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Causes, Consequences, and Solutions to Clinician Burnout

Provider burnout is increasing across the United States, rising about 20 percent between 2011 and 2014, researchers from Mayo Clinic Proceedings found. This creates health hazards for clinicians and their patients.

What is “Burnout”?

Generally, burnout is defined as feelings of physical and emotional exhaustion, increased cynicism, lower motivation, and even feelings of pointlessness or ineffectiveness.

What causes burnout?

Many factors contribute to burnout. Some of the most common include:

Lack of belonging at work

In several studies of mental health providers, researchers found that individuals who have higher perceptions of support and a greater sense of belonging in the workplace are less likely to experience burnout. Younger providers may be at greater risk of burnout, possibly because they have had less time to cultivate a sense of belonging or to develop skills to cope with patient trauma.

High expectations and stigma

Society expects therapists to put their patients’ needs before their own and have all the answers. They may also be tempted to blame themselves for feelings of burnout, thinking they should have been able to prevent it.

Regulatory burdens
Staffing shortages, company consolidations, and the ongoing opioid crisis have increased the workload for counselors. This also hinders their ability to achieve work-life balance, increasing stress and career dissatisfaction.

Lack of leadership support
Mergers and acquisitions and changing leadership can create uncertainty among behavioral health staff. Often leadership roles are not filled by experienced clinicians, which means that executives are less knowledgeable about providers’ needs. This can hinder communication and create frustration and stress.

Consequences of Burnout
Although providers may suffer in silence, the consequences of burnout can be wide-reaching. A few of them include:
Increased risk of medical and administrative errors
Higher staff turnover
Patient dissatisfaction
Drug and alcohol abuse among counselors
Feelings of hopelessness and thoughts of suicide
Physical symptoms such as headaches and gastrointestinal issues

How to Prevent or Reduce Counselor Burnout

Even when the causes of burnout are systemic, there are ways that therapists and practices can reduce burnout risk:
Healthy stress management: Individual clinicians can learn methods for stress management. Practices may consider offering stress management workshops for team members.
Promote flexible and part-time scheduling: Encourage work-life balance among clinicians by giving them more control over scheduling options.
Shift administrative tasks to non-medical staff: Letting therapists do what they do best can help them regain their sense of purpose and reduce frustration.
Reach out for support: Having their own therapist or mentor can help clinicians cope with feelings of burnout.
More efficient tools: Use the right EHR system for your practice, one that offers easy implementation, reduced clicks, and thorough technical support.

Don’t settle for a frustrating EHR system that contributes to burnout. BestNotes solutions are created with behavioral health and addiction treatment providers in mind, allowing you to do what you do best. Contact us to learn more.

date:  Oct 22, 2018
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Medically Assisted Treatment for Keeping Opiod Users Safe

There are significant risks associated with the long-term use of opioids, yet many patients depend on them for long-term pain management. A growing body of research shows that the right treatment approach can make patients safer, even when using opioids in the long term.

Risks of Long-Term Opioid Use

Chronic pain affects millions of Americans, creating an estimated $600 billion each year in medical costs and lost productivity.

While long-term opioid use can help reduce pain and maintain quality of life, there are numerous risks. Besides increased tolerance, dependence, and addiction, other potential issues associated with long-term opioid use include:

Nausea and bowel disorders
Depression and anxiety
Sleep disturbances and abnormal breathing
Cardiovascular risks
Increased risk of falls
Hormone disruption

If a patient’s pain is best managed with long-term opioids, they likely have complex healthcare needs. This makes opioid use a complicated decision. Providers have to consider many factors, including the patient’s quality of life, when deciding whether to recommend continuing or tapering off opioid use.

What New Research Shows

In a study described in Mayo Clinic Proceedings, researchers evaluated how the use of healthcare changed among 772 patients. Study participants\ were receiving long-term opioid therapy for chronic, non-cancer pain. These patients were enrolled in a controlled substance agreement (CSA) in 2015.

Researchers looked at patient data 12 months before and after CSA enrollment. Specifically, they looked for a decrease of 1 or more hospitalizations or emergency department visits and 3 or more outpatient primary and specialty care visits.

Study results indicated that CSA enrollment was associated with decreased outpatient primary care visits. Among patients with greater comorbidity, CSA enrollment was associated with fewer outpatient primary care visits and reduced specialty care visits.

