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VA Clinician Burnout Research Agenda: Summary Report

Although many drivers of provider burnout are well-understood, additional new challenges, including increased workplace stress and personal anxiety due to changes in workflow and care delivery models driven by COVID-19, and other societal factors, such as increased recognition and visibility of health disparities, heighten the need for evidence-based solutions. In response to this need, AcademyHealth and the VA Health Services Research and Development (VA HSR&D) are collaborating to produce a research agenda aimed at enhancing the understanding of the drivers of and interventions addressing clinician burnout in the VA.

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This prioritized research agenda builds on existing work and makes clear the imperative and opportunity for VA HSR&D to support an effective VA response to the crisis of clinician burnout by supporting research on system level interventions in the VA. The range of question and topics identified provide guidance to the VA on the most pressing issues facing health system leaders within the VA and in other health care systems and the types of evidence they need to prevent and reduce clinician burnout.

While existing evidence supports immediate action by all levels of the Veterans Health Administration (VHA) in response to the recommendations put forth by the REBOOT Task Force, many questions remain about the most effective and sustainable approaches and the distributional impacts of any changes made. Thus, substantial investments in health services research are needed to continue to guide the VA’s actions, investments, evaluations, and commitment to reducing clinician burnout. 

Key recommendations:

  • Prioritize research on interventions to address burnout at the organization or system levels. The biggest gap in the existing evidence base on clinician burnout is not its drivers or causes, but how to effectively address it across teams, divisions, and whole systems.
  • Capitalize on the variation between VAMCs to study the comparative effectiveness and costs of interventions to address burnout, specifically which approaches work for whom and under which circumstances. Also, there is the opportunity to learn from “positive deviants,” identifying VAMCs with low rates of clinician burnout, and leveraging their approaches at an organizational level.
  • Leverage the VA’s ability to conduct large, controlled studies across sites and/or clinician types, particularly for “whole system interventions” with varying components. Findings should be widely disseminated and implemented across VA sites and share their learnings with health systems nationally and globally.
  • Focus on the effectiveness of burnout interventions on clinicians of color and other dimensions of diversity and identity that affect the clinician’s interactions with healthcare staff and patients. This is a salient gap in the evidence.
  • Include studies on the role of effective VA leadership (from senior leaders to supervisors of frontline staff), including strategies for leadership training and support, trust in leadership, and approaches for leaders to create and sustain a welcoming and supportive culture were all aspects of the priority questions.