Becker's Clinical Quality & Infection Control

26 PATIENT & CAREGIVER EXPERIENCE What does 'quiet quitting' look like at hospitals? By Kelly Gooch T he trend of "quiet quitting" has recently gained traction on social media, referring to a phenomenon in which workers to reduce their enthusiasm at work and stick to the minimum expectations of their role. Some professionals, including Generation Z workers, have embraced the concept as an increased form of work- life balance, and others see it as a lesser-version of actually quitting. Regardless of how an individual interprets the idea, the concept is not new among the U.S. workforce or in healthcare, according to Jeremy Sadlier, executive director of the American Society for Healthcare Human Resources Administration. "Before the term quiet quitting was in vogue, we were talking about employees who would 'quit and stay,'" said Mr. Sadlier, who previously served as a market director of human resources and provided operational support at Advocate Aurora Health, an organization with dual headquarters in Downers Grove, Ill., and Milwaukee. "In essence, it's the same concept with a nearly identical motivation. No matter the term used, many disengaged employees will stick around long aer they're finding motivation and stimulation in their work." In healthcare, this phenomenon has only grown. An April Gallup poll found that 34 percent of U.S. employees were actively engaged at work in 2021, compared to only 32 percent this year. Healthcare professionals saw the largest dip in engagement, with their engagement scores dropping nine points year over year. Mr. Sadlier noted that this trend can have significant effects in the industry. "Any lack of engagement on the part of staff ultimately impacts patient care, teamwork, safety and throughput, all of which impact the financial health of an organization and the patient experience. It's incredibly important for leaders to focus on engagement, growth opportunities, and to recognize and reward hard work. ese are a few ways to focus on your employees to help them feel engaged with their work," he said. Still, quiet quitting doesn't look significantly different in healthcare than it does in other industries, according to Mr. Sadlier. "Colleagues in other industries like hospitality and retail, for example, all talk about a lack of willingness among workers to pick up extra shis, or work beyond the bare minimum requirements. at's a sign of growing disengagement and may be quiet quitting," he said. It is greatly concerning that, while the motivation may not be largely different than in other industries, the effects of quiet quitting in healthcare have a direct connection to patient care, quality and safety, according to Mr. Sadlier. He also said lower patient experience scores may indicate that a hospital is experiencing decreased employee engagement, which can spread among all its staff. "ere's an absolute hierarchy [in healthcare], and it doesn't require somebody to work in healthcare to recognize that when physician engagement falters, that impacts nurses, and when nurses don't feel engaged, that impacts the rest of the staff, whether it's ancillary staff, support services," he said. "ere's a trickledown effect to a lack of How to improve patient experience, clinician well- being concurrently By Erica Carbajal I mproving the patient experience doesn't have to come at the cost of clinician well-being. There's a way to prioritize both, two physicians wrote in a July 18 article in Harvard Business Review. A common belief in healthcare is that improving the patient experience is in conflict with physician well-being, especially now, given how the pandemic has increased workloads and exacerbated clinician burnout. Thus, "many [clinicians] are in no mood to receive information about how to improve the patient experience and may feel 'this is just one more thing you are asking me to do,'" write Jessica Dudley, MD, chief clinical officer at Press Ganey and assistant professor of medicine at Boston-based Harvard Medical School, and Thomas Lee, MD, Press Ganey's chief medical officer and internist and professor of medicine at Harvard Medical School. Three steps to prioritize both, according to Drs. Dudley and Lee: 1. Emphasize the positive, especially positive patient feedback data, to double down on what is working and help clinicians understand where they are excelling. "Instead of telling clinicians they must become better, help them recognize when their care is at its best, and support them in providing such care with high reliability," the physicians write. 2. Create a culture that values high reliability and the psychological safety required to give and receive feedback. "The strongest cultures are those so committed to excellence that leaders create the space for team members to speak up and speak out when they see opportunities for improvement, small or large," the article says. 3. Fix the systems and eliminate work that doesn't improve patient care. Seeking input from both clinicians and non-clinicians is important to identify where to weed out meaningless activity. "Whenever we see marked improvement in patient experience and other quality metrics, we can virtually always identify a systemic improvement. The explanation is never 'we put more pressure on individual physicians to do a better job,'" the physicians wrote. n

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