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Success Story: Mini Z Survey Uncovers Drivers of Burnout at Beth Israel Deaconess Medical Center

Based on an American Medical Association news article published May 30, 2019 and Sara Berg's interview with Alexa Kimball, MD, President and CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center Inc., and Professor of Dermatology, Harvard Medical School, Boston, MA.

Learn how the Mini Z burnout survey helped uncover 12 priorities to help reduce physician burnout at Beth Israel Deaconess Medical Center (Beth Israel).

What Was the Problem?

Physician burnout surveys are often helpful in understanding the size and nature of the problem within the workplace. However, for Beth Israel, many of the available surveys did not provide customized strategies on how to intervene. To identify appropriate steps in establishing how to address burnout, Beth Israel worked in collaboration with the AMA to administer the Mini Z burnout survey.

Developing the Intervention

Before deploying the Mini Z to identify and evaluate physician burnout, the leadership team at Beth Israel identified 20 changes that could improve doctors' work life and that they knew they could implement. The team then asked physicians to rate each of these options.

“We used our survey to assess our baseline status, but simultaneously as an opportunity to ask the physicians to prioritize interventions that were most important to them,” said Alexa Kimball, MD. “We gave them a list of things we felt confident we could achieve and that we thought could have an impact.”

Here is how the Mini Z helped Beth Israel improve their approach to identifying and evaluating physician burnout.

Preparing the team

“Even before the results of the survey were available, we expected that there would be things we could do to help improve the physicians' experience,” said Dr Kimball. “We searched the literature for interventions that had been tried, we brainstormed amongst ourselves, and we asked the departments to share their best practices.”

After brainstorming, it was important to ensure each task was achievable.

“This approach allowed us to have buy-in from the groups that would have to implement the change even before we knew what the physicians wanted,” she said. “This approach also allowed us to intervene right out of the gate once we had the data back—we didn't have to wait to design an intervention. We knew exactly what we wanted to do.”

Compiling a list

The list included many ideas from the IT department, but also from across multiple other domains. After completion of the Mini Z, the team at Beth Israel incorporated a list from their academic physicians, which resulted in these 12 priorities:

  1. Simplify or provide more support for Harvard promotion process (CV assistance).

  2. Cut the number of clicks in their EHR.

  3. Provide additional training for administrative team members to enhance the patient experience.

  4. Add a split screen to keep notes open while reviewing other sections of their EHR.

  5. Streamline and simplify credentialing paperwork.

  6. Shorten and simplify mandatory training and provide CME credit when possible.

  7. Automatically populate ICD-10 billing codes into orders, notes, and problem lists.

  8. Provide medical assistants with additional training so they can assist more during ambulatory visits.

  9. Provide more help with processing prior authorizations for medications or procedures.

  10. Develop tools to help address underutilization or cancellations (operating room time, ambulatory clinic space, patient visits).

  11. Provide more consolidated benefits information online.

  12. Expand childcare and family resources.


“The results allowed us to prioritize our efforts and also set us up for a positive and consistent communication back to our physicians that say, ‘We asked, we listened, and here's what we have done,’” said Dr Kimball.

“We are pleased to report that we have completed 11 of the top 12, and the 12th is in progress,” said Dr Kimball. “We have also consistently reported back to our faculty those results throughout the year. Having a priority list also gave us tremendous influence in speaking to other groups who needed to help us because we could say, ‘This is what the physicians told us they needed.’”

To learn more or to use the open access Mini Z at your organization, contact the American Medical Association's Practice Transformation team at Practice.Transformation@ama.assn.org “Mini Z Inquiry” in the subject line.

For More Information:

  1. A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study. https://link.springer.com/article/10.1007/s11606-015-3235-4

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