Healthcare today is under such pressure that every resource we have seems in short supply.
Time, supplies, patience, money, access to tools, and even patients all seem scarce at times, and many of us are under intense pressure to manage them.
A recent article in the New England Journal of Medicine, however, used data to shed light on the question of what our most precious resource truly is... and how we might manage that resource more skillfully.In the April 19th, 2018 issue of the New England Journal of Medicine, researcher Graham McMahon, MD, MMSc looks at a set of data for residents' duty schedules.
The primary purpose of the study, the iCOMPARE study of residents, was to compare two duty-hour schedules -- a more traditional set structure and a more flexible structure.
The results seemed to indicate that overall, the more flexible structure was much more successful. But that depended a lot on the speciality of the resident (internal medicine vs. surgery, for instance).
More interestingly, the author drew some fascinating insights from the study about how we value healthcare professionals: "Many healthcare institutions appear to have lost sight of the truism that our health professionals are our most precious resource.” He also says that many healthcare professionals have lost the spirit of "volunteerism and soul" that has so animated our profession for so long.
Specifically, he looked at how the shift structure affected burnout quite dramatically. In fact, just the change in shift structure resulted in more than 2/3 of residents reporting high or moderate levels of emotional exhaustion, depersonalization, and low perceptions of personal accomplishment. McMahon explains, "Burnout among health care professionals is generally attributed to work-related factors, such as overload, loss of meaning, and lack of autonomy, and ultimately affects many dimensions of care quality, including rate of error, patient mortality, teamwork, malpractice suits, patient satisfaction, productivity, and costs.”
But McMahon is careful to not imply that shift structure in itself is what needs changing. He emphasizes that regulatory expectations may need to differ across specialities and that training organizations should, above all, examine how they are:
- Funding and supporting educators and mentors
- Supporting and managing individual growth
- Providing sufficient time for electives and remediation
- Creating work environments that promote deliberate practice, reflection, and feedback without excessive clerical or clinical burden.
McMahon's most emphatic insight, however, is that healthcare organizations must prioritize people. He argues that the concerns and experience of healthcare professionals isn't a "side effect" or an ancillary concern -- these things are central and primary to the mission of those organizations.
This certainly resonated with our experience, as well. So many organizations spend huge amounts of time and money on complex hardware installations for projects like telemedicine, without really considering the usability and sustainability of the system -- they don't stop to consider people. It's assumed that provider schedules will accommodate videoconferencing, that people should be able to learn difficult interfaces, and that providers need to adapt to the project (not the other way around.)
Whether it is for telemedicine or training, our most precious resource is people. Not hardware. Not time. Not money. People. Because if the people are inspired, and trained, and allowed to work as a team, they will thrive and patient results will flourish. That's why when it comes to telemedicine, we believe organizations should spend less time and money on hardware and more time and money exploring the best workflows, interfaces, and simple tools to support people in working together in the ways that they want to.
So, choose systems and tools that acknowledge that people are important -- and that put people first in how those tools work and what they do.
For a people-centric model of telemedicine, check out hybrid store-and-forward telemedicine: