CIN Resource Page: Building a Resilient Primary Care Workforce


Understanding the unique experiences of primary care providers is essential to alleviating burnout and addressing the secondary trauma and moral injury rising in this field. Health care delivery organizations are increasingly implementing programs and initiatives to support workforce well-being and working to alleviate structural and environmental pressures contributing to this issue.

This page provides resources to better understand the causes and consequences of burnout, secondary trauma, and moral injury and contains ideas and practices for better supporting the primary care workforce.

For CIN resources specifically on physician burnout, please see our CIN Connections, Spring 2018 Issue: Healing the Healers and the resource page from that meeting.

Resources listed on this page reflect the focus and interests of a CIN partner meeting and will be periodically updated.

Have a resource for this page? Please submit to [email protected]

Cultural and Structural Features of Zero-Burnout Primary Care Practices
This examination of 715 small-to-medium-size primary care practices found that zero-burnout practices had higher levels of psychological safety and adaptive reserve, as well as more quality improvement strategies, more commonly were solo and clinician owned, and less commonly had participated in accountable care organizations or other demonstration projects. (Samuel T. Edwards et al., Health Affairs, June 2021)

Beyond Burned Out
This article provides a definition of burnout, identifies its drivers, and outlines how the COVID-19 pandemic has exacerbated burnout in all industries. The author argues that burnout is an organizational problem that requires upstream interventions to combat and provides proven approaches for ways organizations can address burnout. (Jennifer Moss, Harvard Business Review, Feb. 10, 2021)

Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being
This book highlights the complex and systemic issues of primary care clinician burnout that ultimately impacts the quality of care that patients receive across the nation and worldwide. The authors outline the need for immediate action by health care organizations, health professions educational institutions, and health care policy entities and recommend a systems approach to combating the prevalent issue of burnout. (National Academies Press, 2019)

CIN Webinar — How to Prevent Staff and Provider Burnout
This webinar explores strategies to address burnout and promote resilience for health care professionals. Learn the key takeaways on workforce burnout in health care, how leaders can reduce burnout in their organizations, and how to promote resilience during change. (California Improvement Network, May 23, 2019)

Getting Rid of Stupid Stuff
This article explores the connection between the daily burden of administrative tasks for clinicians and burnout. Learn about an approach that seeks to remove unnecessary documentation from electronic health records (EHRs). (Melinda Ashton, New England Journal of Medicine, Nov. 8, 2018)

Physicians Aren’t “Burning Out.” They are Suffering from Moral Injury
This article outlines the definition of “moral injury,” a personal and emotional wound that breaks a person’s identity, sense of morality, and relationship to society, including how physicians are suffering from burnout due to a broken health care system. Read more to learn about the impact moral injury has on physicians and what the authors believe will necessitate change to better support this workforce. (Simon G. Talbot and Wendy Dean, Stat, July 26, 2018)

A Journey to Construct an All-Encompassing Conceptual Model of Factors Affecting Clinician Well-Being and Resilience
This framework, developed by the National Academy of Medicine, describes the factors associated with clinician well-being and resilience. This model applies factors across all health care professions, settings, and care stages, and emphasizes the link between clinician well-being, and the outcomes for patients, clinicians, and the health system. (Timothy Brigham et al., NAM Perspectives, Jan. 29, 2018)

Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey
In this study, read about the extent to which primary care providers share responsibility with other team members on 14 distinct tasks and which of those are associated with primary care provider burnout. (Linda Y. Kim et al., Journal of General Internal Medicine, Jan. 2018)

IHI Framework for Improving Joy in Work
This framework, developed by the Institute for Healthcare Improvement, provides health care organizations with steps that leaders can take to make improvements and restore joy in the workplace. Read more about the nine critical components for ensuring a joyful and engaged workforce. (Jessica Perlo et al., Institute for Healthcare Improvement, 2017)

Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations
This study demonstrates the time primary care physicians spend on entering patient data into the electronic health record and tested the understanding of how this time contributes to burnout. Read more to see the results of this study and recommended ways that primary care physicians can delegate the EHR-related work to reduce their workload and improve their professional satisfaction. (Brian G. Arndt et al., Annals of Family Medicine, Sept./Oct. 2017)

California’s Primary Care Workforce: Supply, Characteristics, and Pipeline
This report provides information to help policymakers, consumers, and leaders of health care delivery organizations and educational institutions understand California’s primary care workforce needs. (Janet Coffman, Igor Geyn, and Kristine Himmerick, Healthforce Center at UCSF, Feb. 16, 2017)

Executive Leadership and Physician Well-Being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout
This article describes nine organizational strategies to promote physician engagement, including how some of these approaches have been implemented at the Mayo Clinic. (Tait D. Shanafelt and John H. Noseworthy, Mayo Clinic Proceedings, Jan. 1, 2017)

The Stanford Model of Professional Fulfillment
This framework, developed by Stanford Medicine, illustrates that well-being is driven not only by the individual but also by the organization’s efforts to foster a space for provider well-being. (Stanford Medicine, 2016)