Second Year of Coronavirus Pandemic Took Heavy Toll on Clinicians

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Survey data shows 45% of clinicians reported burnout in 2019, with the burnout rate rising to 60% in late 2021.

A new study found that clinician burnout spiked in the second year of the coronavirus pandemic, and the researchers identified aggravators and mitigators of burnout.

An earlier study found that emotional exhaustion increased from 31.8% of healthcare workers in 2019 to 40.4% in 2021. Emotional exhaustion is one of three scales in a widely used measure of burnout—the Maslach Burnout Inventory. Another earlier study found that physicians reporting at least one burnout symptom increased from 38.2% in 2020 to 62.8% in 2021.

The new study, which was published last week by JAMA Health Forum, is based on survey data collected from more than 20,000 clinicians. The survey data was collected between February 2019 and December 2021.

The new study features several key data points:

  • Burnout was reported by 45% of clinicians in 2019, 40% to 45% of clinicians in early 2020, 50% of clinicians in late 2020, and 60% of clinicians in late 2021
     
  • Higher rates of burnout were reported in chaotic workplaces (odds ratio 1.51) and settings with low work control (odds ratio 2.10)
     
  • Higher rates of burnout were associated with poor teamwork (odds ratio 2.08)
     
  • Lower rates of burnout were associated with feeling valued (odds ratio 0.22)
     
  • In the fourth quarter of 2021, the burnout rate was 36% in calm environments and 78% in chaotic environments
     
  • In the fourth quarter of 2021, the burnout rate was 39% in environments with good work control and 75% in environments with poor work control
     
  • In the fourth quarter of 2021, the burnout rate was 37% when clinicians felt valued and 69% when they did not feel valued
     
  • At the end of 2021, clinician satisfaction decreased and intent to leave increased

“Results of this survey study show that in 2020 through 2021, burnout and intent to leave gradually increased, rose sharply in late 2021, and varied by chaos, work control, teamwork, and feeling valued. Monitoring these variables could provide mechanisms for worker protection,” the study’s co-authors wrote.

Interpreting the data

The data reveal clinician well-being trends during the pandemic, the study’s co-authors wrote.

“Levels of burnout were high and fairly stable during early 2020, with slight rises late in 2020 and a sharp rise late in 2021; likewise, intent to leave was stable at moderate levels in 2020 and 2021 until a steep rise toward the end of 2021. The lack of increase in burnout through the difficult year of 2020 is notable and may indicate a sense of determination and purpose among these professionals. However, the data show how the persistent lack of control of workload, chaotic environments, challenges with teamwork, and a lack of feeling valued by organizations may have contributed to worsening burnout and a rise in intent to leave,” they wrote.

The data identify key aggravators of clinician burnout, the study’s co-authors wrote. “Variables related to higher levels of burnout and intent to leave included chaotic (fast-paced) workplaces and lack of control of workload. Absolute differences in burnout between favorable and unfavorable environments were 30% or higher, which is notable. Understanding and managing work pace and modulating workload by giving clinicians greater control of their own schedules could mitigate stress seen during COVID-19 surges.”

The data also identify primary mitigators of clinician burnout, the study’s co-authors wrote. “Feeling valued and good teamwork were associated with favorable outcomes. How to make clinicians feel valued is being actively explored, but general principles include having a receptive leadership team who listens to frontline workers and makes tangible changes based on feedback and needs, and providing organizational support for work-life integration, as well as clinician self-care. … Good teamwork refers to not only team member camaraderie and a positive team culture, but also solid team-based care workflows that allow for efficient task-sharing and minimizing non-patient-facing tasks for clinicians.”

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.



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