A key component of the triple aim is to provide patients in the health care system with quality care. In order to deliver such care, clinicians also need to have a quality experience in their workplace.
That is the premise of an initiative to address professional burnout underway at one of Oregon’s coordinated care organizations (CCOs).
A medical professional at a typical clinic will see between 20 and 24 patients in an eight-hour day—many of them dealing with pain, disease and suffering.
Throughout the day the clinician also has lab tests to review, medications to prescribe and refill, phone calls to return and perhaps emergencies to manage. Clinicians are also working hard every day to improve patient satisfaction, create quality outcomes, and capture medical records electronically.
Health care providers often worry about patient outcomes, even late at night at home, because first and foremost they care about their patients above everything—including, at times, their own health.
All of this is a lot to take on, and it can lead to burnout.
Safina Koreishi, MD, MPH, takes burnout seriously. Koreishi is medical director of Columbia Pacific CCO, a coordinated care organization serving Oregon Health Plan members in Northwestern Oregon’s Clatsop, Tillamook and Columbia counties.
For professionals, burnout can lead to depression, lack of focus, irritability and ultimately decreased quality of care and poor patient satisfaction. It also can contribute to job turnover, which affects continuity of care and access—already big issues in our medical system.
Koreishi has developed an initiative at Columbia Pacific to raise awareness about the issue of clinician burnout and wellness and how they’re linked to health care improvement, transformation and ultimately good patient care. Koreishi is conducting confidential, validated surveys at Columbia Pacific to evaluate burnout
among clinicians, and holding clinician focus groups to learn what might be helpful to improve wellness.
The idea behind the initiative is to develop and fund interventions that clinicians feel may help to promote resilience and vitality for providers at Columbia Pacific. Examples of possible interventions include:
- Mindfulness-based stress reduction;
- Shared regional provider meetings called “community of practice”;
- Leadership development; or
- A scribe program.
She also stresses the shared responsibility of the individual, the organization and the health system in addressing this issue; the ways that larger health issues such as chronic pain can influence the level of provider burnout; and that working on ways to support providers in this work can help improve burnout.
“I have personal experience with burnout,” says Koreishi, who is board certified in both family and preventive medicine, and has spent her career practicing family medicine in safety net clinics. She also is an adjunct associate professor of family medicine at Oregon Health & Science University (OHSU) and sees patients at OHSU Family Medicine in Scappoose.
“I felt these symptoms very early in my career, and the personal burden of dealing with burnout very quickly became clear,” she says. “As I moved on in my career and into leadership, I realized how pervasive it is, and fundamentally how much it is related to all aspects of patient care.”
Koreishi’s passions are providing medical care to underserved populations and communities, and improving and transforming the systems of care—for patients and providers.
In rural and underserved areas, fewer providers means access is a huge issue. And resources for providers are often scarce, so it is hard to get the support you need as a provider to give the patients the care that they need.
In addition, working in these settings can be isolating. Also, because of culture, poverty, chronic illness and mental illness, the populations they serve often have more and more complex needs all—of which adds to potential clinician burnout.
