Improving the Work Life of Health Care Workers: Building on Nursing’s Experience

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In 2008, Berwick et al1 presented a framework for improving the health care system through the pursuit of 3 aims: improving the experience of care, improving the health of populations, and reducing per capita costs of care. Several years later, a number of clinicians advocated for expanding the “Triple Aim” to include improving the work life of health care clinicians and staff, observing that this fourth aim was foundational to achieving the other 3.2,3 As concern about the quality of clinician work life continued to mount,4–6 groups including the American Nurses Association (ANA),7 the American Association of Critical Care Nurses (AACN),8 the Institute for Healthcare Improvement (IHI),9 the Critical Care Societies Collaborative,10 the National Academy of Medicine (NAM),11 Press-Ganey,12 and health care leaders13 committed to safeguarding patient care quality, improving the patient experience, and returning joy to work began to examine the detrimental effects of burnout on health care practitioners and its relationship to clinical well-being and patient outcomes.14–17 In 2017, recognizing the threats of high levels of clinician burnout, the NAM launched the Action Collaborative on Clinician Well-Being and Resilience.18 The initiative’s goal is to engage health professional groups, health care organizations, and other stakeholders in assessing and understanding the underlying drivers of clinician distress and burnout and to advance appropriate solutions.
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