associate professor of medicine, Harvard Medical School, and chief medical officer, Schwartz Center for Compassionate Healthcare, Boston, Massachusetts former director of health policy and strategic partnerships, Schwartz Center for Compassionate Healthcare; and professor of psychiatry and human behavior and professor of neurology, Brown University Warren Alpert Medical School, Providence, Rhode Island.
J Healthc Manag. 2019 Nov-Dec;64(6):398-412. doi: 10.1097/JHM-D-18-00023.
Organizational leaders are recognizing the urgent need to mitigate clinician burnout. They face difficult choices, knowing that burnout threatens the quality and safety of care and the sustainability of their organizations. Creating cultures and system improvements that support the workforce and diminish burnout are vital leadership skills. The motivation to heal draws many health professionals to their chosen work. Further, research suggests that compassion creates a sense of personal reward and professional satisfaction. Although many organizations stress compassion in mission and vision statements, their strategies to enhance well-being largely ignore compassion as a source of joy and connection to purpose.Passage of the HITECH (Health Information Technology for Economic and Clinical Health) Act in 2009 and the Affordable Care Act in 2010 ushered in a new era in healthcare. Little is known about how changes in the healthcare delivery system related to these legislative milestones have influenced health professionals' capacity to offer compassionate care. Further, advances such as artificial intelligence and virtual care modalities brought more attention to the elements that form the clinician-patient relationship.This study analyzed the views of U.S. healthcare providers on the status of compassionate healthcare compared with 2010. Postulating that compassion is inversely correlated with burnout, we studied this relationship and contributing factors. Our review of evidence-based initiatives suggests that leaders must define the organizational conditions and implement processes that support professionals' innate compassion and contribute to their well-being rather than address burnout later through remedial strategies.
组织领导者认识到缓解临床医生 burnout（职业枯竭）的迫切需要。他们面临着艰难的选择，因为他们知道 burnout 会威胁到护理质量和安全，以及组织的可持续性。创造支持员工并减少 burnout 的文化和系统改进是至关重要的领导技能。治愈的动力吸引了许多医疗保健专业人员从事他们选择的工作。此外，研究表明，同情心会产生一种个人回报和职业满足感。尽管许多组织在使命和愿景声明中强调同情心，但他们增强幸福感的策略在很大程度上忽略了同情心作为快乐和与目标联系的源泉。2009 年通过的 HITECH（医疗信息技术经济和临床健康）法案和 2010 年通过的平价医疗法案开启了医疗保健的新时代。人们对与这些立法里程碑相关的医疗服务系统的变化如何影响医疗保健专业人员提供富有同情心的护理的能力知之甚少。此外，人工智能和虚拟护理模式等进步更多地关注构成医患关系的要素。本研究分析了美国医疗保健提供者对富有同情心的医疗保健状况的看法，与 2010 年相比。我们假设同情心与 burnout 呈负相关，因此研究了这种关系及其影响因素。我们对循证举措的审查表明，领导者必须定义支持专业人员内在同情心并促进其幸福感的组织条件，并实施相关流程，而不是以后通过补救策略来解决 burnout 问题。
