Stop Physician Burnout - first, STOP Doing Stupid Stuff

Posted by Dike Drummond MD

Primum-Non-Actio-Stupidus-stop-physician-burnout-dike-drummond-first-stop-doing-stupid-stuff-OPT-150WTo stop physician burnout in large healthcare organizations, here is a key component of your Quadruple Aim Strategy - in Latin of course:

Primum Non Actio Stupidus
[ First Don't Do Stupid Things ]

This is Blog Post #285

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A recent article in NEJM highlights two fundamental burnout prevention principles - Leaders and Managers, please listen up:
  • STOP making the doctors and nurses do stupid things

  • If you want to know what these stupid things are ... all you have to do is ask the doctors and nurses

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From our position in the trenches of the physician burnout epidemic, I can't state this strongly enough to senior healthcare leaders. 

Primum Non Actio Stupidus

... just STOP IT ...  Please !
  • Any energy wasted on any activity that is not mission-critical to quality patient care or the mission of the organization -- is just additional burnout fodder.
  • One of the key responsibilities of an effective healthcare leader is to constantly root out this waste.

Someone must be shadowing the moment-to-moment actions of your physicians and staff during patient care hours - especially regarding any interaction with the digital systems in your organization -- EMR / Patient Portals / Email / Text messaging.
For each individual task:

1) Ask "Does the Completion
Add Value to the Patient or Organization?"

2) If the answer is NO ...

3) Help them STOP DOING IT


G.R.O.S.S. = the "Getting Rid Of Stupid Stuff" Project

[ If you are not willing to study your people and ask the question above, here is a down-and-dirty first project to wring stupidity out of a healthcare system - just please don't mistake this for a full burnout prevention strategy. ]
An October 2017 NEJM article by Melinda Ashton, MD, a physician with Hawaii Pacific Health in Honolulu overviews their "Getting Rid of Stupid Stuff" project.
Primum-Non-Actio-Stupidus-stop-physician-burnout-dike-drummond-first-stop-doing-stupid-stuff-the-hap[py-md_opt220WThe team asked all employees at the healthcare network to review their daily documentation practices and nominate aspects of the EHR they thought were "poorly designed, unnecessary or just plain stupid."

They were inundated with 188 immediate suggestions. 
(NOTE: Nurse suggestions outnumbered the doctor's 3:1)
Dr. Ashton and her team took immediate action, including cutting out one click that saved about 1,700 nursing hours per month and eliminating 10 of the 12 most frequent EMR alerts because they were not being responded to.
1) Forcing physicians and staff to login to their workstations manually is the single most stupid and useless EMR task in any organization. 

2) Dr. Ashton's program only asked about the EMR program. Imagine all the additional systems you could eliminate stupid stuff from if you asked different questions.

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What are some stupid things you would like put on the list?

If you are a physician leader, when can you start your own stop doing stupid stuff project?

Here is the original article - you must be an NEJM subscriber to access

Tags: Dike Drummond MD, EMR, stop physician burnout