Qualities of an Effective Controlled Substance Agreement (CSA)

Patients in the CSA received an individualized plan for managing their pain. This included:
Psychological screening
Pain monitoring
Prescription monitoring programs
Drug testing to evaluate the patient’s opioid use
Advising CSA participants to have only one care team prescribe the opioids
Expectations for follow-up appointments among patients
Showing patients how to store medications safely
Warning patients not to share medications
Warning patients not to change doses without contacting the prescriber

Medication-Assisted Treatment for Opioid Dependency
For patients with opioid use disorders (OUD), there are numerous options for reducing dependence.

Medication-assisted treatment (MAT) has been shown to be an effective form of treatment. This approach uses one of three FDA-approved medications, along with counseling and behavioral therapies. The three medications currently approved for treating opioid dependence include buprenorphine, methadone, and naltrexone.

Because of the effectiveness of MAT, the FDA recommends that anyone seeking treatment for an OUD be offered access to any of the three medications. Because OUD may be a chronic condition, providers and patients should occasionally reevaluate the need for continuing with MAT. It is possible for MAT to be indefinite for some individuals.

Besides understanding of their patients’ treatment needs, behavioral health providers need the right tools to operate an effective practice. Contact BestNotes today to get started with EHR and CRM solutions tailored to your specific needs.

date:  Oct 16, 2018
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What is Kanban and How Can It Help Your Behavioral Health Practice?

Kanban is a visual system that helps manage workflow. The word “kanban” is Japanese for “visual signal” or “card.” This system can help teams communicate the work to be done and when to do it, and can help identify and fix bottlenecks to help the work proceed most efficiently.

Taiichi Ohno, an industrial engineer for Toyota, used a form of Kanban in the Toyota Production System, known as Lean Manufacturing in the United States, to eliminate waste. This helped Toyota achieve a just-in-time production control system, increasing their productivity and limiting costly inventory of raw materials and half-finished products.

The main tool in Kanban is a visual Kanban board. This board can be electronic, such as an Excel spreadsheet or an app like Trello, or a physical board on an office wall. At its most basic, this board will include three columns: “To do,” “Doing,” and “Done.” These columns can be further divided to accommodate more complex processes.

With Kanban, the goal is to limit the number of tasks in the “Doing” column at any one time. When one task is finished, the next one is brought into play.

Benefits of Kanban

Organizations that adopt a Kanban system can expect numerous benefits, such as:

  • Transparency
    Everyone involved can look at the Kanban board and know the state of the process, and what still needs to be done and when.
  • Reduction of wasted work
    Work is only done as needed, reducing the risk of starting or finishing a task too soon.
  • Reduced multitasking and overburdening
    Teams attempt to limit the amount of work in any one column. Limiting the amount of work-in-progress can prevent them from trying to do too much at once.
  • More collaboration
    Instead of each person working on their own isolated to-do list, team members who use a Kanban board can see the status of each task, and what everyone has left to do.

How is BestNotes using Kanban?

BestNotes has incorporated Kanban into our software development processes. We visualize our work using a Kanban board to help limit work-in-progress and increase efficiency. Teams meet regularly to examine our Kanban board and decide which tasks to make a priority for the week.

Can your practice use Kanban?

Even behavioral health providers can apply the Kanban system. How can you start?

Create a Kanban board, either electronic or physical, to visualize all your work.
Limit work-in-progress. Collaborate with coworkers and break down each project into simple tasks.
Manage workflow. Use the Kanban board to identify bottlenecks and become more aware of how to prioritize work.
Make your policies clear.
Use feedback. Meet with team members regularly to identify priorities and consider where you can make improvements.
Use the scientific method to make changes. Create a hypothesis, then do an experiment to test that hypothesis. Analyze the data and draw a conclusion. Report on whether your results support your hypothesis or not.

Want to learn more about Kanban and how you can incorporate it into your practice? Interested in an EHR system that emphasizes collaboration and efficiency?
Contact BestNotes today.

date:  Oct 05, 2018
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What Providers Should Tell Family Members About Addiction

Addiction can affect whole families.

Here are some tips for getting families on board for treatment.

Encourage family involvement in recovery.

Because addiction can impact entire families, recovery should involve whole families, as well. Addiction treatment professionals should encourage family members to support the patient seeking recovery. Providers should encourage families to maintain healthy boundaries, be united in their support of the patient, and avoid the temptation to shift blame to others.

Emphasize the individual’s responsibility.

