Fort Belvoir Community Hospital - Flickr

Shifting from a volume-based healthcare model to a value-based model makes sense when you consider that the U.S. trails other wealthy nations on improving health outcomes. As the healthcare industry makes this shift, hospitals and other healthcare organizations are continuing to experience a growing consequence of the pressure to assess and improve the quality of care. As Ian Morrison points out in Hospitals & Health Networks Daily, this consequence is known as “improvement fatigue.” Improvement fatigue was first discussed in a 2007 Journal of the American College of Cardiology article. It affects clinical leaders, medical directors of physician associations and health systems as well as nurses and physicians who provide care. More specifically, these providers can feel overwhelmed as they try to modify the way care is delivered while they are actually delivering care.

There are a number of factors that drive improvement fatigue, but the key ones include:


The Affordable Care Act has been the reason for a lot of change as health plans, health systems and consumers pressure caregivers to make improvements.

Inadequate Commitment

Harris surveys discovered that boards, CFOs and management teams are bought into the need for change, but doctors, nurses and patients need a better understanding of it.

Multiple Initiatives

The variety of improvement projects underway in most clinical areas and the related complexity creates confusion.

Electronic Health Records

Although the intent and ultimate benefit of an electronic version of a patient’s medical history is positive, switching to this from hard copy is an arduous process.

Given these factors, what can healthcare leaders do to reduce improvement fatigue? There are some essential steps.

Reconsider Physician Leadership

Explore different approaches that will enable physicians to take the lead in getting all clinicians to embrace the work that needs to be done. This includes using dyads of physicians and administrators (e.g., Mayo Clinic) and providing these leaders with the budgets and authority to make lasting change.

Share a Concise, Consistent Story

There is no such thing as over communication when it comes to helping people understand the need for change. This is especially true for busy, front-line caregivers. Just make sure the message you want to deliver is clear and genuine.

Offer Ongoing Support

Look for lessons learned to inform your approach and provide guidance, training and relevant resources on a regular basis. This will build momentum that will ultimately ensure the capabilities are developed to sustain the change in the healthcare organization.

Connect to the Mission

Strong leadership, a clear message and ongoing support will get even more traction to overcome improvement fatigue if you help front-line caregivers see that the change will benefit patients, families and the communities the healthcare organization serves.


Ryan Lahti is the founder and managing principal of OrgLeader, LLC. Stay up to date on Ryan’s STEM-based organization tweets here: @ryanlahti

(Photo: Fort Belvoir Community Hospital, Flickr)