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Physician Burnout Case Report: Hennepin County Medical Center Hospital and Trauma Center

Hennepin County Medical Center (HCMC) is a safety net hospital and Level 1 Trauma Center that serves the Minneapolis area. Mark Linzer, MD, an internal medicine doctor and Director of the Division of General Medicine at HCMC, is a nationally recognized expert on physician burnout. Dr. Linzer wanted to create a support network within HCMC to help retain and recruit top practitioners. While HCMC physicians encounter similar levels of stress and burnout as others across the county, Dr. Linzer felt that HCMC could help its physicians sustain their busy workload by applying the findings from the national Work–Life Study.1

Following Dr. Linzer's suggestion, HCMC established a Provider Wellness Committee—composed of physicians and advanced practice providers from 12 of HCMC's 16 departments—with the objective to support and sustain provider wellness.2 The committee reports to executive leadership and is tasked with identifying provider stressors and executing solutions. Within one year of implementing the Provider Wellness Committee, reports of provider burnout decreased from 33 percent to 27 percent.

The committee meets monthly for 40 minutes during the lunch hour and offers attendees a healthy lunch option. While these features may seem trivial, the short meeting time and lunch are greatly appreciated by the busy participants. During initial meetings, the committee developed a charter to improve efficiency and make it easier to disseminate wellness initiatives throughout the HCMC system. Importantly, this charter opens a direct line of communication to HCMC leadership so they can stay informed about the impact that Provider Wellness Committee-initiated policies are having on providers. This line of communication also gives providers a better understanding of why specific policies are in place.

All 16 departments at HCMC have a Wellness Champion (WC), who acts as the “face of wellness” for their department and who can be approached with complaints and suggestions. A WC can be any provider—a physician, dentist, psychologist, nurse practitioner, or physician assistant—as long as they are invested in making wellness happen at HCMC. WCs often serve on the Provider Wellness Committee and they also work directly with department chairs to implement committee improvement tactics. This relationship helps ensure a more evenly distributed workload and supports rapid uptake of changes in the department. The WC infrastructure is a key component of wellness promotion at HCMC.

One of the committee's first major initiatives was to transform select physical spaces. The former Doctors' Dining Room was renamed the Provider Dining and Wellness Center after it was transformed into a multi-purpose area open to all physicians, nurse practitioners, physician assistants, psychologists, and dentists. Private philanthropy made it possible to give the area a complete facelift. Space was carved out for exercise equipment, lockers, showers, and a dressing room to accommodate providers who exercise during the day or bike into work. The space also hosts weekly Reflection Rounds, where residents can talk about the challenges of practicing medicine in a safe and supportive environment.

A Reset Room was also created for providers who want to have a few quiet moments away from colleagues and residents, as a place they can go if they need to regroup after a traumatic encounter with a patient, or as a place to take a private phone call.3 The Reset Room is a serene environment modeled after a spa relaxation room. Revamping a formerly underutilized dining area and creating a new sanctuary are just two of the tangible ways HCMC has shown its commitment to provider wellness.

The other major task of the Provider Wellness Committee is running the annual wellness survey. The Mini Z survey comprises 10 questions along with one optional open-ended question. About half of the respondents take the time to write in sources of stress and possible solutions. The survey results are shared in small meetings with the chairs of each department. WCs also attend these meetings, which is incredibly valuable since they are often able to bring insights gathered firsthand from colleagues. Immediate assistance is provided to departments that exhibit a great deal of stress and burnout. Departments with low burnout rates are also targeted to learn what makes them function so well. The survey findings are not shared outside of departments or used to compare one department to another. There is also no benchmarking to other organizations or departments across the country. The survey is only used to assess each department's progress year to year.

Committee members and WCs are given time away from clinical practice to participate in the annual wellness retreat. The time away is paid for by the institution and does not count as vacation or personal time away from the office. The retreat is an opportunity for all Provider Wellness Committee members and supporters to:

  • share findings of new provider burnout research.

  • discuss wellness initiatives.

  • connect with others within the institution who care about provider wellness.

  • share ideas across departments.

  • participate in personal wellness initiatives.

  • discuss survey data.

  • brainstorm new interventions.

Everyone leaves the annual retreat with a tangible plan for discussing the proceedings of the retreat with their department chair and a clear understanding of the resources available to assist with departmental challenges.

In addition to establishing the Provider Wellness Committee and selecting Wellness Champions, HCMC has further demonstrated its commitment to provider wellness by establishing the Office of Professional Worklife (OPW). OPW plays an advocacy and support role, working between hospital executive leadership and departments experiencing worklife stresses. The OPW is a place that providers can go when they need assistance, have suggestions, or need conflict resolution assistance. The OPW also introduces wellness programs at HCMC during new provider orientations.

HCMC is very fortunate to have these programs focused on provider wellness. None of this work would be possible without support from leaders and champions that span all offices and levels within the organization. They understand that being a provider is challenging and have acted to make it less demanding, with the goal of making HCMC one of the best places to practice medicine!

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Linzer,  M, Poplau,  S., Grossman,  E., Varkey,  A., Yale,  S., Williams,  E., Hicks,  L., Brown,  R.L., Wallock,  J., Kohnhorst,  D., & Barbouche,  M. (2015).  A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: Results from the Healthy Work Place (HWP) Study.  Journal of General Internal Medicine, 30(8), 1105-1111. doi: 10.1007/s11606-015-3235-4Google ScholarCrossref
Hennepin County Medical Center News. (2016).  Healthy work/life balance is essential for caregivers: Office for Professional Worklife is the first of its kind to address physician stress.  Retrieved from https://hcmcnews.org/2016/01/14/healthy-worklife-balance-is-essential-for-caregivers/
Parks,  T. (2016).  Physicians take to “reset room” to battle burnout.  AMA News. Retrieved from https://www.ama-assn.org/practice-management/physician-health/physicians-take-reset-room-battle-burnoutGoogle Scholar

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