days, to payment models, the clinicians that HIMSS surveyed identified a broad range of factors contributing to the build-up of stress and professional overload.
It’s this stress and overload that, when excessive and persistent, leads to the symptoms we associate with clinician burnout—feelings of exhaustion, increased mental distance from one’s job, reduced professional efficacy.
“Stress in healthcare has always been an issue. I am reflecting on the doctors’ suicides over the decades I have been witnessing in healthcare.”Janette Gogler, Chief Nursing and Midwifery Officer, Monash Health, Melbourne, Australia
One key factor highlighted by HIMSS research is the scale of healthcare workloads. A study of employees at the University of Zaragoza in Spain has associated weekly workloads of over 40 hours with a greater risk of “frenetic” burnout. 55% of the doctors and 43% of the nurses involved in Nuance and HIMSS’ online survey stated that they were exceeding this threshold, in an environment that, unlike academia, features the stresses concomitant with preserving human life and wellbeing.
Compared to their peers in other regions, Australia’s clinicians were more likely to report a relatively healthy work-life balance. 20% of Australia’s nurses said they worked over 40 hours a week—the lowest national figure featured in the study—and 35% of its doctors. The highest national figures for nurses were reported in France with 47% and for doctors in Belgium and the Netherlands with 67%.
Documentation loads also significantly contribute to exhaustion and burnout, with this reported by 82% of all participating doctors and 73% of all participating nurses. This finding comes shortly after the Journal of the American Medical Informatics Association published an article linking clinician burnout to increased documentation, following the adoption of the EHR in the US.
“Invest into digital tools and processes to streamline bureaucracy, e.g. reduce the documentation workload.”Dr Clair Sullivan, Program Lead, Queensland Digital Health Academy Research Group, University of Queensland; Chief Digital Health Officer, Metro North Hospital and Health Service, Australia
What prevents clinician burnout? What the clinicians said…
HIMSS also asked the clinicians what could be done to help prevent burnout amongst healthcare professionals.
The full report examines ten different factors that reduce the risk of burnout. Here are just three, with sample responses from the clinicians:
- Efficient administrative processes — “Invest in digital tools and processes to streamline bureaucracy, e.g. reduce the documentation workload,” states Dr Clair Sullivan from Australia.
- Promoting a work-life balance — “Actively promote flexibility and a work-life balance”, said Dr Steve Hambleton from Australia.
- Reliability of workplans — “For nursing staff, reliability in the duty roster is what counts above all—not always having to fill in at night because someone has fallen ill. This creates a lot of stress,” answered Prof. Christel Bienstein from Germany.
HIMSS also observes the perception of information and communication technology in healthcare, quoting clinicians on its ability to “reduce stress” and “cope with the tasks ahead.”
It must be the right technology, introduced at the right time, with the right training. Summarising respondents’ sentiments, HIMSS notes, “Technology must address a specific issue and create an imminent value; it ultimately must stand the test of whether it improves working conditions.”
When a new technology passes this test, the benefits are felt by clinicians and patients. As said by Lene Søvold, a Mental Health Advisor from Sweden, “It [technology] has huge potential to reduce the burden of time spent on routine-based and documentation-based tasks. This gives clinicians more time to focus on the most essential task: providing help and guidance to their patients.”
“I am a firm believer that a doctor who uses AI will replace a doctor who does not in the next 10 years. We need to socialise those thoughts and early successes as soon as possible. Rather than feeling or ‘complaining’ that my clinical autonomy has been curtailed, we need to understand that my decision making has been ‘enhanced’ and that my decisions are ‘more precisely aligned to my patient’s needs’.”Dr Steve Hambleton, Deputy Chair of the Primary Healthcare Reform Steering Committee, Adjunct Professor, University of Queensland and General Practitioner, Australia
Action points for reducing clinician stress
HIMSS concludes its study with a set of clear action points for healthcare organisations. Download a copy of the white paper to discover its recommendations. Inside, you’ll also find:
- The full list of factors that drive and prevent burnout, according to clinicians across the world
- Research into the impact of COVID-19—including data on the use of remote consultations
- Insight into new technologies that promise to lighten clinician loads
Survey methodology: Nuance Communications commissioned HIMSS to survey clinicians in nine different countries, between November 19, 2020 and February 26, 2021. 443 clinicians participated. 416 clinicians from Australia, Belgium, Denmark, France, Germany, Norway, Sweden, and The Netherlands responded to an online survey. 27 clinicians from these countries, Finland, and the UK, were also interviewed as part of a qualitative telephone survey. (Detailed methodology available in From overload to burnout. What clinicians think.)