Human Factors/Ergonomics (HFE) in Leadership and Management: Organizational Interventions to Reduce Stress in Healthcare Delivery

Abstract

Clinician Burnout is a personal and public health issue. Most occupational stressors contributing to clinician burnout are systemic. The combination of organizational interventions along with individual interventions is necessary to make significant lasting difference in reducing burnout, improving clinician and patient satisfaction and reducing latent error in healthcare delivery. Application of Human Factors/Ergonomics (HFE) science in healthcare leadership and management is a gap in current training for leaders. HFE uses concepts from organizational, educational and cognitive science, systems science and industrial engineering. HFE application is especially necessary in a fast changing highly stressful healthcare environment which impacts the wellbeing of clinicians and the safety of patients under care. Practical suggestions for working with various healthcare leadership styles and organizational dynamics, while aligning wellness efforts with institutional mission are discussed. Concrete examples of decreasing extraneous mental load on clinicians to preserve their brainpower to achieve quality patient care are illustrated. Organizational interventions in combination with individual interventions to reduce and manage burnout have enormous potential to improve clinician wellbeing and satisfaction in taking care of patients, reduce costs, risk of error and create the safe working environment needed to sustainably give high quality care to patients.

Physician Well-being 2.0: Where Are We and Where Are We Going?

“…111,126 The principles of human factors engineering and design are embraced. [127][128][129] The organizational focus shifts from patient needs to a people focus that attends to the needs of all individuals in the practice environment as both necessary and mutually beneficial to achieve the desired outcomes. This includes caring for the team and creating an organizational environment that attends to leadership, professionalism, teamwork, just culture, voice and input, and flexibility.…”

“…This includes caring for the team and creating an organizational environment that attends to leadership, professionalism, teamwork, just culture, voice and input, and flexibility. 102,112,127,130 The needs of individual clinicians, including sleep and work-life integration, are acknowledged and supported. 117,131 In the Wellbeing 2.0 phase, the organization transitions from viewing wellness as a necessary cost center to viewing it as a core organizational strategy.…”

“…84 Organizations must embrace human factors engineering and pursue system redesign that creates sustainable workloads, provides coverage when physicians are ill, and incorporates appropriate breaks and rest. [127][128][129] Health care organizations must deepen their commitment to leadership development, increase receptivity to input from health care professionals, make a more authentic commitment to teamwork and optimization of team-based care, and foster an environment built on trust. 89 For leaders, accelerating the transition to Well-being 2.0 requires attending to the leadership behaviors that cultivate professional fulfillment for individuals and teams.…”

Radiologist Well-Being and Professional Fulfillment in the COVID-19 Era: Fostering Posttraumatic Growth

“…Similarly, frameworks have been proposed that categorize radiology tests based on intent and level of reporting considered necessary [31]. The recognized work efficiency stressors to address include workload, control over work environment, lack of community, lack of fairness relating to resource allocation, and value conflicts that arise from expectations of participation in suboptimal or even unethical practices [32].…”

“…Systems engineering approaches that rely on humancentered design can reimagine and optimize workflow [32]. This means that workspaces must be designed to enable social distancing, and innovative staffing models must meet service coverage needs and should anticipate predictable shortages and support the remote work environment.…”