The advisory begins by looking at the scope of health worker burnout, including some insights from the Surgeon General himself as he reflected both on the pandemic and on his own training as a physician. It outlines the negative consequences of burnout on multiple layers of our society – from the challenges that health care workers themselves face as a result (physical and mental health issues, relationship troubles exhaustion) to the impact on patients (delays in care, lower quality care, errors) to the impacts on the health care system itself (workforce shortages, retention challenges, increased costed, limited services). All of these impacts build up to a societal impact of erosion of trust, worsening population health outcomes, increased disparities, and lack of preparation for crises.

Given the multi-faceted impact of burnout, the solutions discussed in the advisory are myriad and cut across societal actors. Some of the suggestions for improving the environment for health care workers are big, bold ideas – ensuring living wages, offering affordable health care that is inclusive of mental health and substance abuse, promoting family friendly policies like universal paid leave. These would certainly involve huge investments of money by governments through various levers – the creation of new programs or enhancement to current reimbursement streams for example.

Many of the recommendations for health care organizations are steps that LeadingAge members are already initiating – working to create better cultures at their own organizations. Some specifics offered in the advisory include recruiting and training workers from the communities, promoting continuing education and professional development of staff, promoting diversity, equity, and inclusion, and participating in peer support model programs like the Nursing Home COVID-19 Action network that many members participated in earlier in the pandemic. Another interesting peer support model cited is called the Community of Practice and Safety Support (COMPASS) program which aims to prevent injuries and advance the health and well-being of home care workers.

The advisory notes that government needs to continue to invest in reimbursement models that are aligned with goals of high-quality, person-centered care. LeadingAge agrees with this recommendation but would add that the government also needs to invest in making sure that reimbursement aligns with the costs needed to support workers, residents, clients, and families.

There are a number of recommendations centered around decreasing administrative burdens for health care workers, many of which LeadingAge supports. Examples include examining reporting requirements and identify opportunities for aligning policy, improving health professional licensing processes, and ensuring equitable and increased access to telemedicine and other virtual care and partnering with health care delivery organizations, professional associations, and other stakeholders to reduce documentation burden by 75% by 2025.

Some additional recommendations that are in the advisory that would be of interest to LeadingAge members are:

• Expand loan repayment programs such as HRSA’s National Health Service Corps, Nurse Corps, and Substance Use and Disorder Treatment and Recovery Loan Repayment programs, and support new initiatives for health workforce loan repayment and forgiveness;
• Sustain investments for a representative health workforce through long-term support of American Rescue Plan investments to recruit, hire and train health workers from underrepresented backgrounds;
• Build trust between underserved and marginalized communities and health workers including proactively addressing health misinformation;
• Strengthen health workforce education, training and resources for disaster and public health emergency response;
• Decrease the risk of COVID-19 infection and other respiratory infections among health workers by ensuring appropriate access to PPE, therapeutics, vaccines, and improved engineering controls; and
• Support a National Health Care Workforce Commission, a multi-stakeholder workforce advisory committee charged with coordinating a national health workforce well-being strategy.

LeadingAge will continue to advocate for policies to support workers across our membership and will monitor the policy outcomes of this advisory.