Quality and Safety at Mass General for Children (MGfC) hosted a virtual Pediatric Grand Rounds session during Patient Safety Awareness Week (PSAW) 2023 (March 13-17) that featured Jessica Perlo, MPH, senior director of the Institute for Healthcare Improvement (IHI).

Perlo’s presentation, titled “Fostering Workforce Safety and Wellbeing While Combatting Burnout,” emphasized the importance of prioritizing employee wellbeing as a means to enhance patient safety and decrease burnout in healthcare. She also provided tips on how leadership can identify ways to combat burnout among their workforce and boost organizational performance.

“Greater personal resilience is not the solution to burnout,” said Perlo. “There’s a case to be made for focusing on your workforce. Burnout can lead to more errors, higher staff turnover and more errors in the Intensive Care Unit. It’s the largest threat to patient safety.”

Burnout is an occupational condition characterized by emotional exhaustion, depersonalization or a low sense of personal accomplishment resulting from chronic workplace stress. It costs the average hospital between $4.4 million and $6.9 billion per year in turnover and recruiting costs. To replace one clinical nurse, it costs the average hospital between $40,300 and $64,000 and each percentage change in nurse turnover will cost or save an additional $379,500. In 2021, at the height of the Delta variant of COVID-19, about 60% of health care workers showed symptoms of burnout, according to a study published in JAMA Health Forum, an international, peer-reviewed, online and open access journal that addresses health policy and strategies that affect medicine, health and health care.

The road to decrease burnout starts with leadership asking their workforce “What matters to you?” By listening to what’s most important to each employee, leaders and their staff can work together to address whatever gets in the way of what matters at the team, department or senior leadership level. These conversations are rooted in encouraging employees to share what is meaningful, what makes them proud to work for their organization or how they know they can make a difference. When starting from a positive standpoint, said Perlo, it creates positive energy for change, fosters a sense of validation and celebrates team and individual accomplishments.

Workforce wellbeing is now a national movement that mirrors the quality and safety movement, which originated in the 1990s, starting with the Institute of Medicine’s seminal report, “To Err is Human,” as a call to action in 1999. During the 1990s, other movement efforts included the establishment of the National Quality Forum, then-President Bill Clinton’s issuing of an executive order for “A Patient’s Bill of Rights” and the IHI’s 100,000 Live Campaign. The creation of the chief quality officer role was also implemented in hospitals across the nation. From 2017-2022, the workforce wellbeing movement paralleled the quality and safety movement with the National Academy of Medicine’s (NAM) seminal report, “To Care is Human,” the establishment of the National Action Collaborative on Clinician Wellbeing and Resilience, the Surgeon General joining NAM as co-chair to address issues of burnout and the rise of the chief wellness officer role in hospitals. President Joe Biden also signed into law the Dr. Lorna Breen Health Care Provider Protection Act, which provides federal funding for mental health education and awareness campaigns to protect the wellbeing of health care workers.

Perlo closed Grand Rounds on a hopeful note by sharing a quote from Don Berwick, MD, MPP, FRCP, president emeritus and senior fellow of IHI: “The gifts of hope, confidence and safety that health care should offer patients and families can only come from a workforce that feels hopeful, confident and safe. Joy in work is an essential resource for the enterprise of healing.”

Other PSAW 2023 virtual and in-person events at MGfC and Massachusetts General Hospital included:

  • “Having the Wrong Thing in Your Hand: Lessons Learned About Human Fallibility and System Design,” presented by David Marx, chief executive officer of Outcome Engenuity, LLC (sponsored by the Department of Pharmacy at Mass General)
  • “Omnipaque Global Shortage Summary at MGB,” presented by Joseph Fay, director of Clinical Operations in Radiology at Massachusetts General Hospital (sponsored by the Department of Radiology at Mass General)
  • “Creative strategies and new training for diminishing conflict and violence to keep our patients safe,” presented by Bonnie Michelman, executive director of Police and Security, Thomas Mahoney, senior manager of Training, Compliance and Special Projects and Matthew Thomas, Training, Development and Communications specialist at Mass General (sponsored by Police and Security at Mass General)
  • “Contrast Reactions and Emergency Management… Who Needs to Know?” presented by the Radiology Simulation Team at Mass General


  • “Anesthesia Grand Rounds: Connecting Purpose and Performance in Perioperative Medicine: A Patient Safety Initiative,” presented by Daniel Cole, MD, president of the Anesthesia Patient Safety Foundation (sponsored by the Department of Radiology at Mass General)
  • “The Safety of Inpatient Care: Our Findings and Where We Go From Here,” the keynote presentation by David W. Bates, MD, chief of General Internal Medicine and Primary Care at Mass General and medical director of Clinical and Quality Analysis at Mass General Brigham (MGB) and Elizabeth Mort, MD, MPH, senior vice president of Quality and Safety and chief quality officer at Mass General and MGB (sponsored by the Mass General/Mass General Physician’s Organization Lawrence Center for Quality and Safety)


  • “To Shield or Not to Shield… That is the Question,” presented by Debbie Ricciardelli, manager of Radiography Quality assurance and Training at Mass General (sponsored by the Department of Radiology)
  • “MGB Radiology Quality, Safety, Equity and Experience: Rationale, Governance and Current Priorities,” presented by Ramin Khorasani, MD, vice chair of Radiology Quality and Safety at MGB (sponsored by the Department of Radiology)