CANDOR programs can boost job satisfaction in health care workers and potentially prevent burnout

The rate of burnout among health care workers has become higher after the COVID-19 pandemic. Unless mitigated, this could have disastrous ripple effects across the entire health care ecosystem in the US. Recent research has shown that Communication and Optimal Resolution (CANDOR) programs not only improve patient care at hospitals but may also improve the well-being of health care workers. Now, a new study highlights the connection between CANDOR programs, increased confidence in hospital leadership, and job satisfaction.

There is widespread concern across the U.S. about the high incidence of burnout among health care workers. The symptoms of burnout include emotional exhaustion, depersonalization—a feeling of disconnection with one’s identity—and a low sense of personal accomplishment. Concerns about burnout have been exacerbated by the COVID-19 pandemic, and the exit of health care workers may result in people having less access to care. This situation could result in fewer health care workers being available to take care of an increasingly aging and ill population.

In 2021, the Surgeon General released a report titled “Addressing Health care Workforce Burnout.” Furthermore, the Surgeon General has spoken extensively across the U.S. about the problem of worker burnout. He was quoted in an American Journal of Cardiology article saying that it is estimated that there will be a shortage of 3 million essential low-wage health care workers by 2027. The Surgeon General also was featured on a Dr. Glaucomflecken video webcast (which has more than 750,000 subscribers, mostly health care professionals) about how the Federal Government is working to improve the well-being of health care workers.

The U.S. Bureau of Labor Statistics has indicated that there could be an urgent need for 1.1 million new nurses by the end of 2022. Many burnout experts believe that professional environment and work culture form the major sources of health care workers’ burnout. In 2022, Congress passed the Dr. Lorna Breen Health Care Provider Protection Act. The Act requires the Department of Health and Human Services to award grants to hospitals and other health care entities for programs to promote mental health and resiliency among health care providers. But what programs should hospitals implement?

A new study suggests CANDOR programs could help hospitals improve staff’s well-being, and hopefully increase the number of staff who stay on at their medical facility. To the extent that CANDOR programs do this, there is some new hope for improving access to future care. The study was published in JAMA Network Open by Health Economist Andrew Friedson and co-authors.

CANDOR is a patient safety, medical liability, and health care professional wellness program designed for when patients suffer an unexpected bad outcome. CANDOR’s basic premise emphasizes honesty in medical error situations. It aims to help patients experiencing unexpected bad outcomes, prevent the recurrence of medical errors, and help health care professionals cope with the aftermath when their patient suffers an adverse outcome.

Hospitals establish a peer support group to counsel health care providers when their patient suffers a bad outcome. Studies have found evidence suggesting that, compared to the common U.S. practice “Deny, Delay, and Defend,” using CANDOR not only benefits current and future patients but also improves the well-being of health care professionals. For example, a survey of anesthesiologists found that anesthesiologists who did not feel supported by their hospital leaders had 6.5 times more symptoms of burnout than those who felt supported. Other, earlier, studies have found evidence that CANDOR can also improve patient care. Presently, more than 800 U.S. hospitals have implemented or are in the process of implementing CANDOR.

In this study, the authors found that there was an association between CANDOR implementation and workers feeling more confident in hospital leadership and feeling more likely to still be working in the hospital in the future. Confidence in senior leadership may particularly be an important factor in retaining employees.

“This is early evidence on the value of CANDOR programs in improving health care worker job satisfaction. It’s exciting to find something that could help improve these metrics. Quality of the work environment and job satisfaction are important for keeping workers in the sector,” says Andrew Friedson.

Dr. Tim McDonald, one of the architects of the CANDOR Toolkit and Chief Patient Safety and Risk Officer at RLDatix states, “We are very pleased to see the data from Friedson et al. that demonstrates improvement in health care professional perceptions of workplace satisfaction and trust in hospital leadership associated with the application of CANDOR principles. This offers hope that CANDOR may be one of the solutions to help address the unprecedented HCP burnout we are currently experiencing.”

This study builds on prior and ongoing work showing that CANDOR programs can improve how hospitals interact with patients by demonstrating that CANDOR also improves how hospitals support their workforce. Friedson concludes, “CANDOR programs in particular may be fertile ground for improving worker satisfaction and with it, hopefully, retention. It may not be enough for health care workers to take pride in their work. They may be more likely to stay when they can also take pride in how their institution handles itself.”

More information:
Andrew I. Friedson et al, Comparison of Health Care Worker Satisfaction Before vs After Implementation of a Communication and Optimal Resolution Program in Acute Care Hospitals, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.2302

Journal information:
American Journal of Cardiology

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JAMA Network Open

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