Pressures in the health system affect the people working in health care as well, and may lead to stress or burnout.
The stresses within the health system are also having an effect on the mental health and wellness of doctors, nurses and the many other health professionals who provide care. In a 2019 survey, 54% of primary care doctors in Ontario reported that their job was "extremely" or "very" stressful, while 37% said it was “somewhat” stressful and 7% said it was “not too” or “not at all” stressful. The percentage who said it was extremely or very stressful was higher in Ontario than the Canadian average of 45%, and was among the highest reported in the provinces, with Nova Scotia at 59%, Prince Edward Island at 48% and British Columbia at 47%. The lowest rate - 33% - was in Quebec.
Internationally, when compared to its socioeconomic peers, Ontario had one of the highest proportions of primary care doctors reporting their job was extremely or very stressful. Sweden had the highest, at 65%, while Australia had the lowest, at 29%.
In the same survey, 49% of Ontario primary care doctors reported they were “slightly” or “not at all” satisfied with their daily workload, while 34% were “moderately” satisfied and 16% were “extremely” or “very” satisfied. The proportion who were only “slightly” or “not at all” satisfied was higher in Ontario than the Canadian average (42%), and compared to other provinces was only significantly lower than in Nova Scotia (61%). Alberta was the top performer at 31%. Compared internationally, the proportion of primary care doctors in Ontario who were only “slightly” or “not at all” satisfied was in the middle of the pack, while Switzerland was best at 23%.
When health professionals experience burnout, it affects not only their productivity, but also has an impact on patient safety, quality of care, and patient satisfaction. This burnout can also add costs to the system through staff turnover and absenteeism. Improving the wellness of health professionals requires recognizing the seriousness of the issue, moving from a focus on burnout to the concept of work-life balance, and having health care organizations taking an active role to improve the wellbeing of their staff and members. 1 Healthy Debate: Burnout in Health Care. https://healthydebate.ca/2018/09/topic/burnout-in-health-care
Health professionals also face risks to their personal safety while at work, which include physical actions against workers – such as punching – and threats of physical violence. To support their workers, all hospitals in Ontario have committed to reporting on workplace violence incidents and putting initiatives in place to reduce these events, with more than three-quarters of hospitals making this a strategic priority. These initiatives include training on violence prevention and appropriate interventions, staff and physician surveys on incidents and responses, and developing protocols to identify or respond to patients at high risk of becoming violent.
Learn about how health care organizations are improving the work experience for health care professionals: https://www.hqontario.ca/Quality-Improvement/Quality-Improvement-Plans/Quality-Improvement-Plan-Guidance
Digital tools ease health care provider stress and burnout
Read more about the Digital Coalition
Doctors and other health care professionals who are part of a new digital technology program in South West Ontario explain how it’s helping to ease stress and burnout among health care providers.
Many doctors and other health care professionals in Ontario are getting stressed and burned out because they spend too much time on computers filling out documents and forms, says Dr. Paul Gill, the Clinical Digital Lead for the province’s South West region. Dr. Gill says a new program called the Digital Coalition is helping to ease that burden. The Digital Coalition – an extension of the Partnering for Quality, Practice Facilitation Program – is a partnership of information technology champions throughout South West Ontario working to embed digital tools into electronic medical records. The key is to do this in a way that works seamlessly into health care professionals’ existing workflows, to save time and effort.
“Digital health tools often have clunky user interfaces, confusing and non-standardized terminology, leading to increased levels of provider stress and burnout,” Dr. Gill says. “Our teams of health care professionals in South West Ontario were each spending 3 to 5 hours per week building forms that had already been built somewhere else in the region, multiple times over. They were receiving a lot of forms requiring constant updates, and this ripple effect was a fast-moving treadmill that providers had to jump on every day. It was exhausting.”
Now with the momentum of the Digital Coalition, there is buy-in from the specialist and primary care doctor or other health professionals on the forms before they are built. The coalition has dramatically improved the health care provider experience by decreasing workload through automation, improving workflow, and reducing redirected and rejected referrals for patients, Dr. Gill says. In just over four months, the Digital Coalition’s work with 28 clinics saved about 1,900 hours of administrative work.
“This is work that truly focuses on the quadruple aim increasing health care provider satisfaction, while simultaneously freeing up clinician and staff time to improve access to care for patients and reducing delays in care,” says Dr. Kellie Scott, lead physician at one of the participating clinics. “The Digital Coalition enables collaboration between siloed clinics which are able to share the administrative workload of forms management.”
Kimberly VanWyk, Executive Director of a participating Family Health Team, agrees. “The Coalition has allowed us to move our reception time from building forms to offering more direct time for patient care,” she says.
Patients, families and the public are central to improving health quality.
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