Organizational Factors – Clinician Well-Being Knowledge Hub

A Call to Action: Improving Clinician Well-Being and Patient Care and Safety

NAM — Fri, 13 Mar 2020 13:18:44 +0000

The Health Policy Institute of Ohio collaborated with The Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare to create A Call to Action: Improving Clinician Well-Being and Patient Care and Safety. The Call to Action outlines the bi-directional relationship between clinician well-being and patient care, calls attention to the health problems clinicians face related to burnout, and highlights the need for a comprehensive approach to prevention, treatment, and recovery efforts. As part of this approach, state policymakers and healthcare leaders have an important role in implementing evidence-informed policies and practices such as advancing positive organizational culture, promoting wellness programs, reducing stigma toward seeking mental health treatment, increasing access to mental health services, and monitoring the data on student and clinician wellness.

Prevalence and Factors Associated with Burnout among Frontline Primary Health Care Providers in Low- and Middle-Income Countries: A Systematic Review

NAM — Thu, 19 Sep 2019 20:20:36 +0000

This systematic review analyzes the prevalence and factors associated with provider burnout in low and middle income countries. Articles from three electronic databases (EMBASE, MEDLINE, and CAB) were searched to find information on outpatient provider burnout in LMICs. They were reviewed to identify prevalence of factors associated with provider burnout. Results found heterogeneity in the definition and prevalence of burnout. Prevalence of burnout was found across multiple medical specialties (physicians, nurses, community health workers, etc.) Most studies used the Maslach Burnout Inventory to assess burnout. Further studies are still required to better measure the cause and consequences of burnout in order to guide the development of effective interventions.

Association of Clinical Specialty With Symptoms of Burnout and Career Choice Regret Among US Resident Physicians

NAM — Wed, 18 Sep 2019 21:02:10 +0000

This study sought to identify the association between rates of burnout and career choice regret amongst resident physicians and whether this varies by clinical specialty. A prospective cohort study was conducted in which US resident physicians completed baseline questionnaires during their fourth year of medical school and then during their second year of residency. Exposures that were measured through the questionnaires included clinical specialty, demographics, educational debt, US Medical Licensing Examination Step 1 scores, and reported levels of anxiety, empathy, and social support. Results found that symptoms of burnout and career choice regret were prevalent amongst physicians, and were relatively higher within the fields of urology, neurology, emergency medicine, ophthalmology, and general surgery.

2015 Dentist Well-Being Survey Report

NAM — Wed, 18 Sep 2019 13:23:07 +0000

The ADA Health Policy Institute, along with the ADA Council on Dental Wellness Advisory Committee (DWAC), surveyed in 2015 to examine various stresses that may affect dentists today. The survey includes questions regarding job satisfaction, workload, medical conditions, workplace safety, the effect of personal responsibilities on work, and the effect of health on work. Participants were professionally active, licensed dentists, along with ADA members. Results from the survey are intended to be used to design more effective education programs.

Addressing Burnout in Radiologists

NAM — Tue, 10 Sep 2019 16:32:31 +0000

This report published by The Association of University Radiologists presents a review of prevalence, causes, and impacts of burnout among radiology faculty and trainees. A survey using the Maslach Burnout Inventory (MBI) to evaluate the prevalence of burnout found that 61% of radiologists reported symptoms relating to burnout. Increasing workload is a leading source of job-related stress contributing to the issue. The practice environment may also contribute to increasing levels of burnout. Significant impacts of physician burnout include loss in productivity, decrease in personal effort, high physician turnover, worsening physician shortages, and more. Several individual and organization directed interventions have been discussed to help prevent burnout in radiologists and promote well-being.

Physician Burnout: Resilience Training is Only Part of the Solution

NAM — Tue, 10 Sep 2019 16:18:29 +0000

This reflection piece discusses interventions to address both avoidable and unavoidable occupational suffering among physicians. It distinguishes between the two as one that’s inherent in the physician’s role (unavoidable) and one that is the result of system failures that are preventable (avoidable). While resiliency training may help in addressing inevitable suffering, it is not the right solution to organizational structures that lead to avoidable suffering. Building an evidence base for improving work systems is vitally essential in mitigating occupational adversity in health care.

Measuring Our Values – Redoubling on a Commitment to Physician Health

NAM — Mon, 09 Sep 2019 16:11:36 +0000

Among the most telling statistics, suicide is the second leading cause of resident physician death. Growing health care costs, worsening physician shortages, along with a growing population needing health care, are factors to rethink in providing valuable physician training programs. The New England Journal of Medicine published a study that surveyed residency programs. Policies that allowed “flexible” duty hours (did not specify limits on shift length or mandatory time off between shifts) had negative impacts on overall well-being. Efforts should be made to ensure that trainees have the flexibility in their schedules to access mental health resources. The organizational and systemic factors that contribute to adverse mental health outcomes is a primary focus for physicians at all levels.

Health Care Leaders must put Physician Well-Being at Top of Agenda

NAM — Thu, 15 Aug 2019 20:25:39 +0000

The following article highlights Tait Shanafelt, MD, the first chief physician wellness officer at an academic medical center. He suggests addressing three domains to reduce burnout and promote professional fulfillment: personal resilience, efficiency of practice and a culture of well-being. Previous efforts to address wellness have just skimmed the surface and focused on individual tactics including mindfulness of yoga. However, a true culture of wellness stems from organizational and systematic factors, such as leadership and peer support.

Organization-Level Interventions to Promote Physician Health and Well-Being: From Taking Care of Physicians to Giving Care to Patients.

NAM — Wed, 14 Aug 2019 20:29:19 +0000

The following article published in Physician Mental Health and Well-Being by Kirk J. Brower, examines the benefits in supporting both individual and organizational interventions to combat physician burnout. Because organizational culture, and individual resilience and values, differ across healthcare systems and clinical units, interventions must address local conditions. When organizational values are implemented successfully, engaged and healthy physicians will improve the healthcare of populations, enhance their patients’ experience of care, and reduce overall costs.

Interns’ Participation and Learning in Clinical Environments in a New Zealand Hospital

NAM — Fri, 09 Aug 2019 20:54:47 +0000

Published in Academic Medicine, the following study explores factors encouraging interns to participate actively within clinical rotations. The findings resulted in a model for participation in clinical settings where two critical components were identified: the tasks of patient care and engagement with the clinical team. These two components are further divided into two aspects: initiation and maintenance. The outcome of all four factors working well is a reinforcing cycle of activities that promote and encourage effective participation and learning. The authors posit that this model could provide a framework for faculty development and thereby allow both supervisors and learners to gain confidence and satisfaction.