Preventing Burnout In Your Organization: Setting Expectations

By: Tripp Johnson

This blog is one in a series about burnout and moral injury in behavioral health. This post and those that follow will dig into some practical solutions that you could apply in your organization. The most effective changes in large systems start at the bottom with those who are impacted most. If you are motivated to solve burnout and moral injury in healthcare, keep on reading! Read the original blog here.

Setting Expectations: Get Clear and Communicate

Individual clinicians should know exactly what is expected of them. They should understand how services should be provided, the number of patient-facing hours that are required, and how the employer is budgeting for administrative time, care coordination, and continuing education.

As a leader, especially if you have P&L responsibility, it’s on you to provide this clarity. A private pay psychiatry practice is going to be run differently than a government-funded community mental health agency, and that’s okay. Regardless of the type of organization you work in, here are a few questions that need to be answered with detailed specificity.

How many patient-facing hours are you expected to provide? (I.e., we expect all fully-licensed therapists to conduct 26 hours of individual psychotherapy per week.)

What is the administrative burden on providing those services? (I.e, we expect that it takes 15 minutes to write each note for an hour of psychotherapy, therefore we are allotting you 6.5 hours/week for notes.)

What else are you expected to do in the normal course of work? (I.e., we have a weekly treatment team meeting that is one hour, you’re expected to coordinate with other providers which we estimate takes three hours per week, etc.)

What is the plan when demand outstrips the ability to provide quality care? (I.e., will providers receive a bonus for going above and beyond? Is there a good plan for knowing when to hire additional clinicians instead of just asking for more out of the existing team?)

Here are the three documents that we use at Green Hill and Advaita Integrated Medicine (collectively, Advaita Health Ventures) to provide clarity to individual clinicians.

Even with the most comprehensive job description, there are things that fall through the cracks. That’s why I consider a “core functions” document incredibly helpful. Instead of listing responsibilities and requirements line by line, this document outlines the buckets or categories of responsibility. Creating a broader context for the position prevents misunderstanding when something isn’t listed specifically in the job description.

Setting clear expectations is a cornerstone of a healthy, provider-centric culture. No one wants to feel like they are being asked to do too much or that they can’t live up to their supervisor’s expectations.

This is the first step, but the world is always changing so expectations can’t be set in stone. That’s why you need to create a culture that promotes frequent, candid feedback.

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