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Targeting EMS Burnout in the Workplace

EMS-specific actions your agency can take to overcome burnout

Introduction

EMS professionals routinely face extreme physical and mental demands on the job. Over time, when those demands outweigh the resources available, burnout can follow. Occupational burnout has been linked to higher absenteeism and turnover for organizations.

Common approaches to burnout focus on helping the individual become more resilient. In the spirit of “yes, and,” we believe EMS professionals deserve tools to build resilience and agencies should provide job resources that fight burnout at an organizational level.

Below is a checklist of evidence-based actions your agency can take to help prevent and reduce burnout in the workplace.

1Increase job autonomy and cultivate a participatory environment

Autonomy means being able to act on your own values and interests, such as choosing how to complete a task or having influence over your schedule. In EMS, job autonomy is associated with lower odds of burnout. Professionals who feel their organization values their input are also less likely to experience it. Together, autonomy and a participatory culture can reduce burnout, raise satisfaction, and improve retention.

Take action
Look for ways to build autonomy and participation into your processes. Consider crowdsourcing ideas for reorganizing the supply room, or putting a team together to define and run a new community outreach project. Asking for feedback and letting employees take charge of tasks grows engagement and teaches the organization something too.
Software in the real world
Software can make those processes easier to manage. Activities supports creating, running, and reporting on community outreach programs, and scheduling software lets employees bid for the shifts they want.
2Provide clinical performance feedback

Consistent, timely performance feedback can improve quality of care and patient outcomes, yet not all EMS professionals receive it. A national study found that just over half received any clinical performance feedback within a 30-day period. Without it, clinicians are left without information about treatment decisions and patient outcomes, which is a large missed opportunity for learning.

Feedback also matters for burnout directly. Receiving clinical feedback from a medical director was associated with 54% reduced odds of burnout. From a supervisor, the reduction was 64%.

Take action
Set up a regular time and space for clinical feedback, individually or as a group. Highlight where clinicians performed well alongside constructive areas to improve. Consider asking your medical director to commit to a monthly session spotlighting performance on specific cases and sharing perspectives on the best actions and protocols. Over time that creates a feedback loop where employees gain confidence and insight.
Software in the real world
Simplify the QA and QI feedback workflow with software. The ESO Quality Management module makes it straightforward to assign reviews, message crews, and reach insights directly from the patient care report. With ESO Health Data Exchange, clinical outcome information comes directly from hospitals: individual providers can view diagnosis and discharge information for their calls, while systems gain insight into performance on time-critical conditions such as stroke, STEMI, or sepsis.
3Create social support networks

Access to a strong job-based support network may be one of the most important factors in reducing burnout. EMS professionals experience traumatic exposures at a higher rate than most other civilian professions. A culture that supports the mental wellbeing of crews and provides appropriate resources after critical incidents helps counter stress and burnout.

Take action
Agency leadership should stay aware of the incidents that contribute to burnout, particularly stressful or difficult calls, and provide resources such as access to mental health counseling, brief time out periods afterward, or a few days away from the station. Aim for a culture that recognizes the symptoms of burnout and where providers feel confident asking for what they need, whether that is peer support, management assistance, or outside health services.
Software in the real world
Use your software to spot where burnout can take hold, and use the data to encourage employees toward the right resources. Scheduling reports can reveal patterns of overscheduling. For difficult calls, ESO EHR includes a critical incidents feature that lets employees self-select exposure to a traumatic situation, so you can help them confidentially.
4Deliver adequate training

The first day at a new job can be overwhelming, particularly when the job involves decisions that affect someone’s life. Having the knowledge to perform duties safely and effectively is central to preventing burnout, and orientation training shows new hires they are supported while serving the community. In EMS, adequate orientation training has been linked to a 64% reduction in the odds of burnout.

Take action
Start by reviewing your current orientation procedures. Does the training reflect the calls you actually see today? Are new hire sessions aligned with your most recent protocols? Ask medics what they wish they had known when they were hired, and encourage training officers to set a schedule for annual review so the material stays current.
Software in the real world
Use a blend of learning modalities to keep crews engaged with your protocols and with the latest research. Online education software such as EMS1 Academy provides CAPCE accredited education across a wide range of topics to supplement your own procedures. Track courses taken and expiration dates, so that beyond orientation your team keeps up with current evidence and practice.

Make a change

There is no better time to start making adjustments in your agency, particularly changes that set your crew up for success. It is also worth evaluating how software tools can help you manage job-centered burnout proactively.

See ESO EHR in action

References

  1. Saragih S. The Effects of Job Autonomy on Work Outcomes: Self Efficacy as an Intervening Variable. International Research Journal of Business Studies. 2011;4:203–215.
  2. Cash RE, Crowe RP, Rodriguez SA, Panchal AR. Disparities in Feedback Provision to Emergency Medical Services Professionals. Prehospital Emergency Care. 2017;21(6):773–781.
  3. Crowe RP, Fernandez AR, Pepe PE, et al. The association of job demands and resources with burnout among emergency medical services professionals. JACEP Open. 2020;1:6–16.
  4. Lewis-Schroeder NF, Kieran K, Murphy BL, Wolff JD, Robinson MA, Kaufman ML. Conceptualization, Assessment, and Treatment of Traumatic Stress in First Responders: A Review of Critical Issues. Harvard Review of Psychiatry. 2018;26(4):216–227.