About
Healthcare workforce burnout threatens health systems and optimal healthcare delivery. To address this issue, the Veterans Health Administration implemented a Chief Well-Being Officer role, focused on clinicians.
Background
Clinician burnout can lead to bad organizational outcomes, including lower productivity, more absences, attrition, substance use, depression, and suicide.123 The Veterans Health Administration (VHA), with 172 VA medical centers and 1,138 outpatient sites, is the largest integrated U.S. healthcare system.4 VHA recognizes that burnout can negatively affect the care delivered to veterans.5 Recently, the National Academy of Medicine6 and the Office of the Surgeon General7, recommended actions to address health workforce burnout. Following this, VHA implemented the Chief Well-Being Officer (CWO) role, which focuses on clinicians.
Approach
A 2021 pilot effort across nine locations resulted in improved engagement, a culture of health and well-being, and readiness to change. The pilot revealed:
- Servant leadership, a leadership philosophy that prioritizes service, helped create an environment that encouraged health-promoting activities.
- Readiness to change and a culture of health and well-being were linked to measures of satisfaction, engagement, and workplace civility.
Challenges from the pilot reflected these needs:
- Dedicated CWO staff rather than existing staff who take on extra duties.
- Leadership engagement.
- Role clarity and distinction from other well-being roles.
In 2022, senior VHA leadership approved VHA facilities to hire CWOs.
Impact
As of April 2024, VHA had 34 CWOs across the country. These CWOs are leaders, strategists, and advocates for clinician well-being. They focus on transforming organizational culture to reduce burnout and prioritize professional fulfillment.
Examples of CWO work include:
- Addressing clinical inefficiencies, including electronic health records.
- Reducing training burdens.
- Fostering a culture of well-being by creating the following:
- Social groups where people can come together and share meals.
- Analytics to track time-of-note signatures (the time that a note in an electronic health record is signed by a clinician) and servant leadership skills.
- Social groups where people can come together and share meals.
To support CWOs, VHA created a national CWO Program that provides education, community, and national collaboration opportunities. The CWO Program partnered with Leading Evaluations to Advance VA’s Response to National Priorities, an evidence-based policy center. Together, they designed a 3-year evaluation focused on organizational readiness for the CWO role and potential impact. The findings from the first year emphasized how important executive sponsorship is. In response to this, the program developed executive sponsor engagement sessions and increased consultative efforts.
The CWO Program will continue to evolve based on industry standards, CWO feedback, and the evaluation. Reducing clinician burnout is crucial, so expanding the CWO role is a step in the right direction.
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- Hamidi MS, Bohman B, Sandborg C, Smith-Coggins R, de Vries P, Albert MS, Murphy ML, Welle D, Trockel MT. Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: a case study. BMC Health Services Research. 2018;18(1):851
- Meredith, L. S., Bouskill, K., Chang, J., Larkin, J., Motala, A., & Hempel, S. (2022). Predictors of burnout among US healthcare providers: a systematic review. BMJ open, 12(8), e054243. https://doi.org/10.1136/bmjopen-2021-054243
- Willard-Grace, R., Knox, M., Huang, B., Hammer, H., Kivlahan, C., & Grumbach, K. (2019). Burnout and Health Care Workforce Turnover. Annals of family medicine, 17(1), 36–41. https://doi.org/10.1370/afm.2338
- https://www.va.gov/health/aboutVHA.asp
- National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington (DC): National Academies Press (US); 2019 Oct 23. 3, Extent and Consequences of Clinician Burnout. Available from: https://www.ncbi.nlm.nih.gov/books/NBK552628/
- National Academy of Medicine. 2022. National Plan for Health Workforce Well-Being. Washington, DC: The National Academies Press. https://nap.nationalacademies.org/catalog/26744/national-plan-for-health-workforce-well-being.
- Office of the Surgeon General. Addressing Health Worker Burnout. The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce. 2022. https://www.hhs.gov/surgeongeneral/priorities/health-worker-burnout/index.html.