Long hours and highly stressful situations often get the blame for professional burnout in the healthcare workforce. But speakers at a session of the 2025 Midyear Clinical Meeting & Exhibition urged pharmacy leaders to be alert to an even more insidious factor: cognitive overload.
Cognitive overload occurs when the amount of information exceeds someone’s working memory, explained Tara Feller, a pharmacist with Froedtert & Thedacare Health who worked with ASHP on its Well-Being Ambassador Program.
Such overloads happen when employees are navigating complex tasks while dealing with multiple distractions.
As an example, Feller said, imagine a new pharmacy technician who’s learning to put an oncology order in a patient’s electronic health record. The technician is working through complex information, including weight-based dosing and lab values.
At the same time, however, the technician is also dealing with irrelevant popups on her screen and a co-worker with multiple questions — all while also trying to follow a poorly written protocol.
“None of these factors help [the technician] learn or solve the problem at hand,” Feller said. “They’re extraneous load, and they start taking up precious working memory space.”
Studies show cognitive overload is strongly associated with emotional exhaustion, one of the key elements of burnout, said Feller.
Researchers have identified and validated multiple survey tools, most notably one designed for surgeons, that measure cognitive overload in the healthcare workforce, said Mary Ann Kliethermes, ASHP’s director of medication safety and quality. Respondents answer questions on such issues as mental demands, time pressures, distractions, and frustration levels.
But studies haven’t pinpointed the sources of burnout in pharmacy.
“When we talk about cognitive load and burnout, what we realize is that we don’t really know where that’s occurring,” Kliethermes said.
ASHP has a pending federal grant proposal to study how to adapt these tools to pharmacy practice. Kayla Waldron, ASHP’s director of medication use and quality improvement, discussed how ASHP developed the Pharm-TLX tool through a pilot study of participants in the Well-Being Ambassador Program.
The tool asks health-system pharmacists detailed questions about the complexity of their tasks, distractions, and their feelings of success and anxiety. ASHP plans to test Pharm-TLX in practice, evaluate particular workflows that are “hot spots” for creating cognitive overload, and identify ways to modify workflows to reduce burdens on employees, Waldron said.
ASHP’s work to foster well-being in the pharmacy workforce has demonstrated that organizations, not just individuals, must step up efforts to reduce burnout.
“One of the big things we learned is we really need to focus on systems issues,” said Waldron. “Yes, there is a place for things that bring individuals joy — meditation, yoga — but we also need to be changing the workplace, the way work is done, the way work is designed.”
Until many of those major changes are made, managers can still take steps to reduce cognitive overload, particularly by reducing distractions, said Feller. Steps can also include devising checklists for certain tasks, investing in automation tools, and providing time for “deep work.”