While social support is valuable for addiction recovery, it is ultimately up to the individual. The patient must understand that he or she is responsible for his or her own behavior and commitment to recovery. The family should support addiction recovery efforts, but they are not responsible for an individual’s success.

Clarify your role as a health provider.

Addressing addiction can be an emotional ordeal for many family members, and some individuals can become defensive or deny the problem. Even if patients or loved ones do not want to address addiction, explain that it is your role as the medical provider to offer health recommendations. Let them know that you will come back to the issue at future visits.

Offer specific medical reasons.

Make sure you are giving patients and family members specific medical reasons for your recommendations. If there are doubts about the extent of the problem, let them know what health issues are connected to drug or alcohol addiction. Take time to explain these reasons in plain language and address questions and concerns.

Ask about past recovery attempts.

In order to make the best recommendations for a patient struggling with substance use disorder, the provider must first understand what patients and families have already tried. Ask if the patient has tried to quit substance abuse in the past. If so, ask about those methods and if there were withdrawal symptoms.

Stress the importance of a new approach.

Sometimes families may have difficulty accepting when current methods of recovery have not worked. Providers have greater results when they have taken the time to discuss all practical options for recovery. This may include alternative methods of pain relief (if the addiction involves opiates), attending a support group, or pursuing medication-assisted treatment.

Be aware of the language techniques.

It may not help patients or family members to use words such as “alcoholic” and “addict,” not only because they may be offended, but because they may have their own personal definition. Many people with unhealthy alcohol consumption, for example, have a specific idea of what an “alcoholic” looks like, and insists they do not meet the criteria. Providers are tasked with helping to define the substance use disorder.

We would love to show you how BestNotes can help make your life easier!  Contact us today!

date:  Oct 02, 2018
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News Roundup: Addiction and Behavioral Health in Idaho

Idaho has its own specific challenges in behavioral health and addiction treatment. Here is the latest news from around the state.

Blue Cross of Idaho Implements New Guidelines for Opioid Prescriptions

Blue Cross of Idaho, which insures about 542,000 state residents, is taking steps to curb the rise of opioid addiction. This is partly a response to new research and guidelines from the Centers for Disease Control and Prevention.

The new guidelines from Blue Cross of Idaho state that opioids should have limited strength and should be prescribed for as brief a period as possible. The company recommends that immediate-acting options take priority over extended-release forms. Blue Cross of Idaho also moved naloxone to the top tier on its formulary, which will reduce copays for its generic form.

Breaking Down Barriers to Mental Health in Rural Idaho

Idaho social worker Shawn Briley takes a unique, personalized approach to increasing access to mental health treatment in rural Idaho. Although the licensed clinical social worker has an office, she also meets clients wherever necessary, such as behind a gas station parking lot or at homes in remote areas.

About 20 percent to 30 percent of rural Idaho residents lack health insurance, and such communities tend to have fewer mental-health specialists. Residents may have to drive an hour or more to a therapist’s office. Telehealth options could help reduce some of these barriers. The state is also encouraging more private health providers to make house calls.

Idahoans Rally for Addiction Recovery

As part of National Recovery Month, hundreds of state residents gathered in Boise on September 3 to support and celebrate individuals who are recovering from drug and alcohol addiction. The event aimed to reduce the stigma associated with addiction and mental illness. Attendees also emphasized that addiction recovery should be a community-wide effort, with success largely dependent on how much social support a person receives.

FDA Warns About Youth Vaping

The U.S. Food and Drug Administration (FDA) has called youth vaping a “national epidemic” that threatens the health of U.S. teens. Although many people think e-cigarettes are safer than traditional cigarettes, the devices can still lead to nicotine addiction. Some research also found a risk for “popcorn lung,” a disease linked to the flavoring chemical diacetyl.

A 2017 survey found that about 59 percent of Idaho high-school students used electronic vaping products. As the FDA works to update guidelines on vaping, local vape stores also have stepped up efforts to limit sales to minors.

Resource Fair Hopes to Help Released Inmates

Community organizations and government agencies gathered in Pocatello on Sept. 13 to explore how to improve outcomes for released inmates. This Community Information and Resource Fair mimicked earlier events in Boise and Idaho Falls. One aim of the fair was to explore how to prevent relapses among released offenders and make sure that individuals in need receive help with issues like addiction and mental illness.

Looking to improve your behavioral health or addiction treatment practice in Idaho? Contact BestNotes today to learn how we can help.

date:  Sep 25, 2018
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