Can human-centered design reduce burnout and improve the work experience for nurses and other clinicians?

By Courtney Sherman, consulting managing director, and Colleen Bordeaux, senior manager, Deloitte Consulting, LLP

More than one-third of registered nurses are thinking about leaving their jobs, and 75% say they experienced extreme stress and anxiety over the past year, according to a recent survey of 1,000 nurses.¹ Another survey of more than 10,000 nurses found that burnout among nurses jumped from 4% to 18% six months after the COVID-19 pandemic emerged.² Some of our clients are looking to use the human-centered design concept to reduce burnout by creating a better work experience for physicians, nurses, and other clinical staff. Human-centered design is an approach that incorporates the human perspective in each step of the problem-solving process.  

While the pandemic has certainly added a new level of stress, burnout among nurses is not a new phenomenon. According to a 2018 report, burnout was cited by nearly one-third of nurses as the reason for leaving the profession.³ Heavy workloads, inadequate staffing levels, long hours, and limited control can all contribute to burnout.⁴

The mental, physical, and emotional implications of nursing are more stressful than the average job. Although many nurses love their work, these stresses can lead to burnout, which contributes to attrition. COVID-19 took burnout to the next level. Short-staffed nursing departments became shorter staffed. Some nurses barely had time to catch a breath as they cared for severely ill and dying patients. With so much time devoted to caring for others, nurses often neglect their own self-care and well-being. Hospital and health system leaders should prioritize nurse well-being and make systemic changes that support their nursing workforce.

How can human-centered design reduce burnout?

Backed by data, a human-centered approach examines the emotional drivers of a problem—like burnout among nurses—by suspending bias and getting to the root cause. This is a new approach to solving problems that centers on human insight and examines a person’s emotions, relationships, and values within the workplace.

Consider these human-centered-design strategies to address potential burnout among nurses:

• Use scientific observation and psychologically safe interviews with nurses and key individuals involved with the nurse experience: This can help pinpoint nurses’ needs and can also help to identify critical touchpoints along their professional journey.
• Work with nurses to identify themes and to gather feedback: This can help identify low-hanging fruit to capture quick wins on nurse experience.
• Include nurses and key stakeholders when discussing potential solutions: Nurses are the end recipient of any solution and can help develop a plan tailored to the workplace and unique needs of the nurses involved.

Human-centered design in action

A recent client in the home health care space was experiencing high turnover among its nursing staff and was facing a shortage of clinical talent. The organization initially approached this challenge by creating an aggressive compensation package for nurses. While the higher salary and good benefits helped give it an edge over competitors, it didn’t solve the turnover issue. A human-centered design approach helped the organization’s leaders understand the opportunities to further engage, develop, and retain the next generation of nurses and nurse leaders, ultimately supporting their vision to become the employer of choice for nurses. Our research shows that worker experiences with a company can have a significant impact on market performance. Nurses, like all employees, are humans who are driven by their values and emotions. Addressing nurse retention should require health care leaders to explore the root causes that drive negative emotion and experiences among their nurses.

Nurses will play an important role in the Future of Health

The RN workforce is expected to grow from 3 million in 2019 to 3.3 million in 2029. The Bureau of Labor Statistics also projects 175,900 openings for RNs each year through 2029.⁵ However, there are far from enough nurses entering the workforce to meet this demand. Some estimates project a shortage of 510,394 registered nurses nationwide by 2030. A shortage in nursing could cause burnout to grow exponentially. The need to care for one additional patient increases burnout 23% and dissatisfaction 15%.⁶

Addressing the root cause of burnout is critical

Reducing burnout among nurses and other clinical staffers has perplexed hospital and health system leaders for decades. No amount of money can solve the problem. The pool of talent is shrinking, and many hospital and health system leaders are facing a critical talent crisis. They will likely need to re-imagine the way the work is structured. They also should challenge their own biases about what creates a positive work experience for a nurse. What is the root cause of burnout? What do nurses tell their colleagues, friends, and families about their jobs and their work environment? 

A talent transformation can only emerge when the organization’s leaders understand the emotions and root causes of their retention challenges. Traditional strategies often don’t work because they fail to address the root cause of the problem. Human experience by design targets the root causes of burnout and can help solve the problem. Psychologically safe-interviews, for example, can give nurses an opportunity to openly express their needs and experiences. Co-creation sessions allow both organizational consultants (and the humans at the center of the challenge) to collectively develop insights that result in a talent strategy that recognizes the organization’s values while empowering employees to share their needs. How will we know if this human-centered strategy is having a positive impact? When nurses report that they feel cared for as individuals.

Taking a human-centered, experience-based approach to nursing retention is a low-cost, high-reward way to move the needle on a challenge that health systems have historically failed to address. To stay competitive in an ambiguous future, hospital and health system leaders should consider new ways to address work-related stress and burnout.

Acknowledgements: Betsy Grace and Emily Rubin

Endnotes

^{1.        Burnout and stress amid pandemic add to nurse shortage; one-third considering leaving bedside, Staffing Industry Analysts, April 5, 2021; Burned out by the pandemic, 3 in 10 health-care workers consider leaving the profession, Washington Post, April 22, 2021}

^{2.        Nurse burnout has soared during pandemic, survey shows, Medscape, December 24, 2020}

^{3.        Prevalence of and factors associated with nurse burnout in the US, JAMA, February 4, 2021}

^{4.        Burnout in nursing: a theoretical review, Human Resources for Health, June 5, 2020}

^{5.        Occupational outlook handbook: Registered nurses, Bureau of Labor Statistics}

^{6.        United States registered nurse workforce report card and shortage forecast, National Library of Medicine, May/June 2018} 

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