Healthcare News & Insights

Leading causes of ‘improvement fatigue’ — and what to do

Hospital leaders are feeling pressure to simultaneously improve different areas of their operations — but what can they do when the staff is fed up with all the improvements? 

Asian woman doctor physician

Asian woman doctor physician

This is certainly not a new question for healthcare execs, but it’s taken on a new urgency given the recent industry push for facilities to improve care outcomes, patient experiences and how they leverage health IT.

However, as the industry continues its inevitable shift toward care value over volume, hospital leaders are seeing large portions of their staff affected by “improvement fatigue.”


Often, in addition to knowing what needs to be changed, caregivers need to understand the why driving improvement programs, says Ian Morrison, PhD, author and healthcare consultant, in an article for Hospitals & Health Networks.

Sources of fatigue

To understand how best to address improvement fatigue, Morrison says leaders need to understand some of the factors driving fatigue in their facilities.

Many providers blame the implementation of the Affordable Care Act for improvement fatigue. But Morrison notes the changes the industry is currently undergoing were bound to come about anyway — and Obamacare just expedited the process.

Instead, he points to several other sources providers need to focus on, including:

  • Lack of front-line understanding — When Morrison surveys hospital staffs, he typically finds many front-line clinicians don’t understand the motivators behind changes. Often times leaders worry about getting board buy-in for changes, while leaving front-line staff in the dark.
  • High stakes and concurrent improvement programs — More hospitals are relying on incentives tied to quality improvement programs to compensate for falling revenue from inpatient services. At the same time, trying to qualify for multiple programs, some which may have competing measures, can leave front-line workers feeling stretched thin and confused about priorities.
  • Electronic health records (EHRs) and health IT — Numerous surveys have linked provider burnout and frustration with difficulties implementing health IT, particularly EHRs.

Treating staff fatigue

Obviously, this puts leaders and boards in a difficult position, as the transition toward more patient-centric care grinds on.

However, Morrison notes there are several ways they can begin to address improvement fatigue:

  • Consistently explain the “why” behind improvement programs to front-line clinicians. As Morrison notes, most physicians and workers value transparency about operations so it’s not possible to “over-communicate” with them about where your facility is heading and why.
  • Reconsider physician leadership. Having doctors lead the way in care improvement efforts is an important part of making lasting, effective change to your operations. However, there’s often a Catch 22 in this area. Many execs feel like there aren’t enough capable physician leaders, while physicians want more experience and opportunities to develop their leadership skills, but don’t get them. Morrison recommends leaders consider using dyads, where physicians work closely with current leaders and administrators as another form of training.
  • Collaborate and communicate with other leaders/organizations. Work with other facilities in the area to share best practices and advice for actionable initiatives.

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