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Top 10 Culture Change Interventions to Reduce Burnout and Improve Physician Well-being

Interventions you and your colleagues can use in your practice to reduce burnout and promote a culture of well-being.

  1. Limit work hours and offer flexible work arrangements.

  • - Medscape - Dec 05, 2016.
  • Shanafelt TD, Noseworthy JH. Mayo Clin Proc. 2017;92(1):129-146. doi:10.1016/j.mayocp.2016.10.004.
  1. Invest in leadership development.
  • Shanafelt T, Gorringe G, Menaker R, et al. Mayo Clin Proc 2015;90(4):432-440. doi: 10.1016/j.mayocp.2015.01.012.
  1. Create a 鈥淲ellness Committee.鈥 Identify a 鈥淲ellness Champion and create a 鈥淲ellness Toolbox鈥 that includes ingredients for changing residency culture to be in support of wellness, as opposed to simply 鈥減reventing burnout.鈥
  • Eckleberry-Hunt J, Van Dyke A, Lick D, Tucciarone J. J Grad Med Ed 2009;1(2):225-30.doi: 10.4300/JGME-D-09-00026.1.
  1. Establish wellness as a quality indicator for the practice. Distribute an annual wellness survey and use the results to create interventions to address burnout and enhance well-being.
  • Preventing Physician Burnout 鈥 STEPS Forward. STEPSforward.org
  1. Conduct facilitated physician discussion groups incorporating elements of mindfulness, reflection, shared experience, and small-group learning.  Offer humanistic teaching, role modeling and narrative reflection combined with skills training using experiential learning techniques.
  • Branch WT, Frankel RM, Hafler JP, et al. Acad Med. 2017;XX(X):1-7. doi:10.1097/ACM.0000000000001940.
  • West CP, Dyrbye LN, Rabatin JT, et al. JAMA Intern Med. 2014;174(4):527. doi:10.1001/jamainternmed.2013.14387.
  1. Establish a culture (time, space, training) in which teamwork and relationships are prioritized: relationships with patients and relationships with peers and colleagues.
  • Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T. Ann Fam Med. 2013;11(3):272-278. doi:10.1370/afm.1531.
  1. Provide relationship-centered communications skills training for physicians.
  • Boissy A, Windover AK, Bokar D, et al. J Gen Intern Med. 2016;31(7):755-761. doi:10.1007/s11606-016-3597-2. Epub 2016 Feb 26. PMID: 26921153
  1. Conduct workflow and Qi projects aimed at addressing clinician concerns.
  • Linzer M, Poplau S, Grossman E, et al. J Gen Intern Med. 2015;30(8):1105-1111. doi:10.1007/s11606-015-3235-4. Epub 2015 Feb 28.
  1. Implement the 鈥淟isten-Act-Develop鈥 model which is based on organizational psychology and social science, with integration from institutional efforts related to quality improvement, safety culture, burnout- engagement and leadership development.
  • Swensen S, Kabcenell A, Shanafelt T, Clinic M. J Healthc Manag. 2016;61(2):105-127. PMID: 27111930.
  • Eckleberry-Hunt J, Van Dyke A, Lick D, Tucciarone J. J Grad Med Educ. 2009;1(2):225-230. doi:10.4300/JGME-D-09-00026.1.
  1. Proactively work to reduce the stigma associated with mental illness to encourage clinicians to seek help when they need it.
  • Kishore S, Dandurand DE, Mathew A, Rothenberger D. Breaking the Culture of Silence on Physician Suicide. National Academy of Medicine.

Additional Research

  • Panagioti M, Panagopoulou E, Bower P, et al. JAMA Intern Med. 2017;177(2):195. doi:10.1001/jamainternmed.2016.7674.
  • Linzer M, Sinsky CA, Poplau S, et al. Health Aff. 2017;36(10):1808-1814. doi:10.1377/hlthaff.2017.0790.
  • Shanafelt T, Goh J, Sinsky C. JAMA Intern Med. 2017. doi:10.1001/jamainternmed.2017.4340.