Addressing health care provider burnout: the Thrive study’s innovative approach

Much was written during the COVID-19 pandemic about health care provider burnout. Understanding the severe stress health care workers were experiencing in the workplace (hospitals and clinics in particular), people across the country showed their support by clapping from their windows and posting signs in their front yard. Yet burnout among health care providers dates from well before the pandemic and remains a significant public health crisis.

Burnout is clearly not unique to the health care workforce. Workers in other sectors, such as education, also experience it. Across professional settings, burnout has been associated with decreases in job satisfaction, productivity, and professionalism, as well as increases in career choice regret and intent to leave. However, burnout in the health care setting comes with many additional risks, such as impacts on patient care delivery, quality of care, patient safety incidents, and treatment outcomes.

Practitioners, researchers, and policymakers have increasingly recognized that it is imperative to reduce provider burnout by means of targeted interventions. Although we now know that burnout is driven by many factors, most interventions evaluated to date have focused on psychological and mindfulness approaches. Moreover, much of the existing research on burnout in the health care workforce has focused on the immediate effects of a particular intervention, and few studies have looked at whether improvements can be maintained over time.

There is no single intervention that will solve the burnout crisis in health care organizations. Instead, thoughtful applications of multiple intervention approaches may have an additive positive effect. In light of this, Keck Medicine of USC, funded by the UniHealth Foundation and in partnership with USC Dornsife Public Exchange, is conducting a randomized controlled trial (RCT) of three different interventions called the Thrive study, to address provider burnout. We hypothesize that the three interventions may reduce health care provider burnout through distinct mechanisms. Specifically, one intervention includes psychological training using techniques that have been shown to impact individual mental health and resilience. The second intervention includes individualized training regarding the optimization of the Electronic Health Record (EHR), helping clinicians reduce the time and effort needed for health system documentation. The third intervention engages health care providers to empower them to enact self-directed changes to optimize their daily work flow.

With Thrive, we hope to obtain an evidence-based roadmap to facilitate provider flourishing and to reduce burnout that can be utilized by hospitals across the nation. Through our targeted intervention approaches, we hope to address both the individual as well as system-level drivers of burnout that can make a difference in the lives of our health care workforce. Subsequently, effective interventions will be sustained across the Keck Medicine of USC health system and protocols to enact similar interventions elsewhere will be disseminated through professional organizations and publications. Thus, learnings from Thrive have the potential to positively impact clinician burnout throughout the Nation.