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The SMART program A novel way to decrease burnout By Richa Sood, MD, and Amit Sood, MD
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Balancing tensions Improved chronic disease management By Audrey Hansen, BSN, MA, PMP; Sarah Horst Evans, MA; and Claire Neely, MD
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he Triple Aim of better care, better health, and lower cost challenges clinicians and care systems to constantly improve. Pursuing these aims often uncovers underlying tensions; seemingly opposing forces that complicate how best to accomplish these goals, too often leaving care systems frustrated with their ability to improve
outcomes, and physicians and others feeling blamed for slowing progress. The Institute for Clinical Systems Improvement (ICSI) has experienced first hand how these tensions manifest themselves. Over the last several
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ealth care professions are currently experiencing an epidemic level of burnout with over 50 percent of physicians reporting at least one burnout symptom. Burnout is associated with absenteeism, turnover, early retirement, increased rate of medical errors, and a decrease in patient satisfaction. Organizational level interventions to decrease and optimize physician workload, while helpful, are not always feasible or effective. Several interventions to enhance individual stress management skills have been tested with modest efficacy. A novel resiliency enhancement intervention, the Stress Management and Resiliency Training (SMART) program, that is anchored in neuroscience and designed as a scalable program with high effect size, offers a potential solution. Combining SMART with organizational approaches may offer an effective long-term strategy to decrease health care provider stress and burnout. This article provides the rationale, evidence of efficacy, and features of the SMART program.
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